• Title/Summary/Keyword: 사망의 주요 원인

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A Comparison Study for Mortality Forecasting Models by Average Life Expectancy (평균수명을 이용한 사망률 예측모형 비교연구)

  • Jeong, Seung-Hwan;Kim, Kee-Whan
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.115-125
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    • 2011
  • By use of a mortality forecasting model and a life table, forecasting the average life expectancy is an effective way to evaluate the future mortality level. There are differences between the actual values of average life expectancy at present and the forecasted values of average life expectancy in population projection 2006 from Statistics Korea. The reason is that the average life expectancy forecasts did not reflect the increasing speed of the actual ones. The main causes of the problem may be errors from judgment for projection, from choice, or use of a mortality forecasting model. In this paper, we focus on the choice of the mortality forecasting model to inspect this problem. Statistics Korea should take a mortality forecasting model with considerable investigation to proceed population projection 2011 without the errors observed in population projection 2006. We compare the five mortality forecasting models that are the LC(Lee and Carter) model used widely and its variants, and the HP8(Heligman and Pollard 8 parameter) model for handling death probability. We make average life expectancy forecasts by sex using modeling results from 2010 to 2030 and compare with that of the population projection 2006 during the same period. The average life expectancy from all five models are forecasted higher than that of the population projection 2006. Therefore, we show that the new average life expectancy forecasts are relatively suitable to the future mortality level.

Clinical Features of Brain Abscesses in Neonates and Children: A Single Center Experience from 1997 to 2006 (단일기관에서 조사한 소아 뇌농양의 임상양상(1997-2006))

  • Lee, Teak Jin;Chu, Jin-Kyong;Kim, Ki Hwan;Kim, Khi Joo;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.30-35
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    • 2008
  • Purpose : We evaluated clinical presentations of brain abscesses, including predisposing factors, causative organisms, and mortality rate in neonates and children. Methods : We retrospectively reviewed the medical charts of neonates and children with brain abscesses treated at Severance Hospital from January 1997 through December 2006. Results : Among 27 neonates and children with brain abscesses, overall mortality was 22 % and 38% of survivors developed neurologic sequelae. The mortality rate was 38% in 8 infants with brain abscesses. The most common location of brain abscesses were frontal and parietal lobes, followed by temporal lobe. There were 7 cases with multiple brain abscesses. Streptococci (33%), Staphylococci (27%), and Gram-negative enterics (20%) were commonly isolated. The common predisposing conditions were neurosurgical procedure (30 %), cyanotic congenital heart disease (15%), and sinusitis/otitis (7%). Fever (74%), headache (37%), nausea/vomiting (33%), and altered mental status (33%) occurred commonly. Compared with children older than 1 year of age, infants were associated with multiple brain abscesses (63%, P=0.011) and high rates of death or neurologic sequelae (88%, P= 0.033). Conclusion : We should have a high index of suspicion in order to recognize the condition as early as possible, especially in infancy with brain abscesses who presents vague or nonspecific symptoms and signs.

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RETROSPECTIVE STUDY OF TRACHEOTOMY IN CHILDREN (유소아 기관 절개술의 후향적 고찰)

  • 정명현;홍원표;장미숙;이정환
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1991.06a
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    • pp.26-26
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    • 1991
  • 기관 절개술은 절대적으로 필요한 수술 방법임에도 불구하고 경우에 따라서는 매우 심각한 합병증이나 후유증을 유발하고 있어 가능한 피하는 것이 좋으며 부득이하여 시술을 하더라도 그 적절한 시기를 정하기 어려운 경우가 많다. 특히 유소아에서는 최근에 개량된 삽관튜브의 출현으로 비교적 장기간의 기관삽관이 가능해지자 기관절개술의 적용예가 많이 감소하기는 하였으나 합병증이나 후유증을 너무 우려한 나머지 기관절개술을 기피하거나 적절한 수술시기를 놓쳐 더욱 어려운 입장에 처하게 되기도 한다. 저자들은 1977년도부터 1990년까지 세브란스 병원에서 기관절개술을 시행받은 15세이하의 유소아 환자 94례에서 기관절개술의 원인 질환과 적용시기 및 합병증을 알아보고 기관삽관과의 관계를 후향적으로 조사하여 다음의 결과를 얻었다. 1. 유소아 기관 절개술의 원인 질환은 두부외상이 28례(29.8%)로 가장 많았고, 신경계 질환 17례(18%), 기도 감염 10례(10.6%)의 순이었고 그 외 선천적 기형 종양, 외상, 감염 등으로 다양한 분포를 보였다. 2.기관 절개술전에 기관삽관을 시행하지 않았던 예는 18례(19.1%)이고 기관삽관을 시행했던 예는 76례(80.9%)이며, 38례(40.4%)는 일주이내에 기관절개술을 시행하였고 12례(12.8%)는 2주이내에, 8례(8.5%)는 3주이내, 6례(6.4%)는 4주이내에 시행하였으며 12례(12.8%)는 기관 삽관후 4주이후에 기관절개술을 시행하였다. 3.기관 절개술후, 합병증은 26례(27.7%)에서 있었고 육아조직 형성이 14례(14.9%) 였고 기관 협착이 12례(12.8%)의 순이었다. 4.인공 호흡기률 사용하였던 46례(48.9%)중 14례(14.9%)에서 합병증이 있었고, 인공 호흡기를 사용치 않았던 48례(51.5%)에서는 12례(12.8%)에서 합병증이 발생하였다. 5.삽관 발거를 시행할 수 있었던 예는 47례(50%)였으며, 기관 절개술후 1개월이내에 시행한 예가 21례(16%), 6개월이내 시행한 예가 16례(17%), 2년이내에 시행한 예가 6?(6.4%)였으며 2년 이후 시행할 수 있었던 예도 4례(4.3%) 있었다. 6.기관 절개술 환자중 26례(27.7%)는 원인 질환으로 결국은 사망하였으며, 21례(22.3%)는 삽관 발거를 하지 않은 상태에서 퇴원하여 추적이 불가능하였다.

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Effect of Splenectomy on Development of Primary Amoebic Meningoencephalitis (비장적출(splenectomy)이 원발성 아메바성 뇌수막염의 발생에 미치는 영향)

  • Sin, Ho-Jun;Im, Gyeong-Il;Choe, Rim-Sun
    • Parasites, Hosts and Diseases
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    • v.23 no.1
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    • pp.156-164
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    • 1985
  • To elucidate the effect of splenectomy on the development of experimental primary amoebic meningoencephalitis in mice, the death rate and survival time of mice infected intranasally with Naegleria fowleri trophozoites $5{\times}10^4$ cultivated in CGVS medium were compared according to the mouse age when splenectomy was done, and post-operation until experimental infection. Immunodigusion was undergone to detect the presence of serum antibod). due to N, fowleri infecttion in mice. Polyacrylamide gel electrophoresis was done to compare the protein fractions of mouse serum in each experimental groups. In experiment I, splenectomy was done 3 weeks and infection 4 weeks after birth, the death rate of control, sham operated and splenectomized group were 100%, 85% and 95%, and the mean survival time after infection 7.3 days, 7.5 days and 7.8 days, respectively. In experiment II, splenectomy was undergone 3 weeks and infection 6 weeks after birth, the death rate of of control, sham operated and splenectomized group were 95%, 95% and 95%, and the mean survival time after infection 12.1 days, 11.5 days and 11.5 days, respectively. In experiment III, splenectomy was done 5 weeks and infection 6 weeks after birth, the death rate of control, sham operated and splenectomized group were 95%, 90% and 95%, and the mean survival time after infection 8.1 days, 8.3 days and 8.5 days, respectively. By Ouchterlony immunodigusion, anti-JV. fowleri antibody in the serum of mouse with primary amoebic meningoencephalitis was detected against a N. fowleri antigen, which was prepared by ultrasonication of N, fowleri trophozoites, each reacting two lines of precipitation. The patterns of serum fractions by polyacrylamide gel electrophoresis were different between control and sham operated groups from splenectomized group in fraction II, III and V, the sera of which were collected after N. fowleri infection. This results may be summarized as that splenectomy has no effect on the development of primary amoebic meningoencephalitis in mice.

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Small area estimations for disease mapping by using spatial model (질병지도 작성을 위해 공간모형을 이용한 소지역 추정)

  • An, Daeseong;Han, Junhee;Yoon, Taeho;Kim, Changhoon;Noh, Maengseok
    • Journal of the Korean Data and Information Science Society
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    • v.26 no.1
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    • pp.101-109
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    • 2015
  • SMRs (standardized mortality rates) for major diseases, accidents, cancer are considered in small areas of administrative units such as Eup/Myeon/Dong from years 2005 to 2008. Due to small sample issue in small areas, the precision of directly estimated crude SMR for each area can be low. In this study, we consider the HGLM (hierarchical generalized linear model) with MRF (Markov random field) to account for the spatial correlations among the small areas. The effects of covariates for cause of mortality by Dongs in Seoul and disease maps based on the estimated SMR are presented. The results suggest how we analyze and interpret the difference in mortalities by small areas such as Dongs by revealing the spatial patterns.

Effects of the ANP Models on the Comparison Indicators of Electric Power Systems (ANP 모델이 전력 시스템의 비교 지표에 미치는 영향)

  • Kim Seong-Ho;Kim Kil-Yoo;Kim Tae-Woon
    • Proceedings of the Korea Society for Energy Engineering kosee Conference
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    • 2006.05a
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    • pp.371-376
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    • 2006
  • 서로 갈등적인 관계에 있는 다중 기준 하에서 다양한 국가 전력 시스템을 정량적으로 비교하는 데에는 전력 시스템의 비교 지표가 필요하다. 이러한 비교 지표를 산출하기 위하여 해석적 망형 과정(Analytic Network Process; ANP) 모델 가운데 상호 의존도 수중이 낮은 되먹임 모델 및 상호 의존도가 없는 독립성 모델이 개발되었다. 이러한 ANP 모델은 구성요소로 교점들(nodes)과 상호작용 관계를 표현하는 가지들(arcs)을 포함하고 있다. 의사결정 목표 교점에는 세 가지 유형의 리스크 성향이 포함되었다. 이러한 리스크 성향은 원자력 발전소 같은 위험 설비에 대한 전문가(그룹)의 리스크 성향이며, 더 구체적으로 말하면, 리스크 감수 성향, 리스크 혐오 성향, 리스크 중립 성향 등이다. 여기서 수행된 연구의 주요 목적은 ANP 모델을 구성하는 교점들 가운데 하나인 평가 기준 교점에서의 변화가 전력 시스템의 비교 지표에 미치는 영향을 해석하려는 것이다. 이러한 모델 변이가 비교 지표에 미치는 영향을 알아보기 위한 사례 연구에서 각 발전원의 특성을 비교할 평가 기준은 기준 사례와 비교 사례 각각에 대하여 상이하게 선정되었다: 기준 사례의 경우에는 보건성을 대표하는 생명 단축 [yr/TWh], 환경성을 대표하는 지구 온난화 [$g\;CO_{2}-eq./kWh$], 사회성을 대표하는 지속가능 정도[-], 경제성을 대표하는 발전 단가 [\/kWh] 등이 선정되었다; 반면에, 비교 사례의 경우에서는 보건성을 대표하는 사고 사망 [death/GWh]만이 다르고 나머지는 동일하게 선정되었다. 이러한 보건성을 대표하는 생명 단축 또는 사고 사망의 선정은 다음과 같은 비교 지표에 영향을 미친다는 것이 발견되었다: (1) 되먹임 모델에서는 성향 가중치 및 기준 등급에 영향을 준다. (2) 되먹임 모델과 독립성 모델에서는 시스템 등급에 영향을 준다. 향후에는 더욱 더 다양한 상호의존 모델들이 정량화될 필요성이 있다고 본다.

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Bioactive Functions of Detoxified Puffer Liver Oil (제독처리한 복어 간유의 생리활성)

  • 최종원;김나영;김동수
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.7
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    • pp.1126-1131
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    • 2003
  • In this study, we investigated the effects of detoxified puffer liver (PL) oil on fatigue, hepatotoxicity and hyperlipidemia. There are no toxicities in both raw and purified PL oil. The test of swimming time was extended in detoxified PL oil pretreated group compared to the non-treated group. When rats treated with PL oil, the hepatic injuries induced by carbon tetrachloride or DL-galactosamine were reduced. The increased serum triglyceride and total cholesterol by poloxamer-407 were lowered by treating with PL oil remarkably. Also the bleeding time of hyperlipidemic animals was extended and plasma clotting time was delayed by PL oil.

Analysis of neonatal sepsis in one neonatal intensive care unit for 6 years (최근 6년간 단일 신생아중환자실에서 발생한 패혈증 환자의 분석)

  • Chun, Peter;Kong, Seom-Gim;Byun, Shin-Yun;Park, Su-Eun;Lee, Hyung-Du
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.495-502
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    • 2010
  • Purpose : Sepsis is a significant cause of morbidity and mortality in the newborn, particularly in preterm. The objective of this study was to analyze the incidence rate, causative pathogens and clinical features of neonatal sepsis in one neonatal intensive care unit (NICU) for 6 years. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics including sex, gestational age, birth weight, Apgar score, length of hospitalization, length of total parenteral nutrition, presence of central venous catheter, underlying diseases, laboratory findings, microorganisms isolated from blood culture, complications and mortality in 175 patients between January 2003 and December 2008. Results : 1) Sepsis was present in 175 of 3,747 infants for 6 years. There were more gram-positive organisms. 2) The gram-negatives were more prevalent in preterm. There were no significant differences of other clinical features between two groups. 3) Underlying diseases were found in 73.7%, and the most common disease was cardiovascular disease. The most common organisms of gram-positives and gram-negatives were methicillin resistant Staphylococcus aureus (MRSA) and Serratia marcescens. 4) There was statistically significant difference on platelet counts between two groups (P<0.05). 5) Complications were found in 18.3% and septic shock was the most common. MRSA was the most common pathogen in sepsis with complication. 6) The mortality rate was 7.4%. 7) There were differences in monthly blood stream infection/1,000 patient-days. Conclusion : The studies about the factors that can influence neonatal sepsis will contribute to decrease the infection rates in NICUs.

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

Nitrogen Removal Rate of A Subsurface Flow Treatment Wetland System Constructed on Floodplain During Its Initial Operating Stage (하천고수부지 수질정화 여과습지의 초기운영단계 질소제거)

  • Yang, Hong-Mo
    • Korean Journal of Environmental Agriculture
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    • v.22 no.4
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    • pp.278-283
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    • 2003
  • This study was carried out to examine the nitrogen removal rate of a subsurface-flow treatment wetland system which was constructed on floodplain of the Kwangju River from May to June 2001. Its dimensions were 29m in length, 9m in width and 0.65m in depth. A bottom layer of 45cm in depth was filled with crushed granite with about $15{\sim}30\;mm$ in diameter and a middle layer of 10cm in depth had pea pebbles with about 10 mm in diameter. An upper layer of 5 cm in depth contained course sand. Reeds (Phragmites australis) were transplanted on the surface of the system. They were dug out of natural wetlands and stems were cut at about 40 cm height from their bottom ends. Water of the Kwangju River flowed into it via a pipe by gravity flow and its effluent was funneled back into the river. The height of reed stems was 44.2 cm in July 2001 and 75.3cm in September 2001. The number of stems was increased from $80\;stems/m^2$ in July 2001 to $136\;stems/m^2$ in September 2001. Volume and water quality of inflow and outflow were analyzed from July 2001 through December 2001. Inflow and outflow averaged 40.0 and $39.2\;m^3/day$, respectively. Hydraulic detention time was about 1.5 days. Average nitrogen uptake by reeds was $69.31\;N\;mg/m^2/day$. Removal rate of $NO_3-N$, $NH_3-N$, T-N averaged 195.58, 53.65, and $628.44\;mg/m^2/day$, respectively. Changes of $NO_3-N$ and $NH_3-N$ abatement rates were closely related to those of wetland temperatures. The lower removal rate of nitrogen species compared with that of subsurface-flow wetlands operating in North America could be attributed to the initial stage of the system and inclusion of two cold months into the six-month monitoring period. Increase of standing density of reeds within a few years will develop both root zones suitable for the nitrification of ammonia and surface layer substrates beneficial to the denitrification of nitrates into nitrogen gases, which may lead to increment in the nitrogen retention rate.