• Tuberculosis and Respiratory Diseases
• /
• v.59 no.5
• /
• pp.522-529
• /
• 2005

Background : Several national societies have published guidelines for empirical antimicrobial therapy in patients with severe community-acquired pneumonia (SCAP). This study investigated the etiologies of SCAP in the Asan Medical Center and assessed the relationship between the initial empirical antimicrobial regimen and 30 day mortality rate. Method : retrospective analysis was performed on patients with SCAP admitted to the ICU between March 2002 and February 2004 in the Asan Medical Center. The basic demographic data, bacteriologic study results and initial antimicrobial regimen were examined for all patients. The clinical outcomes including the ICU length of stay, the ICU mortality rate, and 30 days mortality rates were assessed by the initial antimicrobial regimen. Results : One hundred sixteen consecutive patients were admitted to the ICU (mean age 66.5 years, 81.9 % male, 30 days mortality 28.4 %). The microbiologic diagnosis was established in 58 patients (50 %). The most common pathogens were S. pneumoniae (n=12), P. aeruginosae (n=9), K. pneumonia (n=9) and S. aureus (n=8). The initial empirical antimicrobial regimens were classified as: ${\beta}$-lactam plus macrolide; ${\beta}$-lactam plus fluoroquinolone; anti-Pseudomonal ${\beta}$-lactam plus fluoroquinolone; Aminoglycoside combination regimen; ${\beta}$-lactam plus clindamycin; and ${\beta}$-lactam alone. There were no statistical significant differences in the 30-day mortality rate according to the initial antimicrobial regimen (p = 0.682). Multivariate analysis revealed that acute renal failure, acute respiratory distress syndrome and K. pneumonae were independent risk factors related to the 30 day mortality rate. Conclusion : S. pneumoniae, P. aeruginosae, K. pneumonia and S. aureus were the most common causative pathogens in patients with SCAP and K. pneumoniae was an independent risk factor for 30 day mortality. The initial antimicrobial regimen was not associated with the 30-day mortality.

• Fisheries and Aquatic Sciences
• /
• v.13 no.1
• /
• pp.71-78
• /
• 2010

We investigated the effect of Cu exposure on the activities of protective antioxidant enzymes in the gills and digestive glands of the manila clam Ruditapes phillippinarum exposed to subchronic concentrations (0, 20, 40, and $80{\mu}gL^{-1}$) of waterborne Cu. No mortality occurred during the experimental period, and no significant condition index differences were observed in any exposure group compared with the control. No significant differences were observed in the digestive glands and gills of the clams observed during 15 days of exposure, but after 30 days, the SOD activity in the gill showed a significant difference between the $80{\mu}gL^{-1}$ Cu-exposed group and the control. GPx activities in the digestive glands and gills were significantly lower after 30 days of Cu exposure. Gill GR activity in the high-exposure group ($80{\mu}gL^{-1}$) was significantly elevated compared with that in the control group. GST activities in the digestive glands of all groups did not change over 30 days. However, GST activity in the gill at $80{\mu}gL^{-1}$ Cu was significantly higher after 15 and 30 days of exposure. GSH activities in the gill showed patterns similar to those of GST activities during exposure periods. In the digestive glands, GSH activity was higher only at $80{\mu}gL^{-1}$ after 30 days exposure. In digestive glands and gills, the MDA levels of clams exposed to $80{\mu}gL^{-1}$ Cu were significantly higher after 30 days of exposure.

• The Korean Journal of Pesticide Science
• /
• v.12 no.3
• /
• pp.236-242
• /
• 2008

Laboratory and greenhouse experiments were conducted to evaluate the effect of root zone application of some systemic insecticides for control of the brown planthopper (BPH), Nilaparvata lugens, as one of the management option to minimize the adverse effects and maximize the efficacy of insecticide application. Five systemic insecticides, namely, carbofuran, carbosulfan, diazinon, ethoprophos and imidacloprid, as granular formulation were placed in the root zone and measured the mortality, fecundity, and nymphal survivorship of the planthopper. Diazinon and ethoprophos did not show the significant mortality of the BPH. When the BPH were inoculated at the day of carbofuran treatment, adult mortality was shown almost 100% at seven days after treatment and BPH nymphs were remained very few on rice at 25 days after treatment. When carbofuran were placed 10 days before the BPH inoculation, it showed almost 100% adult mortality after one day, and no nymphs were found until 25 day after inoculation. Efficacy of carbofuran on BPH when applied in 10 day-old rice was higher than in 30 day-old rice. These results indicated that the root zone application of carbofuran can control N. lugens effectively with less adverse effect to the natural enemies inhabited on rice plants.

• Asian-Australasian Journal of Animal Sciences
• /
• v.25 no.2
• /
• pp.248-255
• /
• 2012

Three levels of boron (0, 30, 60 ppm) were supplemented in practical corn-soybean based starter and grower diets, containing either adequate or inadequate Ca or P. A total of 1,800, 1-day-old sexed broiler chicks were assigned to six dietary treatments and fed with the experimental diets for 42 days. Boron improved the overall feed conversion ratio, but increased body weight only at 21 days of age (p<0.01). Boron decreased feed intake in the case of feeding on a diet deficient in Ca and P, and tended to increase feed intake when birds received a diet adequate in Ca and P, signifying significant boron by Ca-P interaction (p<0.01). Mortality was not influenced by boron (p>0.05). Dietary Ca and P deprivation reduced body weight and feed consumption significantly, but did not influence the feed conversion ratio and mortality (p>0.05). Serum Ca level, ALP and ALT activities were not influenced either by dietary Ca and P deficiency or boron supplementation. Serum P content increased with respect to boron at 30 ppm. Bone breakage strength was not affected by dietary variables. Tibia ash, Ca and P were increased in response to the supplementation diet with 30 ppm boron, whereas 60 ppm showed no effect in most cases. Accordingly, the dietary boron supplementation of 30 ppm significantly decreased fecal Ca and P excretion, while there was a numerical decline in the 60 ppm boron as compared to the 0 ppm boron group. Data presented herein indicated that boron, either at the 30 ppm or 60 ppm supplementation level, was effective in conversion of feed to body weight, whereas only boron at 30 ppm contributed to the mineralization of bone thereby augmenting more Ca and P while excreting less through faeces.

• Journal of Chest Surgery
• /
• v.50 no.4
• /
• pp.242-246
• /
• 2017

Background: Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution. Methods: The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA. Results: Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, $14.5{\pm}7.8days$), and the mean gestational age of these patients was $30.3{\pm}4.6weeks$ (range, 26 to 40 weeks) with a mean birth weight of $1,292.5{\pm}703.5g$ (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs. Conclusion: Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.

• Journal of Chest Surgery
• /
• v.16 no.4
• /
• pp.431-443
• /
• 1983

A hundred and fifty-one patients with congenital heart disease less than 24 months old underwent intracardiac repairs from January 1982 to July 1983, which consists 24.2% of all the patients with congenital heart diseases operated during the same period. There were 98 patients[64.9%] with acyanotic congenital heart disease and 53 patients[35.1%] with cyanotic congenital heart disease, and 55 patients[36.4%] were less than 1 year of age. Twenty-two patients died within 30 days after surgery and 3 patients died after postoperative 30th day: Ventricular septal defect, four of 90 patients; Tetralogy of Fallot, five of 23 patients; Transposition of great arteries, nine of 17 patients; Tricuspid atresia, four of 5 patients; Pulmonary atresia, all of 2 patients; Single ventricle, one of single patients. Over all mortality was 16.6% and mortality of acyanotic congenital heart disease, cyanotic congenital heart disease and patients less then 1 year of age was 4.1%, 39.6% and 20.0% respectively. Still the mortality of cyanotic congenital heart disease is high. Careful preoperative evaluation of the detailed intracardiac anatomy and hemodynamics of the patients and proper selection of surgical treatment yield better clinical results.

• Korean Journal of Clinical Pharmacy
• /
• v.30 no.3
• /
• pp.161-168
• /
• 2020

Background: Recently, a study comprising adult patients with sepsis admitted in the intensive care unit (ICU) was conducted. The patients were treated with high doses of intravenous ascorbic acid, thiamine, and hydrocortisone; the clinical outcomes demonstrated significant therapeutic benefits. The mortality rate in children with sepsis is approximately 25%. However, the effects of additional treatment with ascorbic acid and thiamine ("vitamin protocol") in children are rarely investigated. Methods: A retrospective analysis was performed using medical records of patients diagnosed with sepsis and admitted to the pediatric ICU (PICU) between September 2016 and June 2019. The control group received treatment only as per sepsis protocol, whereas the treated group received both sepsis protocol and the vitamin protocol. The primary endpoint was change in Vasoactive-Inotropic Score (VIS) for 5 days. The secondary endpoints included the length of stay in the PICU, duration of using mechanical ventilators and vasopressors, and mortality rate. Results: The number of patients in the treated and control groups was 33 and 24, respectively. The treated group showed greater decrease in their VIS for 5 days than the control group (44.4 vs 18.6); however, the difference was not statistically significant. The length of stay in the PICU was significantly longer for the treated group than for the control group [10.0 days (Interquartile range (IQR), 6-18) vs 4.5 days (IQR, 4-10.3); p=0.004]. Conclusions: No significant treatment benefits were observed following vitamin protocol administration to the pediatric patients with sepsis. Further studies are necessary for improving the efficacy and safety of the vitamin protocol.

• Journal of Trauma and Injury
• /
• v.34 no.3
• /
• pp.155-161
• /
• 2021

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

• Journal of Chest Surgery
• /
• v.51 no.3
• /
• pp.172-179
• /
• 2018

Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

• Journal of Korean Neurosurgical Society
• /
• v.66 no.1
• /
• pp.95-104
• /
• 2023

Objective : Hypernatremia is a common complication encountered during the treatment of neurocritically ill patients. However, it is unclear whether clinical outcomes correlate with the severity of hypernatremia in such patients. Therefore, we investigated the impact of hypernatremia on mortality of these patients, depending on the degree of hypernatremia. Methods : Among neurosurgical patients admitted to the intensive care unit (ICU) in a tertiary hospital from January 2013 to December 2019, patients who were hospitalized in the ICU for more than 5 days and whose serum sodium levels were obtained during ICU admission were included. Hypernatremia was defined as the highest serum sodium level exceeding 150 mEq/L observed. We classified the patients into four subgroups according to the severity of hypernatremia and performed propensity score matching analysis. Results : Among 1146 patients, 353 patients (30.8%) showed hypernatremia. Based on propensity score matching, 290 pairs were included in the analysis. The hypernatremia group had higher rates of in-hospital mortality and 28-day mortality in both overall and matched population (both p<0.001 and p=0.001, respectively). In multivariable analysis of propensity score-matched population, moderate and severe hypernatremia were significantly associated with in-hospital mortality (adjusted odds ratio [OR], 4.58; 95% confidence interval [CI], 2.15-9.75 and adjusted OR, 6.93; 95% CI, 3.46-13.90, respectively) and 28-day mortality (adjusted OR, 3.51; 95% CI, 1.54-7.98 and adjusted OR, 10.60; 95% CI, 5.10-21.90, respectively) compared with the absence of hypernatremia. However, clinical outcomes, including in-hospital mortality and 28-day mortality, were not significantly different between the group without hypernatremia and the group with mild hypernatremia (p=0.720 and p=0.690, respectively). The mortality rates of patients with moderate and severe hypernatremia were significantly higher in both overall and matched population. Interestingly, the mild hypernatremia group of matched population showed the best survival rate. Conclusion : Moderate and severe hypernatremia were associated with poor clinical outcomes in neurocritically ill patients. However, the prognosis of patients with mild hypernatremia was similar with that of patients without hypernatremia. Therefore, mild hypernatremia may be allowed during treatment of intracranial hypertension using hyperosmolar therapy.