• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5253-5256
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• 2015

Background: A number of randomized trials addressing alternative operative and multimodality approaches to gastric cancer have characterized early postoperative morbidity and mortality rates. The aim of this study was to compare mortality and morbidity and disease free survival after D1 and D2 gastrectomy for adenocarcinomas of the stomach Materials and Methods: From June 2006 to January 2012, patients were selected according to information of the cancer administrator center of Ahvaz Jundishapur Medical University. The inclusion criteria were age between 20-85 years and histologically proven adenocarcinoma of the stomach without evidence of distant metastasis. Patients were excluded if they had previous or coexisting cancer or disability disease. In this research, D1 was compared to D2 gastrectomy. Results: 131 patients were randomised, 49 allocated to D1 and 82 to D2 gastrectomy. The two groups were comparable for age, sex, site of tumors, and type of resection performed. The overall post-operative morbidity rate was 17.5%. Complications developed in 14.2% of patients after D1 and in 19.5% of patients after D2 gastrectomy (p=0.07). Postoperative mortality rate was 0.8% (one death); it was 2% after D1 and 0% after D2 gastrectomy. In this research disease free-survival after 3 years was 71.2 % with 63.2% after D1 and 76.8% after D2 gasterctomy. Conclusions: This study indicates that D2 gastrectomy with pancreas preservation is not followed by significantly higher morbidity and mortality than D1 resection. Based on the results of present study, D2 resection should be recommended as the standard surgical approach for resectable gastric cancer.

• Journal of Korean Medical Science
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• 제33권52호
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• pp.335.1-335.17
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• 2018

Background: Spontaneous bacterial peritonitis (SBP) is a serious infectious complication in patients with liver cirrhosis. However, information about prognosis of SBP in hepatocellular carcinoma (HCC) patients is limited. We investigated the clinical course of SBP in HCC patients. Methods: This study enrolled patients diagnosed with SBP between 2005 and 2017. Medical records of patients were reviewed and clinical course was compared between the non-HCC and HCC groups. Results: In total, 123 SBP cases including 49 HCC cases were enrolled. Men were predominant (48/74, 64.9% vs. 34/49, 69.4%; P = 0.697); median age was 58 years in both non-HCC and HCC groups (P = 0.887). The most common etiology was alcohol (32/74, 43.2%) in non-HCC group and hepatitis B (30/49, 61.2%) in HCC group (P = 0.009). Antibiotic resistance rate was higher in non-HCC than in HCC group (29.7% vs. 12.2%; P = 0.028); in-hospital mortality did not differ between the groups (25/74, 33.8% vs. 13/49, 26.5%; P = 0.431). Development rate of hepatorenal syndrome did not differ between non-HCC and HCC group (14/74, 18.9% vs. 10/49, 20.4%; P = 1.000), but hepatic encephalopathy was less common in HCC group (26/74, 35.2% vs. 9/49, 18.3%; P = 0.008). The most important predictor of in-hospital mortality in patients with HCC was white blood cell count above $11,570cells/mm^3$ (odds ratio, 6.629; 95% confidence interval, 1.652-26.590; P = 0.008). Conclusion: Prognosis of SBP in HCC patients is relatively less severe. This result may be related with reduced antibiotics resistance and lower development rates of other complications, such as hepatic encephalopathy. Degree of systemic inflammation may be the most important factor for in-hospital mortality.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.99-103
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• 2013

Purpose: This hospital has operated a trauma system of the inclusive trauma system under the sponsorship of this hospital and with financial support from the government from 2011, and it has been designated as a specialized trauma center (candidate) since November 2008. Therefore, this emergency medical center evaluated the influence of the inclusive trauma system on the course of healing and on the results for trauma patients within the region. Methods: The medical records of all patients who were registered as trauma patients from among those who visited the emergency medical center of this hospital from April 2009 to May 2012 were retrospectively reviewed. The monthly and the annual averages of important indices, such as the time in the emergency room and preventable mortalities, were calculated, and patterns of change were sought. The preventable mortality rate was calculated by using the Trauma Injury Severity Score (TRISS) for each patient. Results: The total number of patients registered from April 2009 to May 2012 was 601, and male patients accounted for a larger proportion(432 males(71.88%) vs. 169 females(28.12%)). Their average age was 46.2 years, the average Revised Trauma Score (RTS) was 5.74 points, and the average Injury Severity Score (ISS) was 26.99 points. The preventable mortality rate during the entire period, which was calculated using the TRISS, appeared lower than the preventable mortality rates reported in past studies in the Republic of Korea. Conclusion: These results for the operation of a new trauma system are limited in that they are only for a local private university hospital. However, results show greater changes and developments in and out of the hospital due to multilateral endeavors by the trauma team and the hospital. These endeavors include increased communications among the departments and development of a complementary patient registration system.

• Safety and Health at Work
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• 제7권1호
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• pp.1-5
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• 2016

Background: Several studies have investigated the relationship between specific occupations and suicide mortality, as suicide rates differ by profession. The aim of this study was to investigate suicide mortality ratios across broad occupational groups in Greece for both sexes in the period 2000-2009. Methods: Data of suicide deaths were retrieved from the Hellenic Statistical Authority and comparative mortality ratios were calculated. Occupational classification was based on the International Classification of Occupations (ISCO-88) and the coding for Intentional self-harm (X60-X84) was based on the international classification of diseases (ICD-10). Results: Male dominant occupations, mainly armed forces, skilled farmers and elementary workers, and female high-skilled occupations were seen as high risk groups for suicide in a period of 10 years. The age-productive group of 30-39 years in Greek male elementary workers and the 50-59 age-productive group of Greek professional women proved to have the most elevated number of suicide deaths. Conclusion: Further research is needed into the work-related stressors of occupations with high suicide mortality risk and focused suicide prevention strategies should be applied within vulnerable working age populations.

• Journal of Chest Surgery
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• 제49권4호
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• pp.242-249
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• 2016

Background: We evaluated early and long-term results after heart transplantation (HTPL). Methods: One hundred five consecutive patients (male:female=80:25) who underwent HTPL between 1994 and 2013 were enrolled. Based on the changes in immunosuppressive regimen, the study patients were divided into two groups. Early and long-term clinical outcomes were evaluated and compared between the patients who underwent HTPL before (group E, n=41) and after July 2009 (group L, n=64). The group L patients were older (p<0.001), had higher incidence of hypertension (p=0.001) and chronic kidney disease (p<0.001), and more frequently needed preoperative mechanical ventilation (p=0.027) and mechanical circulatory support (p=0.014) than the group E patients. Results: Overall operative mortality was 3.8%, and postoperative morbidities included acute kidney injury (n=31), respiratory complications (n=16), reoperation for bleeding (n=15) and wound complications (n=10). There were no significant differences in early results except acute kidney injury between group E and group L patients. Overall survival rates at 1, 5, and 10 years were 83.8%, 67.7%, and 54.9%, respectively, with no significant difference between the two patient groups. Rejection-free rates at 1 and 5 years were 63.0% and 59.7%, respectively; rates were significantly higher in group L than in group E (p<0.001). Conclusion: Despite increased preoperative comorbidities, group L patients showed similar early and long-term outcomes and significantly higher rejection-free rates when compared with group E patients.

• Journal of Chest Surgery
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• 제51권5호
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• pp.322-327
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• 2018

Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

• Journal of Korean Neurosurgical Society
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• 제54권1호
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• pp.42-46
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• 2013

Objective : Despite several limitations, the Trauma Injury Severity Score (TRISS) is normally used to evaluate trauma systems. The aim of this study was to evaluate the preventable trauma death rate using the TRISS method in severe trauma patients with traumatic brain injury using our emergency department data. Methods : The use of the TRISS formula has been suggested to consider definitively preventable death (DP); the deaths occurred with a probability of survival (Ps) higher than 0.50 and possible preventable death (PP); the deaths occurred with a Ps between 0.50 and 0.25. Deaths in patients with a calculated Ps of less than 0.25 is considered as non-preventable death (NP). A retrospective case review of deaths attributed to mechanical trauma occurring between January 1, 2011 and December 31, 2011 was conducted. Results : A total of 565 consecutive severe trauma patients with ISS>15 or Revised Trauma Score<7 were admitted in our institute. We excluded a total of 24 patients from our analysis : 22 patients younger than 15 years, and 2 patients with burned injury. Of these, 221 patients with head injury were analyzed in the final study. One hundred eighty-two patients were in DP, 13 in PP and 24 in NP. The calculated predicted mortality rates were 11.13%, 59.04%, and 90.09%. The actual mortality rates were 12.64%, 61.547%, and 91.67%, respectively. Conclusion : Although it needs to make some improvements, the present study showed that TRISS performed well in predicting survival of traumatic brain injured patients. Also, TRISS is relatively exact and acceptable compared with actual data, as a simple and time-saving method.

• 대한간호학회지
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• 제9권2호
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• pp.73-83
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• 1979

The objectives of this study have been conducted to establish effective clinical teaching program to I.C.U in terms of proper assignment of the clients for the students, proper rotation schedule, priorities in critical nursing problems and selection of the teaching and learning. We have analyzed statistically 1,850 patients who have been admitted during a period from January 1977 to October 31 1979 in Ewha Woman's University Hospital. The results are as follows: 1. The proportion to the total inpatients number was 6.5% and mortality rate was 16.3%. 2. The average hospitalized days were 5.8 days in I.C.U and the total death was occured from 1 st hospital day to 5th hospital day. So it shows a certain difficulties for clinical experiences of the senior students in I.C.U. 3. In the age of the death, 41.3% of the patients were in the 41-60 year age group. It shows highest mortality rate in socially active and productive age groups. 4. The mortality rates of the departments of the medicine was 18.7%, general surgery 18.5%, and neurosurgery 14.7%. 5. The number of patients admitted to the department of neurosystem was 30.6%, cardiovascular system 22.6%, respiratory system 11.1 ％ and urinary system 2.9%. 6. On utilizing instruments and machine for diagnosis and client's assessment in I.C.U, they have utilized everything a usual. But they never utilize angiogram and cardiac catheterization in cardiovascular system, and retroperitoneal pneumography in the urologic system. Further more we would recommend as follows 1. In consideration of the average hospital days and the date of death, the rotation program for clincal experience need to be adjusted as continuing practice program in apposite to current alternative practice program for comprehensive nursing care. 2. Socioeconomic needs for the patient's families and himself should be emphasized by the students in addition to physical needs. 3. Course content for critical care might be built up in considering of core disease centered nursing problems. 4. The diagnostic procedures and client's assessment items which could not experience in our university hospital by the students might be considered and refilled as filled trips to another hospital and visual aids.

• 대한임상독성학회지
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• 제21권2호
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• pp.69-80
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• 2023

Purpose: Suicide ranks among the top causes of death among youth in South Korea. This study aimed to identify the characteristics of suicidal individuals treated at emergency departments between 2011 and 2020. Methods: A retrospective analysis was conducted using data from January 2011 to December 2020 in the Injury Surveillance Cohort, a prospective registry. Patients' sex, age, mortality, methods of self-harm, and previous suicide attempts were analyzed. The methods of self-harm were categorized into falls, asphyxiation, blunt injuries, penetrating injuries, poisoning, and others. Sub-groups with and without poisoning were compared. Results: The proportion of self-harm/suicide attempts increased from 2.3% (2011) to 5.0% (2020). The mortality rate decreased from 10.8% (2011) to 6.3% (2020). Poisoning was the most common method (61.7%). Mortality rates ranged from 42.0% for asphyxiation to 0.2% for blunt injuries. Individuals in their 20s showed a marked increase in suicide/self-harm attempts, especially in the last three years. A large proportion of decedents in their 70s or older (52.6%) used poisoning as a method of suicide. The percentage of individuals with two or more previous attempts rose from 7.1% (2011) to 19.7% (2020). The death rates by poisoning decreased from 7.7% (2011) to 2.5% (2020). Conclusion: Our findings underscore the urgent need for targeted interventions and suicide prevention policies. Managing and reducing suicide and self-harm in emergency settings will require a focus on poisoning, the 10-29 age group, and the elderly. This paper will be valuable for future policies aiming to reduce the societal burden of suicide and self-harm.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8455-8460
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• 2014

Background: The National Central Cancer Registry of China (NCCR) affiliated to the Bureau of Disease Control, National Health and Family Planning Commission of China is responsible for cancer surveillance in the entire country. Cancer registration data from each local registry located in each province are collected by NCCR annually to be analyzed and published to provide useful information for policy makers and cancer researchers. Materials and Methods: Until 1st June, 2013, 219 population-based cancer registries submitted data of 2010 to the National Central Cancer Registry of China covering about 207,229,403 population, and 145 cancer registries were selected after quality evaluation for this study. Colorectal cancer cases were selected from the database according to ICD-10 coded as "C18-C20". We calculated the crude incidence and mortality rates by sex, age groups and location (urban/rural). The China population in 2000 and Segi's population were used as standardized populations for the calculation of age-standardized rates. The 6th National Population Census data of China was used to combined with the cancer registries' data to estimate the colorectal cancer burden in China in 2010. Results: Colorectal cancer was the sixth most common cancer in China. It was estimated that there were 274,841 new cases diagnosed in 2010 (157,355 in males and 117,486 in females), with the crude incidence rate of 20.1/100,000, highest in males in urban areas. Age-standardized rates by China standard population of 2000 (ASRcn) and World standard population (Segi's population, ASRwld) for incidence were 16.1/100,000 and 15.9/100,000 respectively. There were 132,110 cases estimated to have died from colorectal cancer in China in 2010 (76,646 men and 55,464 women) with the crude mortality rate of 10.1/100,000. The ASRcn and ASRwld for mortality were 7.55/100,000 and 7.44/100,000 respectively, higher in males and urban areas than in females and rural areas. The incidence and mortality rates increased with age, reaching peaksin the 80-84 year old, and oldest age groups, respectively. Conclusions: Colorectal cancer is one of the most common incident cancers and cause of cancer death in China. Primary and secondary prevention, with attention to a health lifestyle, physical activity and screening should be enhanced in the general population.