• Title/Summary/Keyword: Excess mortality

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Pathological evaluation of renal changes induced by multiple nephropathogenic factors in SPF chickens I. Histopathological and electron microscopical observation (신부전 요인에 의해 유발된 닭 신장변화의 병리학적 관찰 I. 병리조직학적 및 전자현미경적 관찰)

  • Kang, Kyung-il;Mo, In-pil;Kwon, Yong-kuk;Kang, Min-su;Hahn, Tae-wook;Han, Jeong-hee
    • Korean Journal of Veterinary Research
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    • v.39 no.6
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    • pp.1126-1140
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    • 1999
  • Renal failure is one of the main causes of economic impacts in the poultry industry and complex syndrome with different severity of clinical signs caused by multiple nephropathogenic factors such as infectious bronchitis viral infection and excess salt and calcium in diet. To evaluate the correlation between severity of renal failure and the causative nephropathogenic factors, one-day-old specific pathogen free chicks were treated with either single causative factor or multiple causative factors described as above. Each group was designed as control for non-treated control, IB for infectious bronchitis virus (IB virus) infection, IBHNa for IB virus infection with high diet salt, IBHCa for IB virus infection with high diet calcium, IBHNC for IB virus infection with high diet salt and calcium, HNa for high diet salt, HCa for high diet calcium and HNC for high diet salt and calcium. Chickens were inoculated with IB virus at 1-day-old and remained on their respective diets until 21 day of age. The high dietary salt feeding groups such as IBHNa, IBHNC, HNa, HNC increased water intake, watery diarrhea, general subcutaneous edema and the high dietary calcium feeding groups such as IBHCa and IBHNC showed severe visceral gout. Two more than treated groups caused high mortality in comparison with the single treated groups. IB virus exposure significantly increased urate deposition and lymphocytic interstitial nephritis. Especially urate deposition dramatically increased when excess diet calcium was combined together. In excess diet salt treated groups enlarged edematous kidneys were observed and hypertrophy of glomeruli were showed. These results suggest that IB virus enhanced the incidence and severity on chicken renal failure clearly related to the quantity of salt and calcium.

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Clinical Outcomes and Risk Factors of Traumatic Pancreatic Injuries (외상성 췌장 손상의 임상 결과 및 예후인자)

  • Lee, Hong-Tae;Kim, Jae-Il;Choi, Pyong-Wha;Park, Je-Hoon;Heo, Tae-Gil;Lee, Myung-Soo;Kim, Chul-Nam;Chang, Surk-Hyo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.1-6
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    • 2011
  • Purpose: Even though traumatic pancreatic injuries occur in only 0.2% to 4% of all abdominal injuries, the morbidity and the mortality rates associated with pancreatic injuries remain high. The aim of this study was to evaluate the clinical outcomes of traumatic pancreatic injuries and to identify predictors of mortality and morbidity. Methods: We retrospectively reviewed the medical records of 26 consecutive patients with a pancreatic injury who underwent a laparotomy from January 2000 to December 2010. The data collected included demographic data, the mechanism of injury, the initial vital signs, the grade of pancreatic injury, the injury severity score (ISS), the revised trauma score (RTS), the Glasgow Coma Scale (GCS), the number of abbreviated injury scales (AIS), the number of associated injuries, the initial laboratory findings, the amount of blood transfusion, the type of operation, the mortality, the morbidity, and others. Results: The overall mortality rate in our series was 23.0%, and the morbidity rate was 76.9%. Twenty patients (76.9%) had associated injuries to either intra-abdominal organs or extra-abdominal organs. Two patients (7.7%) underwent external drainage, and 18 patients (69.3%) underwent a distal pancreatectomy. Pancreaticoduodenectomies were performed in 6 patients (23.0%). Three patients underwent a re-laparotomy due to anastomosis leakage or postoperative bleeding, and all patients died. The univariate analysis revealed 11 factors (amount of transfusion, AAST grade, re-laparotomy, associated duodenal injury, base excess, APACHE 11 score, type of operation, operation time, RTS, associated colon injury, GCS) to be significantly associated with mortality (p<0.05). Conclusion: Whenever a surgeon manages a patient with traumatic pancreatic injury, the surgeon needs to consider the predictive risk factors. And, if possible, the patient should undergo a proper and meticulous, less invasive surgical procedure.

A Time-series Study on Relationship between Visibility as an Indicator of Air Pollution and Daily Respiratory Mortality (대기오염 지표로서의 시정과 일별 호흡기계 사망간의 연관성에 관한 시계열적 연구)

  • Cho, Yong-Sung;Jung, Chang-Hoon;Son, Ji-Young;Chun, Young-Sin;Lee, Jong-Tae
    • Journal of Korean Society for Atmospheric Environment
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    • v.23 no.5
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    • pp.563-574
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    • 2007
  • There seems to be a consensus among most people that visibility impairment is the most obvious indicator of air pollution. While considerable evidence on the association between air pollution and health outcomes including death and disease have been established, based on industrial complex areas or huge urban cities, time-series, case-crossover and cohort studies, scarce literature exists on the direct evidence for the association between visibility and adverse health outcomes. Our study is assessed the effect of air pollution measured by visibility impairment on respiratory mortality over a period of six years. Relative risks in respiratory deaths were estimated by a Poisson regression model of daily deaths between $1999{\sim}2004$. Daily counts of respiratory deaths as dependent variable was modelled with daily 24-hr mean visibility measurements (kilometers) as independent variable by means of Poisson regression. This model is controlled for confounding factors such as day of weeks, weather variables, seasonal variables and $PM_{10}$. The results in this study is observed the statistically significant association between an inverse health effect and visibility during the study period for respiratory mortality (percentage change in the relative risk for all aged -0.57%, 95% Cl, $-1.01%{\sim}-0.12%$; for $0{\sim}15$ aged -7.12%, 95% Cl, $-13.29%{\sim}-0.51%$; for 65+ aged -0.43%, 95% Cl, $-0.93%{\sim}-0.06%$ per 1 km increased in visibility). The effect size was much reduced during warm season. Visibility impairment resulting from air pollution is strongly associated with respiratory mortality, especially for children may be spent at outdoor. Our result provides a quick and useful indicator for eliciting the contribution of air pollution to the excess risk of respiratory mortality in Seoul, Korea.

Mass Mortality of Adult Koi Carp(Cyprinus carpio) in the Early Winter by Aeromonas hydrophila Infection (초겨울 비단잉어에서 발생한 Aeromonas hydrophila에 의한 대량 폐사)

  • Park, Seong-Bin;Nho, Seong-Won;Jang, Ho-Bin;Cha, In-Seok;Dalvi, Rishikesh. S.;Kim, Young-Rim;Ha, Mi-Ae;Jung, Tae-Sung
    • Journal of Veterinary Clinics
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    • v.26 no.3
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    • pp.306-310
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    • 2009
  • Mass mortality was occurred in adult koi carp(Cyprinus carpio) at a private pond near Samchunpo city in the early November, 2007. Its water temperature was $11^{\circ}C$ and turbidity was very high. The fishes diseased were shown widely distributed hemorrhages, deep ulcerations on the whole body surface and severe erosions in the all fins. In necropsy, excess ascitic fluid was observed and spleen and kidney affected were enlarged. In microscopic observation, it was examined widely distributed severe dermal ulceration, multifocal gill lamella hyperplasia, severe fibrinous pericarditis, multifocal nephritis and hepatitis. The bacteria suspected were isolated using tryptone soya agar and identified as motile Aeromonas hydrophila as results of biochemical tests using API 20E and 20NE. According to previous reports, A. hydrophila infection were mainly occurred in fingerling at high temperature. However, this case exhibited that A. hydrophila infection can develop on adult koi carp even in the winter season.

SON PREFERENCE AND FAMILY BUILDING DURING FERTILITY TRANSITION (IMPLICATIONS ON CHILD SURVIVAL) (출산력 전환기의 남아선호와 출산형태)

  • Kim, Minja -Choe;Kim, Seung-Kwon
    • Korea journal of population studies
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    • v.21 no.1
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    • pp.184-228
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    • 1998
  • This study reviews the relationship between son preference and fertility behavior, and infant and chlid mortality in the context of fertility and mortality decline. In Korea the situation reveals that fertility can decline to a very low level even in the presence of strong son preference, but son preference has certain effects on fertility and childhood mortality. The effect of son preference on fertility increased as the level of fertility declined. Our findings show that son preference causes excess female childhood mortality both directly and indirectly through fertility. Also, in Korea, the analysis reveals that female children suffer excessively high level of mortality and part of the excess mortality is due to parents' behavior on family building related to the effort to secure the birth of a son.

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Characteristics on the Crytocaryon irritans of Rock bream, Oplegnathus fasciatus in the embankment fish farm (축제식양식장에서 사육한 돌돔, Oplegnathus fasciatus의 백점충, Crytocaryon irritans 감염 특성)

  • Choi, Hye-Sung;Bang, Jong-Duk;Park, Myoung-Ae
    • Journal of fish pathology
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    • v.23 no.3
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    • pp.281-291
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    • 2010
  • Crytocaryon irritans infection of rock bream was investigated in embankment fish farm from July to December 2009. Prevalence variation was 20.0~88.0% that was high in september and was low in July. While no mortality was found in July and August, it occurred after mid september. Environmental conditions during the survey period were water temperature $19.3{\sim}24.3^{\circ}C$, dissolved oxygen $5.0{\sim}7.1\;mg\;L^{-1}$ and salinity 31.9~33.7 psu, and the water temperature during mortality season was $24.0^{\circ}C$. External symptom of the rock bream was secretion mucus but swimming showed fine in the early infected period. While, the symptoms in the severe outbreak season were excess of mucus, falling off tail and congestion, bleeding spot the surface and weakened swimming. We observed free living and parasitic stages in the gills and body surface of rock bream. Hepato somatic index (HSI) was $1.9{\pm}1.1{\sim}3.5{\pm}1.7%$, which was low in the September being mortality season but was high in November. The percentages of hematocrit infected with Crytocaryon irritans were 37.3% and 41.0% in July and August, respectively while they gradually decreased to 32.1% and 24.2% in september and October, respectively. Total cholesterol and Triglyceride values rapidly decreased by October. After mortality, AST and ALT were 7 and 5 folds higher compared to non-mortality season.

Comparison of Clinical Characteristics and Prognosis by Initial Endoscopic Severity in Caustic Injury (부식제 음독 환자에서 초기 내시경 소견의 중증도에 따른 임상 소견 및 예후 비교)

  • Lee, Sang Min;Choi, Woo Ik;Kim, Sung Jin;Jin, Sang Chan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.2
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    • pp.87-94
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    • 2015
  • Purpose: We investigated comparison of clinical characteristics and prognosis by initial endoscopic severity in caustic injury and then discussed predisposing factors which can be helpful in predicting the prognosis and determining the treatment. Methods: This study was a retrospective review of medical records from patients over the age of 15, who underwent initial endoscopy for caustic injury from April 2007 through November 2014. Patients were classified according to two groups based on the initial endoscopic finding by Zargar's classification: patients with grade 0, I, IIa at esophagus (low risk group) and patients with grade IIb, IIIa, IIIb at esophagus (high risk group). The two groups were then compared. Results: A total of 55 patients were included (low risk group [n=44] vs. high risk group [n=11]). Old age (p<0.001), large amount of ingestion (p<0.05), oropharyngeal symptoms (p<0.01), high SOFA score (p<0.001), high WBC count (p<0.05), low base excess (p<0.01), and HCO3 (p<0.05) were statistically significant factors in the high risk group. A poor prognosis was observed for hospital stay (p<0.001), ICU admission (p<0.001), mortality (p<0.01), and stricture (p<0.001) in the high risk group. Conclusion: Clinical characteristics including age, amount of ingestion, oropharyngeal symptoms, SOFA score, WBC count, base excess, and $HCO_3$ can be helpful in the decision to undergo initial endoscopy and risk assessment by initial endoscopic severity can be helpful in predicting prognosis and determining the treatment plan.

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Early Predictive Values for Severe Rhabdomyolysis in Blunt Trauma

  • Park, Jung Yun;Kim, Myoung Jun;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.26-31
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    • 2019
  • Purpose: Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ${\geq}5,000$) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1-3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters. Methods: We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ${\geq}1,000U/L$ and ${\geq}5,000U/L$, respectively. The diagnosis of AKI was based on RIFLE criteria. Results: The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L. Conclusions: Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

Economic Assessment of Coal-fired & Nuclear Power Generation in the Year 2000 -Equal Health Hazard Risk Basis- (2000년대 원자력과 유연탄 화력 발전의 경제성 평가 -동일 보건 위험도 기준-)

  • Seong, Ki-Bong;Lee, Byong-Whi
    • Nuclear Engineering and Technology
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    • v.21 no.3
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    • pp.171-185
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    • 1989
  • On the basis of equal health hazard risk, economic assessment of nuclear was compared with that of coal for the expansion planning of electric power generation in the year 2000. In comparing health risks, the risk of coal was roughly ten times higher than that of nuclear according to various previous risk assessments of energy system. The zero risk condition can never be achievable. Therefore, only excess relative health risk of coal over nuclear was considered as social cost. The social cost of health risk was estimated by calculation of mortality and morbidity costs. Mortality cost was $250,000 and morbidity cost was $90,000 in the year 2000.(1986US$) Through Cost/Benefit Analysis, the optimal emission standards of coal-fired power generation were predicted. These were obtained at the point of least social cost for power generation. In the year 2000, the optimal emission standard of SOx was analyzed as 165ppm for coal-fired power plants in Korea. From this assessment, economic comparison of nuclear and coal in the year 2000 showed that nuclear would be more economical than coal, whereas uncertainty of future power generation cost of nuclear would be larger than that of coal.

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Evaluation of Health Impact of Heat Waves using Bio-Climatic impact Assessment System (BioCAS) at Building scale over the Seoul City Area (생명기후분석시스템(BioCAS)을 이용한 폭염 건강위험의 검증 - 서울시 건물규모를 중심으로 -)

  • Kim, Kyu Rang;Lee, Ji-Sun;Yi, Chaeyeon;Kim, Baek-Jo;Janicke, Britta;Holtmann, Achim;Scherer, Dieter
    • Journal of Environmental Impact Assessment
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    • v.25 no.6
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    • pp.514-524
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    • 2016
  • The Bio-Climatic impact Assessment System, BioCAS was utilized to produce analysis maps of daily maximum perceived temperature ($PT_{max}$) and excess mortality ($r_{EM}$) over the entire Seoul area on a heat wave event. The spatial resolution was 25 m and the Aug. 5, 2012 was the selected heat event date. The analyzed results were evaluated by comparing with observed health impact data - mortality and morbidity - during heat waves in 2004-2013 and 2006-2011,respectively. They were aggregated for 25 districts in Seoul. Spatial resolution of the comparison was equalized to district to match the lower data resolution of mortality and morbidity. Spatial maximum, minimum, average, and total of $PT_{max}$ and $r_{EM}$ were generated and correlated to the health impact data of mortality and morbidity. Correlation results show that the spatial averages of $PT_{max}$ and $r_{EM}$ were not able to explain the observed health impact. Instead, spatial minimum and maximum of $PT_{max}$ were correlated with mortality (r=0.53) and morbidity (r=0.42),respectively. Spatial maximum of $PT_{max}$, determined by building density, affected increasing morbidity at daytime by heat-related diseases such as sunstroke, whereas spatial minimum, determined by vegetation, affected decreasing mortality at nighttime by reducing heat stress. On the other hand, spatial maximum of $r_{EM}$ was correlated with morbidity (r=0.52) but not with mortality. It may have been affected by the limit of district-level irregularity such as difference in base-line heat vulnerability due to the age structure of the population. Areal distribution of the heat impact by local building and vegetation, such as spatial maximum and minimum, was more important than spatial mean. Such high resolution analyses are able to produce quantitative results in health impact and can also be used for economic analyses of localized urban development.