Total 20 cases of reoperation for mitral vavular disease, which had been performed during the period from May 1983 till October 1991, were reviewed. This study contained 1 case of previous balloon valvuloplasty and 1 case of death with bleeding from right ventricle during sternal reenrty. The average time intervals between reoperation and previous operation was 19 years in closed mitral commissurotomy[n=4], 7 years and 2 months in mitral valve replacement[n=10], 1 year and 8 months in mitral valvuloplasty[n=4], 3 years and 10 months in open mitral commissurotomy [n=2]. The cause of reoperation in closed mitral commissurotomy was progression of the disease, and residual stenosis with progression was the cause in open mitral commissurotomy cases. Technical failure might be the cause in the cases of valvuloplasty. In prosthetic valve replacement group the causes of reoperation were primary failure. Also two cases of suggested valve thrombosis and one case of failure of tricuspid annuloplasty was noted in prosthetic valve replacement group. The used valves for reoperation were Ionescue-Shiley in 3 cases, Bjork-Shiley in 6 cases, St. Jude Medical in 2 cases and CarboMedics in 8 cases. The mortality rate was 20%[n=4] and the causes of death were low output syndrome in 1 case, multiple organ failure in 2 cases and bleeding in 1 case during sternal reentry. During follow up 1 case of sudden death was observed.
Lim, Soo Young;Subedi, Lalita;Shin, Dongyun;Kim, Chung Sub;Lee, Kang Ro;Kim, Sun Yeou
Biomolecules & Therapeutics
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v.25
no.5
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pp.519-527
/
2017
Excessive activation of microglia causes the continuous production of neurotoxic mediators, which further causes neuron degeneration. Therefore, inhibition of microglial activation is a possible target for the treatment of neurodegenerative disorders. Balanophonin, a natural neolignoid from Firmiana simplex, has been reported to have anti-inflammatory and anti-cancer effects. In this study, we aimed to evaluate the anti-neuroinflammatory effects and mechanism of balanophonin in lipopolysaccharide (LPS)-stimulated BV2 microglia cells. BV2 microglia cells were stimulated with LPS in the presence or absence of balanophonin. The results indicated that balanophonin reduced not only the LPS-mediated TLR4 activation but also the production of inflammatory mediators, such as nitric oxide (NO), prostaglandin E2 (PGE2), $Interleukin-1{\beta}$ ($IL-1{\beta}$), and tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), in BV2 cells. Balanophonin also inhibited LPS-induced inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX2) protein expression and mitogen activated protein kinases (MAPKs), including extracellular signal-regulated kinase (ERK1/2), c-Jun N-terminal kinase (JNK), and p38 MAPK. Interestingly, it also inhibited neuronal cell death resulting from LPS-activated microglia by regulating cleaved caspase-3 and poly ADP ribose polymerase (PARP) cleavage in N2a cells. In conclusion, our data indicated that balanophonin may delay the progression of neuronal cell death by inhibiting microglial activation.
Background: Gastric cancer is one of the most common causes of cancer deaths all over the world and the most important reason for its high rate of death is its belated diagnosis at advanced stages of the disease. Events occur in patients which are regarded not only as themselves factors affecting patients' survival but also which can be affected by other factors. This study was designed and implemented aiming to identify these events and to investigate factors affecting their occurrence. Materials and Methods: Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995-1999 were analyzed. The survival time of these patients was determined after surgery and the effects of various factors including demographic, diagnostic and clinical as well as medical, and post-surgical varuiables on the occurrence of death hazard without relapse, hazard of relapse, and death hazard with a relapse were assessed. Results: The median survival time for these patients was 16.3 months and the 5-year survival rate was 21.6%. Based on the results of multi-state model, age and distant metastases affected relapse whereas disease stage, type and extent of surgery, lymph nodes metastases, and number of renewed treatments affected death hazard without relapse. Moreover, age, type and extent of surgery, number of renewed treatments, and liver metastases were identified as factors affecting death hazard in patients with relapse. Conclusions: Most cancer studies pay heed to factors which have effect on death occurrence, but some events occur which should be taken into consideration to better describe the natural process of the disease and provide researchers with more accurate data.
Objective : Glutamate induced excitotoxicity is one of the leading causes of cell death under pathologic condition. However, there is controversy whether excitotoxicity may also participate in the neuronal death under low intensity insult such as simple hypoxia or hypoglycemia. To investigate the role of NMDA receptor in low intensity insult, we chose anoxia as the method of injury and used organotypically cultured hippocampal slice as the material of experiment. Materials & Methods : The hippocampal slices cultured for 2-3 weeks were exposed to 60 minutes of complete oxygen deprivation(anoxia). Neuronal death was assessed with Sytox stain. Corrected optical density of fluorescence in gray scale, used as cellular death indicator, was obtained from pictures taken at 24 and 48 hours following the insult. The well-known in vivo phenomenon of regional difference in susceptibility of hippocampal sub-fields to ischemic insult was reproduced in HOSC(hippocampal organotypic slice culture) by complete oxygen deprivation injury. Results : $CA_1$ was the most vulnerable to complete oxygen deprivation in hippocampus while $CA_3$ was resistant. Oxygen deprivation for 10 and 20 minutes with glucose(6.5g/l) present was insufficient to induce neuronal death in the cultured hippocampal slice. However, after 30 minutes exposure under anoxic condition, neuronal death was able to be detected in the center of $CA_1$ area. The intensity and area of fluorescence indicating cell death correlated with the duration of oxygen deprivation. NMDA receptor and non-NMDA receptor blocking with MK-801(30 & $60{\mu}M$) and CNQX($100{\mu}M$) did not provide cellular protection to HOSC against damage induced by oxygen deprivation, but increased intracellular calcium buffering capacity with BAPTA-AM($10{\mu}M$) was effective in preventing neuronal death (p=0.01, Student's t-test). Cycloheximide($1{\mu}g/ml$, $10{\mu}g/ml$) provided no protection to HOSC against insult of complete oxygen deprivation for 60 minutes and combined therapy of MK-801(30 & $60{\mu}M$) and cycloheximide(1 & $10{\mu}g/ml$) was also ineffective in preventing neuronal death. Conclusion : The results of this study show that the another mechanism not associated with glutamate receptor(NMDA & non NMDA) may play major role in cell death mechanisms induced by complete oxygen deprivation and increased intracellular calcium during anoxia may participate in the neuronal death mechanism of oxygen deprivation. Further investigation of the calcium entry channel activated during oxygen deprivation is necessary to understand the neuronal death of anoxia.
Seo, Myoung-Won;Woo, Hyo-Jin;Lee, Gil-Seong;Choo, Yeon-Sik;Lee, Ki-Sup;Choi, Kee-Ryong;Park, Yong-Mok
Journal of Ecology and Environment
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v.31
no.4
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pp.333-339
/
2008
We investigated death rates, growth rates and recruitment of culms in two neighboring bamboo (Phyllostachys bamboosoides) stands nested in by two different bird species to analyze stand structure and to design conservation strategies. A third bamboo grove not used by birds, the Taewha stand, was included as a control stand. The bamboo stand occupied by birds in the family Ardeidae (the Ardeidae stand) had an approximately 1.5 times higher culm density than the stand occupied by birds in the family Corvidae (the Corvidae stand). The crude death rate and the number of newly emerged shoots were also higher in the Ardeidae stand than the Corvidae stand. The death rate for bamboo in the Ardeidae stand was not dependent on diameter at breast height (DBH) and was almost 40% for culms of all sizes, whereas most dead culms in the Corvidae stand were < 4 cm DBH. Consequently, we conclude that in the Ardeidae stand, density-independent causes of death are operating, while density-dependent factor are more important in the Corvidae site. The results of soil analysis in these stands suggest that the density-independent death pattern observed in the Ardeidae stand may be due to soil acidification resulting from wastes produced by the birds during breeding. On the other hand, the culm distribution and death patterns in the Corvidae stand suggest that the stand characteristics were not affected by the nesting birds. These results suggest that different conservation strategies must be applied to conserve bamboo groves used by ardeids and corvids for nesting.
Clostridium novyi (C. novyi) is a gram positive, non-capsulated, motile, obligatory anaerobe that produces endospores. Both C. novyi type A and B produce a bacteriophage encoded lethal alpha toxin which belongs to a family of large clostridial cytotoxins. These large clostridial cytotoxins of C. novyi bind to the uncharacterized receptors on host vascular endothelial cells, which leads to the loss of integrity of the vascular endothelium with subsequent edema, refractory hypotension, organ failure, and sudden death. A total of 13 sudden death cases were submitted to Chonbuk National University-Veterinary Diagnostic Center between June and October, 2015. The samples, mainly liver, were collected in sterile vials after necropsy and processed within 12~24 hours for diagnosis, isolation and identification of C. novyi. All of the 4 gram positive samples showed amplification by PCR. Out of 4 positive samples, 3 were detected to be C. novyi type B and 1 was detected as C. novyi type A. Based on the 16S rDNA sequence analysis, 1 case (150564) showed 99% similarity with C. novyi type A while other 3 cases (150388, 150557 and 150775) presented 99% similarity with C. novyi type B. Based on the results, C. novyi was found to be prevalent in Korean pig farms and causes sudden death to finishing pigs or sows during summer season. Thus, C. novyi should be considered for differential diagnosis on sudden death cases during the summer season.
Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.
Jung, NamKyo;Park, Se Jin;Kwon, Soon-Hyun;Jun, Jongarm;Yu, Jaehak
Journal of Platform Technology
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v.9
no.3
/
pp.36-43
/
2021
Stroke disease is one of the leading causes of death worldwide, and in particular, it is the most important causative disease that causes disability in the elderly. Since stroke disease often causes death or serious disability, active primary prevention and early detection of prognostic symptoms are very important. In particular, it is necessary to detect and accurately predict stroke prognostic symptoms in daily life and prompt diagnosis and treatment by medical staff. In recent studies, image analysis such as computed tomography (CT) or magnetic resonance imaging (MRI) is mostly used as a methodology for predicting prognostic symptoms in stroke patients. However, this approach has limitations in terms of long test time and high cost. In this paper, we experimented with clinical data on how stroke disease affects foot pressure in elderly in walking. Experiments have shown that there is a significant difference in * p < .05 in 12 cells between the stroke elderly and the normal elderly during walking. As a result, it is significant that we found a significant difference in the gait patterns in daily life of the stroke elderly and the normal elderly.
The information on mortality from echinococcosis is important not only for a better understanding of the severity of the disease, but also for evaluating the effectiveness of public health interventions. The aim of this research was to study the causes of mortality from echinococcosis. We have collected and analyzed the materials of 1,470 patients in 10 age - groups in the Republic of Armenia (from 2000 to 2016). To find out the causes of mortality from echinococcosis, we have analyzed the medical histories and protocols of postmortem examinations of 19 deaths from echinococcosis and 17 deaths due to other indirect causes not associated with the parasite. The average annual death rate from echinococcosis is 0.007 per 10,000 population, and the mortality is 1.29 (per 100 patients). The highest mortality occurs in people aged 70-79. Mortality from echinococcosis is also recorded among the unoperated children. The rupture of the parasitic cyst and hepatic insufficiency are major among the direct causes of mortality. Sometimes the hydatid cysts unrecognized during the life were first diagnosed at autopsy. Insufficient qualification of doctors in the field of helminthology, as well as the latent course of the disease or manifestation of minor symptoms in echinococcosis over a long period often led to medical errors. Further decline in mortality can be achieved by early diagnosis, timely hospitalization and treatment before the development of severe complications worsening the prognosis and outcomes of surgical intervention.
The number of deaths is often measured to monitor the population health status and priority of health problems. However, number of years of life lost (YLL) is a more appropriate indicator in some cases. We have calculated the YLL of adult cancers and its trend over the past few years in Yazd to provide planners with baseline data. Data obtained from death registration system were used to calculate the YLL, based on each individual's age at death, and the standardized expected YLL method was applied with a discount rate of 0.03, an age weight of 0.04, and a correction factor of 0.165. All data were analyzed and prepared in Epi6 and Excel 2007. A total of 3,850 death records were analyzed. Some 550 patients in Yazd province aged ${\geq}20$ die annually due to cancer (male: female ratio 1.3). The average ages at death in lung, CNS, breast cancer and leukemia cases were 68.5, 59, 58.7 and 61, respectively. The age group of 40-59 with 21 % had the highest cancer mortality percentage. Premature cancer deaths have caused 40,753 YLL (5,823 YLL annually). Females lose on average more life years to cancer than do men (11.6 vs 9.8 years). Lung cancer (12.1%), CNS tumors (11.7%) and leukemia (11.4 %) were the leading causes terms of YLL due to all cancers in both sexes. From 2004 to 2010, cancer-caused YLL as a fraction of all YLL increased from 12.8 to 15.2 %. This study can help in the assessment of health care needs and prioritization. Cancer is the major cause of deaths and the trend is increasing. The use of YLLs is a better index for measurement of premature mortality for ranking of diseases than is death counts. Longer periods of observation will make these trends more robust and will help to evaluate and develop, better public health interventions.
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