• Title/Summary/Keyword: Deaths Number

Search Result 398, Processing Time 0.026 seconds

Surgical Treatment of Complications after Fontan Operation (Fontan수술후의 합병증에 대한 수술적 치료)

  • 박정준;홍장미;김용진;이정렬;노준량
    • Journal of Chest Surgery
    • /
    • v.36 no.2
    • /
    • pp.73-78
    • /
    • 2003
  • The Fontan operation has undergone a number of major modifications and clinical results have been improving over time. Nevertheless, during the follow-up period, life-threatening complications develop and affect the long-term outcomes. Surgical interventions for these complications are needed and are increasing. Material and Method: From April 1988 to January 2000, 16 patients underwent reoperations for complications after Fontan operation. The mean age at reoperation was 8.8 :-5.5 years. Initial Fontan operations were atriopulmonary connections in 8 and total cavopulmonary connections in 8. Total cavopulmonary connections were accomplished with intracardiac lateral tunnel in 5 and extracardiac epicardial lateral tunnel in 3. Five patients had variable sized fenestrations. The reasons for reoperations included residual shunt in 6, pulmonary venous obstruction in 3, atrial flutter in 3, atrioventricular valve regurgitation in 2, Fontan pathway stenosis in 1, and protein-losing enteropathy in 1 Result: There were 3 early and late deaths respectively Patients who had residual shunts underwent primary closure of shunt site (n=2), atrial reseptation for separation between systemic and pulmonary vein (n=2), conversion to lateral tunnel (n=1), and conversion to one and a half ventricular repair (n=1). Four patients who had stenotic lesion of pulmonary vein or Fontan pathway underwent widening of the lesion (n=3) and left pneumonectomy (n=1) In cases of atrial flutter, conversion to lateral tunnel after revision of atriopulmonary connections was performed (n=3). For the atrioventricular valve regurgitation (n=2), we performed a replacement with mechanical valve. In one patient who had developed protein-losing enteropathy, aorto-pulmonary collateral arteries were obliterated via thoracotomy. Cryoablation was performed concomitantly in 4 patients as an additional treatment modality of atrial arrhythmia. Conclusion: Complications after Fontan operation are difficult to manage and have a considerable morbidity and mortality. However, more accurate understanding of Fontan physiology and technical advancement increased the possibility of treatment for such complications as well as Fontan operation itself. Appropriate surgical treatment for these patients relieved the symptoms and improved the functional class, Although the results were not satisfactory enough in all patients.

Early Results of Coronary Bypass Surgery in Patients with Severe Left Ventricular Dysfunction (심한 좌심실 기능저하를 동반한 환자에서의 관상동맥 우회로 조성수술의 조기성적)

  • 정윤섭;김욱성
    • Journal of Chest Surgery
    • /
    • v.30 no.4
    • /
    • pp.383-389
    • /
    • 1997
  • From March, 1992 to March, 1996, a total of 279 patients underwent coronary bypass surgery at the Sejong General Hospital, Puchon. We selected 22 patients with severe left ventricular(LV) dysfunction from them. The criteria were the presence of global or segmental abnormalities of left ventricular contraction and LV ejection fraction(EF) less than 35% based on biplane LV angiography by planimetry method. The mean age of 17 male and 5 female patients was 60$\pm$5.6years(range:47~73 years). All had the anginas, which were Canadian class II in 6, class 111 in 12 and class IV in 4. All patients except one had the history of previous myocardial infarction more than once. Seven of them had the symptoms and signs of congestive heart failure, such as dyspnea on excertion and increased pulmonary vascular markings. Their mean LVEF was 29.4$\pm$4 5%(range : 18~35%) and mean LV end-diastolic pressure was 18.7 $\pm$8. 2mmHg(range:10~42mmHg). 21 patients had 3 vessel-disease and 1 had 2 vessel-disease. Complete revascularization was tried with the use of 16 internal mammary arteries and 60 sapheuous veins and 3 radial arteries grafts. The mean number of distal anastomosis was 3.5$\pm$ 1.1. Concomitantly, one mitral valvuloplasty and annuloplasty was performed in the patient with moderate mitral regurtigation. The hospital mortality was 4.5%. During the follow-up, there were 3 late deaths. Of 18 survivors, 2 patients were lost in follow-up 24 and 27 month respectively after operation and the remaining 16 patients have bcen followed up with an average of 30.4 $\pm$ 13.4 months.15 patients had improvement with respect to angina but 8 patients still have the continuing or progressing heart failure. The 1-year, 2-year and 3-year actuarial survival rate was 85.2, 69.1, 46.1%, respectively. This study indicates that coronary artery bypass sur ery can be performed in the patients with severe LV dysfunction at acceptable risk but does not greatly contribute to the improvement of congestive heart failure.

  • PDF

Analysis of Forest Fires during Chosun Dynasty through Historical Literature Survey (역사문헌 고찰을 통한 조선시대 산불특성 분석)

  • Kim, Dong-Hyun;Kang, Young-Ho;Kim, Kwang-Il
    • Fire Science and Engineering
    • /
    • v.25 no.4
    • /
    • pp.8-21
    • /
    • 2011
  • This study surveyed historical records on outbreak and features of forest fires during Chosun Dynasty's 518 years in being and analyzed the Annals of the Chosun Dynasty; The Diaries of the Royal Secretariat, archives from Records of the Border Defense Council, The Compilation of Ministry Proposals, Posthumous Records of King Cholchong etc. Forest fires were most prevalent and extreme during King Hyunjong (14 cases) and King Sunjo (13 cases) due to strong wind, and the biggest-ever forest fire broke out in the fourth year of King Soonjo (1804) in the east coast of Korea in Kangwon province. The fire had resulted in 61 fatalities and 2,600 destroyed houses. Forest fire in the east coast of Korea, Kangwon province, in the $13^{th}$ year of King Hyeonjong (1672) is recorded to have caused the highest number of deaths, 65people. The most frequent cause of forest fires during Chosun Dynasty was unidentified (42 cases), followed by accidental fire (10 cases), arson or lightning (3 cases), fire during hunting (2 cases), play with fire by children, destruction of patty fields and dry fields by fire and house fire (1 case respectively). By region, 56 % of forest fires erupted in the east coast (39 cases) and this was followed by the west sea (9 cases), Seoul and central region (8 cases) and the southern part of Korea (7 cases). By season, spring was found to be most vulnerable to forest fire as it accounted for 73 % of the total amounting to 46 cases. Behind were summer (11 cases), winter (6 cases) and autumn (0 case). Specifically, most forest fire broke out on April and May, which is the same as today. Archives and literature indicate that the person who involved in forest fire by accidental as well as arson had to be punished by banishment, expulsion from government office and public hanging. Also, officials in charge of the region that suffered forest fire were subject to reprimand. In conclusion, risk and gravity of forest fires were evident during the Chosun Dynasty as specified in historical archives and share many similarities with today's forest fires in terms of the duration and regional patterns.

Factors related to COVID-19 Incidence and Mortality rate in Gyeongsangbuk-do, Korea (경상북도 지역의 코로나19 발생률 및 사망률 관련요인)

  • Kim, Dong-Hwi;Park, Sung-Jun;Kang, Hyun-Jun;Yeom, Eun-Jung;Yoo, Na-Eun;Lee, Jeong-Min;Nam, Eun-Ha;Park, Ji-Hyuk;Lee, Kwan
    • Journal of agricultural medicine and community health
    • /
    • v.45 no.4
    • /
    • pp.235-244
    • /
    • 2020
  • Objectives: Gyeongsangbuk-do has entered a super-aged society with 20.7% of the population aged 65 and older. As of April 30, 2020, the death rate of COVID-19(3.8 people) in Gyeongsangbuk-do is higher than the national mortality rate (2.3 people), and the fatality rate of COVID-19 by age accounts for more than half of the total of 58.6%, so it is time to propose to prevent infectious diseases in the event of additional infectious disease disasters COVID-19. Methods: We collected daily data on the number of confirmed cases and deaths due to COVID-19 from 19 February to 30 April 2020. The data collected was evaluated using the SPSS 21.0 statistical package. Results: As a result of comparing the incidence and death-related factors of confirmed patients in Gyeongsangbuk-do, there were significant differences in age group (p<0.001), underlying disease (p<0.001), and residence type (p<0.033). Conclusion: Factors affecting the mortality rate of confirmed patients in Gyeongsangbuk-do have been combined with individual level factors(age, gender, underlying disease), which means individual characteristics that have existed since before the disease, and regional level factors(Type of Residence), which are external factors that enable the use of medical resources. Therefore, each local government is required to establish preventive measures considering individual and regional level factors.

Analysis of News Agenda Using Text mining and Semantic Network Analysis: Focused on COVID-19 Emotions (텍스트 마이닝과 의미 네트워크 분석을 활용한 뉴스 의제 분석: 코로나 19 관련 감정을 중심으로)

  • Yoo, So-yeon;Lim, Gyoo-gun
    • Journal of Intelligence and Information Systems
    • /
    • v.27 no.1
    • /
    • pp.47-64
    • /
    • 2021
  • The global spread of COVID-19 around the world has not only affected many parts of our daily life but also has a huge impact on many areas, including the economy and society. As the number of confirmed cases and deaths increases, medical staff and the public are said to be experiencing psychological problems such as anxiety, depression, and stress. The collective tragedy that accompanies the epidemic raises fear and anxiety, which is known to cause enormous disruptions to the behavior and psychological well-being of many. Long-term negative emotions can reduce people's immunity and destroy their physical balance, so it is essential to understand the psychological state of COVID-19. This study suggests a method of monitoring medial news reflecting current days which requires striving not only for physical but also for psychological quarantine in the prolonged COVID-19 situation. Moreover, it is presented how an easier method of analyzing social media networks applies to those cases. The aim of this study is to assist health policymakers in fast and complex decision-making processes. News plays a major role in setting the policy agenda. Among various major media, news headlines are considered important in the field of communication science as a summary of the core content that the media wants to convey to the audiences who read it. News data used in this study was easily collected using "Bigkinds" that is created by integrating big data technology. With the collected news data, keywords were classified through text mining, and the relationship between words was visualized through semantic network analysis between keywords. Using the KrKwic program, a Korean semantic network analysis tool, text mining was performed and the frequency of words was calculated to easily identify keywords. The frequency of words appearing in keywords of articles related to COVID-19 emotions was checked and visualized in word cloud 'China', 'anxiety', 'situation', 'mind', 'social', and 'health' appeared high in relation to the emotions of COVID-19. In addition, UCINET, a specialized social network analysis program, was used to analyze connection centrality and cluster analysis, and a method of visualizing a graph using Net Draw was performed. As a result of analyzing the connection centrality between each data, it was found that the most central keywords in the keyword-centric network were 'psychology', 'COVID-19', 'blue', and 'anxiety'. The network of frequency of co-occurrence among the keywords appearing in the headlines of the news was visualized as a graph. The thickness of the line on the graph is proportional to the frequency of co-occurrence, and if the frequency of two words appearing at the same time is high, it is indicated by a thick line. It can be seen that the 'COVID-blue' pair is displayed in the boldest, and the 'COVID-emotion' and 'COVID-anxiety' pairs are displayed with a relatively thick line. 'Blue' related to COVID-19 is a word that means depression, and it was confirmed that COVID-19 and depression are keywords that should be of interest now. The research methodology used in this study has the convenience of being able to quickly measure social phenomena and changes while reducing costs. In this study, by analyzing news headlines, we were able to identify people's feelings and perceptions on issues related to COVID-19 depression, and identify the main agendas to be analyzed by deriving important keywords. By presenting and visualizing the subject and important keywords related to the COVID-19 emotion at a time, medical policy managers will be able to be provided a variety of perspectives when identifying and researching the regarding phenomenon. It is expected that it can help to use it as basic data for support, treatment and service development for psychological quarantine issues related to COVID-19.

A Study on the Growth Diagnosis and Management Prescription for Population of Retusa Fringe Trees in Pyeongji-ri, Jinan(Natural Monument No. 214) (진안 평지리 이팝나무군(천연기념물 제214호)의 생육진단 및 관리방안)

  • Rho, Jae-Hyun;Oh, Hyun-Kyung;Han, Sang-Yub;Choi, Yung-Hyun;Son, Hee-Kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
    • /
    • v.36 no.3
    • /
    • pp.115-127
    • /
    • 2018
  • This study was attempted to find out the value of cultural assets through the clear diagnosis and prescription of the dead and weakness factors of the Population of Retusa Fringe Trees in Pyeongji-ri, Jinan(Natural Monument No. 214), The results are as follows. First, Since the designation of 13 natural monuments in 1968, since 1973, many years have passed since then. In particular, despite the removal of some of the buried soil during the maintenance process, such as retreating from the fence of the primary school after 2010, Second, The first and third surviving tree of the designated trees also have many branches that are dead, the leaves are dull, and the amount of leaves is small. vitality of tree is 'extremely bad', and the first branch has already been faded by a large number of branches, and the amount of leaves is considerably low this year, so that only two flowers are bloomed. The second is also in a 'bad'state, with small leaves, low leaf density, and deformed water. The largest number 1 in the world is added to the concern that the s coverd oil is assumed to be paddy soils. Third, It is found that the composition ratio of silt is high because it is known as '[silty loam(SiL)]'. In addition, the pH of the northern soil at pH 1 was 6.6, which was significantly different from that of the other soil. In addition, the organic matter content was higher than the appropriate range, which is considered to reflect the result of continuous application for protection management. Fourth, It is considered that the root cause of failure and growth of Jinan pyeongji-ri Population of Retusa Fringe Trees group is chronic syndrome of serious menstrual deterioration due to covered soil. This can also be attributed to the newly planted succession and to some of the deaths. Fifthly, It is urgent to gradually remove the subsoil part, which is estimated to be the cause of the initial damage. Above all, it is almost impossible to remove the coverd soil after grasping the details of the soil, such as clayey soil, which is buried in the rootstock. After removal of the coverd soil, a pestle is installed to improve the respiration of the roots and the ground with Masato. And the dead 4th dead wood and the 5th and 6th dead wood are the best, and the lower layer vegetation is mown. The viable neck should be removed from the upper surface, and the bark defect should undergo surgery and induce the development of blindness by vestibule below the growth point. Sixth, The underground roots should be identified to prepare a method to improve the decompression of the root and the respiration of the soil. It is induced by the shortening of rotten roots by tracing the first half of the rootstock to induce the generation of new roots. Seventh, We try mulching to suppress weed occurrence, trampling pressure, and soil moisturizing effect. In addition, consideration should be given to the fertilization of the foliar fertilizer, the injection of the nutrients, and the soil management of the inorganic fertilizer for the continuous nutrition supply. Future monitoring and forecasting plans should be developed to check for changes continuously.

The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
    • /
    • v.3 no.2
    • /
    • pp.163-193
    • /
    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

  • PDF

Facters Affecting Recurrence after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothotax (자연기흉에 대한 비디오흉강경수술후 재발에 영향을 미치는 요인들)

  • 이송암;김광택;이일현;백만종;최영호;이인성;김형묵;김학제
    • Journal of Chest Surgery
    • /
    • v.32 no.5
    • /
    • pp.448-455
    • /
    • 1999
  • Background: Recent developments in techniques of video-assisted thoracic surgery(VATS) and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. Especially, it will probably become the treatment of choice of spontaneous pneumothorax(SP). There is, however, a high recurrence rate, high cost, and paucity of long-term results. We report the results of postoperative follow-up and analyze perioperative parameters affected to recurrence, retrospectively. Material and Method: From march 1992 to march 1997, 276 patients with spontaneous pneumothorax underwent 292 VATS procedures. Conversion to open thoracotomy was necessitated in eight patients, and this patients excluded from the study. Result: The sex distribution was 249 males and 31 females. The mean age was 28.1 12.2 years(range, 15 to 69 years). Primary SP was 237cases(83.5%) and secondary SP was 47cases(16.5%). The major underlying lung diseases associated with secondary SP were tuberculosis 27cases(57.4%) and emphysema 8cases (38.3%). Operative indications included Ipsilateral recurrence 123(43.9%), persistent air-leak 53(18.9%), x-ray visible bleb 40(14.3%), tension 30(10.7%), contralateral recurrence 21(7.5%), uncomplicated first episode 8(2.9%), bilateral 3(1.1%), complicated episode 2(0.7%). Blebs were visualized in 247cases(87%) and 244cases(85.9%) performed stapled blebectomy. Early postoperative complications occurred in 33 cases(11.6%): 16 prolonged air-leak more than 5 days(four of them were required a second operation and found missed blebs); 5 bleeding; 5 empyema; 2 atelectasis; 1 wound infection. No deaths occured. The mean operative time was 52.8 23.1 minutes(range, 20 to 165 minutes). The mean d ration of chest tube drainage was 5.0 4.5 days(range, 2 to 37 days). The mean duration ofhospital stay was 8.2 5.5 days (range, 3 to 43days). At a mean follow-up 22.3 18.4 months(range, 1 to 65 months), 12 patients(4.2%) were lost to follow-up. There were 24 recurrences and seven patients underwent second operation and 6 patients(85.7%) were found the missed blebs. 12 perioperative parameters(age, sex, site, underlying disease, extent of collapse, operative indication, size of bleb, number of bleb, location of bleb, bleb management, pleural procedure, prolonged postoperative air-leak) were analyzed statistically to identify significant predictors of recurrence. The significant predictors of recurrence was the underlying disease[17.0%(8/47): 6.8%(16/237), p=0.038], prolonged postoperative air-leakage[37.5%(6/16): 6.7%(18/268), p=0.001], and pleural procedure [11.4%(19/167): 4.3%(5/117), p=0.034]. Blebectomy has less recurrence rate then non-blebectomy [8.2%(20/244) : 10.0%(4/40), p>0. 5]. However, this difference was not statistically significant(p=0.758). Conclusion: We conclude that it is important that we shoud careful finding of bleb during VATS due to reducing of recurrnece, and cases of no bleb identified and secondary spontaneous pneumothorax were indicated of pleurodectomy. VATS is a valid alternative to open procedure for the treatment of spontaneous pneumothorax with less pain, shorter hospital stay, more rapid return to work, high patient acceptance, less scar and exellent cosmetics. But, there is high recurrence rate and high cost, and than it is necessary to evaluate of long-term results for recurrence and to observate carefully during VATS.

  • PDF