• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3581-3585
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• 2013

Background: Accurate statistics on the cancer burden are essential, both for purposes of research and for setting priorities in healthcare management. So that in vast countries with partial registration coverage, such as Iran, local data are more useful. We here estimated the incidence, prevalence and mortality time trend of four major cancer site, lung, stomach, breast and prostate, over the period 2001-2010 and provided short-range projections to 2015 in Isfahan. Materials and Methods: Estimates were derived by applying the mortality-incidence analysis method, a back-calculation approach to estimate and project incidence, prevalence and mortality of chronic degenerative disease, starting from knowledge of mortality and relative survival information. Results: Age adjusted incidence, mortality and prevalence rates in Isfahan exhibited a clear upward trend for all four sites during the period 2001-2015, with marked increasees in prostate and breast predicted for the future. Difference in incidence trends between males and females might be attributable to the difference in risk factors specific to certain cancer sites, with smoking being the main risk factor. Conclusions: In this study, males and females displayed an increasing pattern for incidence and mortality rate over the entire study period until 2015. This information can be used as basis for planning healthcare management and allocating recourses in public health.

• Journal of Chest Surgery
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• 제33권1호
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• pp.73-78
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• 2000

Background: this study was designed to estimate whether specific risk factors could increase the postoperative complication rate of pneumonectomy for chronic complicated inf-lammatory lung disease. Material and Method: Eighty-five patients underwent pneumon-ectomy for chronic complicated inflammatory lung disease(tuberculosis, 67 ; bronchiecasis 11; aspergio- losis, 4; others, 3) between January 1991 and August 1998. We performed a univariated statistical analysis to identify preoperative and intraoperative risk factors associated with postoperative complications, Result: There was no operative mortality. There were a total of 18 postoperative complications(22.2%) Bronchopleural fistula(BPF) and empyema occurred in 5(5.9%) and 2(2.4%) respectively. General complication rate was significantly higher in patients with right-sided pneumonectomy(p=.029) extrapleural pneu-monectomy(p=.009) and intraoperative pleural spillage due to cavity or lesion perforation (p=.004). The prevalence of BPF and empyema was higher in patients with right sided pneumonectomy(p=.007) extrapleural pneumonectomy(p=.015) and intraoperative pl- eural spillage due to cavity or lesion perforation(p=.003) which is as the same results as gen-eral complication rate. Conclusion: The postoperative complication rate of pneumone-ctomy for chronic complicated lung disease is accptably low. But it is increase in patients with right sided pneumonectomy extrapleural pneumonectomy and intraoperative pleural spillage due to cavity or lesion perforation. therefore more careful and meticulous intra-operatve management are needed in right sided extrapleural pneumonectomy without intra- pleural spillage.

• Journal of Preventive Medicine and Public Health
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• 제52권5호
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• pp.308-315
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• 2019

Objectives: Estimating influenza-associated mortality is important since seasonal influenza affects persons of all ages, causing severe illness or death. This study aimed to estimate influenza-associated mortality, considering both periodic changes and age-specific mortality by influenza subtypes. Methods: Using the Microdata Integrated Service from Statistics Korea, we collected weekly mortality data including cause of death. Laboratory surveillance data of respiratory viruses from 2009 to 2016 were obtained from the Korea Centers for Disease Control and Prevention. After adjusting for the annual age-specific population size, we used a negative binomial regression model by age group and influenza subtype. Results: Overall, 1 859 890 deaths were observed and the average rate of influenza virus positivity was 14.7% (standard deviation [SD], 5.8), with the following subtype distribution: A(H1N1), 5.0% (SD, 5.8); A(H3N2), 4.4% (SD, 3.4); and B, 5.3% (SD, 3.7). As a result, among individuals under 65 years old, 6774 (0.51%) all-cause deaths, 2521 (3.05%) respiratory or circulatory deaths, and 1048 (18.23%) influenza or pneumonia deaths were estimated. Among those 65 years of age or older, 30 414 (2.27%) all-cause deaths, 16 411 (3.42%) respiratory or circulatory deaths, and 4906 (6.87%) influenza or pneumonia deaths were estimated. Influenza A(H3N2) virus was the major contributor to influenza-associated all-cause and respiratory or circulatory deaths in both age groups. However, influenza A(H1N1) virus-associated influenza or pneumonia deaths were more common in those under 65 years old. Conclusions: Influenza-associated mortality was substantial during this period, especially in the elderly. By subtype, influenza A(H3N2) virus made the largest contribution to influenza-associated mortality.

• 한국인구학
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• 제15권2호
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• pp.15-59
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• 1992

After world war II Japanese life expectancy has been improved remarkably, and reached the highest level in the world around late 1970's. The life expectancy of Korean has also shown tremendous improvement in recent years with about 20 year's gap from the Japanese. The reason of rapid improvement of life expectancy can be explained by changes in the structure of cause of death due to health system, living standard, social welfare, health behavior of individuals and so on. Korean in Japan is placed under different situations from both Korean in Korea and Japanese in these regards, and expected to show different picture of cause of death pattern. The objective of this study is the comparision of changing patterns of cause of death of three population groups, Korean in Japan, Korean in Korea and Japanese, and to investigate the reasons which effect to the structural difference of mortality cause with special emphasis on health ecological aspects. One of the major limitations of the Korean causes of death statistics is the under-registration which ranges about 10% of the total events, and inaccuracy of the exact cause of death. Some 20% of registered deaths were unable to classify by ICD. However, it is concluded that the Korean data are evaluated as sufficient to stand for over-viewing of trends of cause of death pattern. The evaluation is done by comparing data from registration and field survey over the same population sample. Population data of Korean in Japan differ between two sources of data; census and foreigner's registration. Correction is done by life table method under the assumption that age-specific mortality pattern would accord with that of the Japanese. The crude death rate was lowest among Korean in Japan, 5.7 deaths per 1,000 population in 1965. The crude death rates of Korean in Japan and Japanese are increasing recently influenced by age structure while Korean in Korea still shows decreasing tendency. The adjusted death rate is lowest among Japanese, followed by Korean in Japan, and Korean in Korea. The leading causes of death of Korean in Korea until 1960's was infectious diseases including pneumonia and tuberculosis. The causes of death structure changed gradually to accidents, neoplasm, hypertensive disease, cerebro-vascular disease in order. The main difference in cause of death between Korean and Japanese if high rate of liver diseases and diabetes for both Korean in Japan and Korea. A special feature of cause of death among Korean in Korea is remakably high rate of hypertensive disease, which is assumed to be caused by physicians tendency in choosing diagnostic categories. The low ischemic heart disease and high vasculo-cerebral disease are the distinctive characteristic of the three population groups compared to western countries. Specific causes of death were selected for detailed sex, age and ethnic group comparisons based on their high death rates. Cancer is the cause of death which showed most dramatical increase in all three population groups. In Korea 20.1% of all death were caused by cancer in 1990 compared with 10.5% in 1981. Cancer of the liver is the leading cause of cancer death among Korean in Japan for both sexes, followed by cancer of the lung and cancer of the stomach, while that of Korean in Korea is cancer of the stomach, followed by cancer of the liver and cancer of the lung for male. Causes of infant mortality were examined among the three population groups since 1980 on yearly bases. For both Japanese and Korean in Japan, leading cause of death ranks as conditions originating in the perinatal period, congenital anomalies, accidents and other violent causes. Trends since 1980 for these two population groups in the leading cause of infant mortality showed no changes. On the contrary, significant changes in leading cause of death structure in Korea were observed : the ranking of leading cause of death in 1981 were congenital asnomalies, pneumonia bronchitis, infectious disease, heart disease, conditions originating in the perinatal period, accident and other violent causes ; in 1990 the ranking shifted to congenital anomalies, accident, pneumonia bronchities, conditions originating in the perinatal period, infectious disease. The mortality rate by congenital anomalies in Korea continuously grew than any other causes. Larger increase ocurred during the 1990's

• Tuberculosis and Respiratory Diseases
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• 제79권3호
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• pp.158-164
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• 2016

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

• Journal of Preventive Medicine and Public Health
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• 제34권3호
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• pp.244-252
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• 2001

Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.

• Journal of Chest Surgery
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• 제28권11호
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• pp.1014-1018
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• 1995

To confirm diagnosis and to set proper therapeutic strategy, open lung biopsies were done in 57 patients who were suspected for diffuse interstitial lung disease from January 1985 to December 1994. Among them, 35 were male and 22 were female[M:F=l.6: 1 and mean age of the patients is 53.5$\pm$ 2.3[24-81 years. Tissue for histologic studies were obtained from left lung in 33, from right lung in 24according to the distributions of the pathology. Preoperative diagnostic work-up`s were chest X-ray, CT[HRCT scan, sputum study, bronchoscopy[BAL, TBLB and PTNA and all of them were unsuccessful to confirm diagnosis. In comparison of pulmonary function tests between preoperative and postoperative values, there were no significant differences in FVC, FEV1, FEV1/FVC[p 0.05 but in AaDO2[p[0.05 . Postoperative complications including atelectasis, wound infection, pulmonary edema and respiratory insnfficiency, were shown in 5 cases[8.8% , and two of them were died of respiratory failure and sepsis[mortality rate 3.5% . Pathologic diagnosis was confirmed in 53 cases postoperatively but it was undetermined in 4[diagnostic yield rate 93.0% . In comparison between preoperative clinical diagnosis and postoperative pathologic diagnosis, new diagnosis were made in 17 cases[29.8% and preoperative tentative diagnosis were confirmed histologically in 36 cases[63.2% . In 4 cases[7.0% , however, diagnoses were not confirmed after biopsies. Therapeutic plans were reset in 46 cases[80.7% in accordance with the final diagnosis.In conclusion, open lung biopsy is recommended for a specific diagnosis and proper therapeutic plan in diffuse interstitial lung diseases because of its high diagnostic yield Irate and it`s relatively low morbidity and mortality rate in these tompromised patents.

• Korean Circulation Journal
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• 제53권5호
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• pp.313-327
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• 2023

Background and Objectives: Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. Methods: PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Results: Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. Conclusions: This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.

• The Korean Journal of Physiology and Pharmacology
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• 제12권3호
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• pp.89-94
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• 2008

In order to reproduce chronic cerebral hypoperfusion as it occurs in human aging and Alzheimer's disease, we introduced permanent, bilateral occlusion of the common carotid arteries (BCCAO) in rats (Farkas et al, 2007). Here, we induced BCCAO in two different rat strains in order to determine whether there was a strain difference in the pathogenic response to BCCAO. Male Wistar and Sprague-Dawley (SD) rats (250-270 g) were subjected to BCCAO for three weeks. Kluver-Barrera and cresyl violet staining were used to evaluate white matter and gray matter damage, respectively. Wistar rats had a considerably higher mortality rate (four of 14 rats) as compared to SD rats (one of 15 rats) following BCCAO. Complete loss of pupillary light reflex occurred in all Wistar rats that survived, but loss of pupillary light reflex did not occur at all in SD rats. Moreover, BCCAO induced marked vacuolation in the optic tract of Wistar rats as compared to SD rats. In contrast, SD rats showed fewer CA1 hippocampal neurons than Wistar rats following BCCAO. These results suggest that the neuropathological process induced by BCCAO takes place in a region-specific pattern that varies according to the strain of rat involved.

• Journal of Preventive Medicine and Public Health
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• 제49권4호
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• pp.220-229
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• 2016

Objectives: The association between educational status and 10-year risk for acute coronary syndrome (ACS) and all-cause mortality was evaluated. Methods: From October 2003 to September 2004, 2172 consecutive ACS patients from six Greek hospitals were enrolled. In 2013 to 2014, a 10-year follow-up (2004-2014) assessment was performed for 1918 participants (participation rate, 88%). Each patient's educational status was classified as low (<9 years of school), intermediate (9 to 14 years), or high (>14 years). Results: Overall all-cause mortality was almost twofold higher in the low-education group than in the intermediate-education and high-education groups (40% vs. 22% and 19%, respectively, p<0.001). Additionally, 10-year recurrent ACS events (fatal and non-fatal) were more common in the low-education group than in the intermediate-education and high-education groups (42% vs. 30% and 35%, p<0.001), and no interactions between sex and education on the investigated outcomes were observed. Moreover, patients in the high-education group were more physically active, had a better financial status, and were less likely to have hypertension, diabetes, or ACS than the participants with the least education (p<0.001); however, when those characteristics and lifestyle habits were accounted for, no moderating effects regarding the relationship of educational status with all-cause mortality and ACS events were observed. Conclusions: A U-shaped association may be proposed for the relationship between ACS prognosis and educational status, with participants in the low-education and high-education groups being negatively affected by other factors (e.g., job stress, depression, or loneliness). Public health policies should be aimed at specific social groups to reduce the overall burden of cardiovascular disease morbidity.