• Title/Summary/Keyword: 30 days mortality

Search Result 373, Processing Time 0.02 seconds

Is There a Need for Bowel Management after Surgery for Isolated Intestinal Malrotation in Children?

  • Salo, Martin
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.22 no.5
    • /
    • pp.447-452
    • /
    • 2019
  • Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28 days (0-5, 293 days). Volvulus occurred in 26 children (60.5%), and bowel resection was required in 4 children (9.3%). Short-term complications categorized as grades II-V according to the Clavien-Dindo classification occurred in 13 children (30.2%). Of these, 5 children (11.6%) required re-operation. Constipation was observed in 9 children (23.7%) at the 1-year follow-up. No difference was observed in the rate of perioperative volvulus between children with and without constipation (44% vs. 65%, p=0.45). Excluding re-operations performed within 30 days after surgery, 3 children (6%) underwent surgery for intestinal obstruction during the study period. Conclusion: Many children undergoing Ladd's procedure require bowel management even at long-term follow-up, probably secondary to constipation. It is important to thoroughly evaluate bowel function at the time of follow-up to verify or exclude constipation, and if treatment of constipation is unsuccessful, these children require evaluation for dysmotility disorders and/or intestinal neuronal dysplasia.

Surfactant Replacement Therapy for RDS: a Collaborative Study of 72 Multi-center Trials in Korea (2010) and a Review of Korean Experiences over 20 Years (2010년 전국 72개 병원에서 신생아 호흡곤란증후군의 폐 표면활성제 치료 결과: 지난 20년간의 비교)

  • Bae, Chong-Woo;Hahn, Won-Ho;Chang, Ji-Young;Kim, Sung-Mi
    • Neonatal Medicine
    • /
    • v.18 no.2
    • /
    • pp.409-411
    • /
    • 2011
  • In Korea, pulmonary surfactant (PS) replacement therapy in respiratory distress syndrome (RDS) was started in 1991 since when Surfacten$^{(R)}$ was imported from Japan. At the present time, Surfacten$^{(R)}$, Newfactan$^{(R)}$, Curosurf$^{(R)}$, and Infasurf$^{(R)}$ are available in Korea. The governmental health insurance covers the expense for multiple dose treatment since 2002 and the early prophylactic treatment (BW: <1,250 g or GP: <30 wks) since 2011. We undertook a multi-institutional collective study to evaluate the outcomes of PS over past 20 years in Korea (Period-I; 1990/91, P-II; 1996, P-III; 2002, and P-IV; 2007, P-V; 2010). There were 60 RDS neonates with PS treatment in P-I (16 hospitals), 1,179 in P-II (64), 1,595 in P-III (62), 1,921 in P-IV (57), and 3,160 in P-V (72). Decreased mortality rate, defined as the percentage of neonates who died within 28 days of birth, was seen between periods, P-V vs P-I, II, III, and IV (mortality rate: 10.1% vs. 40.0%, 30.0%, 18.7%, and 14.3%). We conclude that PS therapy contributed to improve remarkable outcome in RDS neonates over the last 20 years in Korea. However, more efforts should be made to optimize PS therapy for better outcome. Multiple PS doses for relapse and poor response, early prophylactic use, and better supportive care for pre-term infants are mandatory.

Outcomes of Surgical Repair for Truncus Arteriosus: A 30-Year Single-Center Experience

  • Yu Ri Lee;Dong-Hee Kim;Eun Seok Choi;Tae-Jin Yun;Chun Soo Park
    • Journal of Chest Surgery
    • /
    • v.56 no.2
    • /
    • pp.75-86
    • /
    • 2023
  • Background: We investigated the long-term outcomes of truncus arteriosus repair at a single institution with a 30-year study period. Methods: Patients who underwent repair of truncus arteriosus between 1993 and 2022 were reviewed retrospectively. Factors associated with early mortality, overall attrition, and reintervention were identified using appropriate statistical methods. Results: In total, 42 patients were enrolled in this study. The median age and weight at repair were 26 days and 3.5 kg, respectively. Thirty patients (71.4%) underwent 1-stage repair. There were 8 early deaths (19%). In the univariable analysis, undergoing surgery before 2011 was associated with early mortality (p=0.031). The overall survival rate at 10 years was 73.8%. In the multivariable analysis, significant truncal valve (TrV) dysfunction (p=0.010), longer cardiopulmonary bypass time (p=0.018), and the earlier era of surgery (p=0.004) were identified as risk factors for overall mortality. During follow-up, 47 reinterventions were required in 27 patients (64.3%). The freedom from all-cause reintervention rate at 10 years was 23.6%. In the multivariable analysis, associated arch obstruction (p<0.001) and significant TrV dysfunction (p=0.011) were identified as risk factors for all-cause reintervention. Arch obstruction (p=0.027) and a number of TrV cusps other than 3 (p=0.014) were identified as risk factors for right ventricle to pulmonary artery (RV-PA) reintervention, and significant TrV dysfunction was identified as a risk factor for TrV reintervention (p=0.002). Conclusion: Despite recent improvements in survival outcomes after repair of truncus arteriosus, RV-PA or TrV reinterventions were required in a significant number of patients during follow-up.

The Optimal Temperature and Dew Duration Affecting the Control of Water Chestnut by Epicoccosorus nematosporus (온도와 습실조건에 따른 올방개 지문무늬병균에 의한 올방개 방제효과)

  • 홍연규;신동범;조재민;엄재열
    • Korean Journal Plant Pathology
    • /
    • v.14 no.6
    • /
    • pp.578-582
    • /
    • 1998
  • In greenhouse studies, control efficacy of water chestnut (Eleocharis Kuroguwai) by Epicoccosorus nematosporus was affected by temperature and dew condition. The appressoria were formed abundantly in the range of 20~28$^{\circ}C$. When stem segments o(30 cm long) of the water chestnut were inoculated with the conidial suspension of E. nematorporus, the mean conidial number attacted amounted to 2,545 conidia. Out of 2545 conidia attacted to the stem pieces, 1,733 (68%) conidia formed appressoria. When these stem pieces were treated for 24 hr at 28$^{\circ}C$ under dew condition, 183,1 (7.2%) lesions were formed 10 days after incubation. The time necessary for the death of the plants was about 24 days. Appressoria were formed at 15~35$^{\circ}C$, but decreased rapidly in their numbers at the temperature lower than 1$0^{\circ}C$ or at 35$^{\circ}C$. The appressoria formation seemed to be depended on the dew duration, which was effective to the lesion formation and plant mortality. Under dew duration of 16~24 hr with temperature range of $25^{\circ}C$ to 3$0^{\circ}C$, the weed control was increased up to 93.9%. There were no differences between the first and second or third dew treatments. A delay of 2 or 3 days in dew treatment did not increase the mortality of plants. For the use of E. nematosporus as a mycoherbicide of water chestnut, a conidial suspension should be applied when dew conditions are kept for 12 hr after inoculation.

  • PDF

Delayed Sternal Closure After Heart Surgery in Neonate (신생아 개심술후 지연 흉골봉합)

  • 성시찬
    • Journal of Chest Surgery
    • /
    • v.28 no.11
    • /
    • pp.977-982
    • /
    • 1995
  • Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

  • PDF

Report on red muscardine(Paecilomyces fumosoroseus) of the silkworm(Bombyx mori) in Korea (국내 미기록 누에 적강균(Paecilomyces fumosoroseus)에 관한 보고)

  • 남성희;윤철식;김근영;조세연;한명세
    • Journal of Sericultural and Entomological Science
    • /
    • v.42 no.1
    • /
    • pp.28-30
    • /
    • 2000
  • Red muscardine (P. fumosoroseus), first observed on silkworm in Korea, was examined on its cultural characters, infection process, and symptoms. The fungus on PDA medium was grown to 44 mm in diameter in 14 days. Conidiaphore ws 1.45$\mu\textrm{m}$ in diameter, producing 4 to 6 phialides (5.9$\mu\textrm{m}$${\times}$1.8$\mu\textrm{m}$) in cluster. Elliptic conidia wre hyaline and 2.9${\times}$1.3$\mu\textrm{m}$ in size. Diseased silkworm showed typical symptoms of muscardine while becoming stiff. On 3 to 4 days after inoculation of P. fumosoroseus conidia upon the surface of silkworm, it was observed that the silkworm moved and ate less in rearing bed, and amorpnous dark spots of 1∼2 mm appeared on the surface o thorax, abdomen, spirace, and etc. Corrected mortality reached up to 97% at 9th day after inoculation.

  • PDF

Detection of rotavirus and coronavirus from suckling Korean indigenous calves with acute diarrhea

  • Chon, Seung-Ki;Lee, Han-Kyoung;Song, Hee-Jong
    • Korean Journal of Veterinary Service
    • /
    • v.30 no.2
    • /
    • pp.211-218
    • /
    • 2007
  • In order to evaluation of prevalence of rotavirus and/or coronavirus, forty suckling Korean indigenous calves (between 2 and 98 days old) with acute diarrhea were investigated by the immunochromatographic rapid test in the field (veterinary practice) on October and on December 2006. Rotavirus and coronavirus were detected in 13 (32.5%) and 8 (20.0%) of the fecal samples from diarrheal calves, respectively. The highest mortality rate in diarrheal calves occurred in the neonatal period from 2 to 7 days old. Totally, 40.0% of diarrheal calves showing acute enteritis were not detected with rotavirus and/or coronavirus. The rotavirus infection rate was significantly difference (p<0.05) between October and December, and the detection rate of rotavirus was bigger than that of coronavirus. These results suggested that rotavirus can be frequently associated with acute diarrhea of suckling calves and affected with changes of temperature.

Descending Necrotizing Mediastinitis Combined with Cervical Spine Injury (경추 손상과 동반된 하행성 괴사성 종격동염)

  • 금동윤;양보성
    • Korean Journal of Bronchoesophagology
    • /
    • v.7 no.1
    • /
    • pp.76-79
    • /
    • 2001
  • A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

  • PDF

Clinical Study and Risk Factors of Surgical Mortality of Congenital Heart Defects (선천성 심장기형의 임상고찰 및 수술사망율에 미치는 위험인자의 분석)

  • 이상호;김병균
    • Journal of Chest Surgery
    • /
    • v.30 no.1
    • /
    • pp.17-26
    • /
    • 1997
  • Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.

  • PDF

Seven-day and In-hospital Mortality According to Left and Right Ventricular Dysfunction in Patients With Septic Shock

  • Sua Kim;Hyeri Seok;Beong Ki Kim;Yu Jin Kim;Seung Heon Lee;Je Hyeong Kim;Yong-Hyun Kim
    • Korean Circulation Journal
    • /
    • v.53 no.12
    • /
    • pp.813-825
    • /
    • 2023
  • Background and Objectives: The prognostic implications of septic cardiomyopathy have not been clearly demonstrated. We evaluated serial changes in left ventricular (LV) and right ventricular (RV) function in patients with septic shock and their prognostic value on 7-day and in-hospital mortality. Methods: Transthoracic echocardiography was performed within 48 hours of the diagnosis of septic shock and 7 days after the initial evaluation. In addition to traditional echocardiographic parameters, LV and RV function was evaluated using global longitudinal strain (GLS), and tricuspid annular plane systolic excursion (TAPSE). Results: A total of 162 patients (men, 83, 51.5%; 70.7±13.4 years; Acute Physiology and Chronic Health Evaluation [APACHE] II, 30.6±9.2) were enrolled. Initial GLS and TAPSE were -14.9±5.2% and 16.9±5.5 mm, and improved in the follow-up evaluation (GLS, -17.6±4.9%; TAPSE, 19.2±5.4 mm). Seven-day and in-hospital mortality were 24 (14.9%) and 64 (39.8%). Seven-day mortality was significantly associated with initial GLS >-16% (odds ratio [OR], 14.066, 95% confidence interval [CI], 1.178-167.969, p=0.037) and APACHE II score (OR, 1.196, 95% CI, 1.047-1.365, p=0.008). The in-hospital mortality of 7-day survivors was associated with follow-up TAPSE <16 mm (OR, 10.109, 95% CI, 1.640-62.322, p=0.013) and Sequential Organ Failure Assessment score (OR, 1.340, 95% CI, 1.078-1.667, p=0.008). GLS was not associated with in-hospital mortality of 7-day survivors. Conclusions: Fluctuation of both ventricular function was common in septic shock. Seven-day mortality of patients with septic shock was related to GLS, whereas in-hospital mortality of 7-day survivors was related to TAPSE, not to GLS.