• Title/Summary/Keyword: MORTALITY

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Concurrent Chemoradiation in Patients with Cancer of the Esophagus (식도암에서의 동시화학방사선요법)

  • Lee Kang Kyoo;Park Kyung Ran;Lee Jong Young;Shin Hyun Soo;Lee Chong In;Chang Woo Ick;Shim Young Hak
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.7-16
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    • 1998
  • Purpose : To evaluate survival rate and prognostic factors affecting survival of patients with esophageal cancer treated with concurrent chemoradiation. Materials and Methods : Eligibility included biopsy proven invasive carcinoma of the cervical or thoracic esophagus, confined to esophagus and mediastinum with or without regional lymph node and supraclavicular lymph node, and ECOG Performance status $H_0-H_2$. Patients received radiation therapy with 5940cGy over 7 weeks and chemotherapy, consisted of 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days, days 1 to 5 and days 29 to 33) and mitomycin C($8mg/m^2$ intravenous bolus at day 1). After concurrent chemoradiation, maintenance chemotherapy was followed with 5-FU(1000 $mg/m^2/day$ in continuous infusion for 5 days at 9th, 13th, and 17th weeks) and cisplatin($80mg/m^2$ intravenous bolus at the first day of each cycle). Results : From November 1989 to November 1995, 44 patients were entered in this study. After treatment, complete response rate and partial response rate were $59\%$ and $41\%$. Overall 1, 2, and 5-year survivals were $59\%$, $38\%$, and $9.6\%$(median 17 months), Prognostic factors affecting survival were response to treatment and T-stage. Among 26 complete responders, there were 6 local recurrences, 3 distant recurrences, 1 local and distant recurrence, and 2 unknown site recurrences Acute and chronic complication rates with grade 3 or more were $20\%$ and $13.0\%$ and there was no treatment-related mortality. Conclusion : Concurrent chemoradiation, compared with historical control groups that treated with radiation alone, improved median survival and did not significantly increase treatment-related complications. Complete responders had longer survival duration than partial responders. Predominant failure pattern was local failure. So, efforts to improve local control should be proposed.

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Accuracy of the Registered Cause of Death in a County and its Related Factors (일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인)

  • Shin, Hee-Young;Shin, Jun-Ho;Nam, Hae-Sung;Ryu, So-Yeon;Im, Jeong-Soo;Rhee, Jung-Ae;Chung, Eun-Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.153-159
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    • 2002
  • Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.

A Clinical Study of Renal Abscesses in Children (소아 신농양의 임상적 고찰)

  • Hwang You-Sik;Rhie Young-Jun;Ahn Sun-Young;Han Sang-Won;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.64-68
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    • 2005
  • Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

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Perinatal outcomes according To chorionicity in Twin Gestations (쌍생아 임신의 융모막과 주산기 결과)

  • Choi, Eun-Jin;Yun, Hyun-Jin;Hyh, Jae-Won;Hong, Yong-Hong
    • Neonatal Medicine
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    • v.15 no.1
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    • pp.67-74
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    • 2008
  • Purpose : The purpose of this study was to assess the natural history and perinatal outcomes of twin gestations according to chorionicity. Methods : We retrospectively reviewed the medical records of 99 monochorionic (MC) and 206 dichorionic (DC) twin gestations delivered at Il Sin Christian Hospital in Busan between January 2002 and December 2007. The incidences of twin-to-twin transfusion syndrome (TTS) and selective intrauterine growth restriction (sIUGR), as well as perinatal morbidity and mortality, were evaluated. Results : MC twins had a lower gestational age (35.7 vs. 36.6 weeks, P=0.03) at birth and a higher incidence of intrauterine fetal loss (10% vs. 1.5%, P<0.001) than DC twins. The incidence of intrauterine fetal loss was higher in MC sIUGR than in DC sIUGR (19% vs. 2.5%, P=0.025) twins. The number of admissions to the neonatal intensive care unit (NICU; 31% vs. 16%, P=0.042), and the incidence of periventricular leukomalacia (7% vs. 0%, P=0.031), and respiratory distress syndrome with surfactant treatment (27% vs. 11%, P=0.049) were higher in MC than DC twins. The incidences of sIUGR and TTS were 21 and 9% among the MC twins. The incidences of intrauterine fetal loss were higher in MC twins with TTS [6 of 9 (67%)] or sIUGR [4 of 21 (19%)] than uncomplicated MC twins (P<0.001). The frequency of admission to the NICU (P=0.001), the length of hospital stay (P=0.033), the prevalence of periventricular leukomalacia (P=0.011), and intraventricular hemorrhage (P=0.007) were also higher in MC with TTS or sIUGR than in uncomplicated MC twins. Conclusion : The incidence of neonatal complications was higher in MC twins, especially those gestations complicated by TTS or sIUGR.

Comparison of Weekly and Batch Management System for Sows (모돈의 주간관리와 그룹관리 비교)

  • Jang, Young-Dal;Ju, Won-Seok;Long, Hong-Feng;Piao, Long-Guo;Jang, Sung-Kwon;Chung, Chung-Soo;Kim, Yoo-Yong
    • Journal of Animal Environmental Science
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    • v.15 no.2
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    • pp.171-182
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    • 2009
  • Conventionally, many pig producers have utilized a continual sow managements system that the matings, farrowings and weanings are done weekly basis. But this transitional method is not able to cut the cycle of diseases and fully apply all-in/all-out system because of the continuous flow of sows and pigs. Conventional weekly management system is currently limiting in small farm to work efficiently both for workers and pigs. Therefore, pig producers have found novel management methods for applying all-in/all-out system, improving pig health, leading to better growth, lowering mortality and reducing medication costs nowadays. Moreover, all-in/all-out pig management system has known as a strategy for improving productivity in swine farm. The batch system is one of the best management methods to adopt all-in/all-out pig management system that prevent spreading diseases in pig and remove cycle of diseases. Batch farrowing system is a concept for providing a group of sows that delivery within a specific farrowing interval and inducing a large enough scale of piglets to fill the weaner facilities. There are different types of batch farrowing system with batch size and interval of farrowing when several factors at the swine farm are considered such as total number of sows, available facilities in the farm, and the efficiency of workforce. Sow managements such as farrowing, weaning and breeding, every 3 weeks rather than weekly, 2 or 5-week interval have advantages for workers and reproductive cycle of sows as well as pig flow. Because there are several pros and cons both in weekly and batch management system, various factors should be considered to apply the most suitable management system in each individual farm. To improve poor swine productivity in Korea compared to ED, batch system for sows will be an alternative choice which is able to prevent high incidence of diseases in swine farm such as PMWS, PRRS, PRDC and PED because all-in/all-out pig management can be also applied automatically by using this management system.

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Gene analysis of galectin-1, innate immune response gene, in olive flounder Paralichthys olivaceus at different developmental stage (넙치, Paralichthys olivaceus 발생단계별 galectin-1 유전자의 발현 분석)

  • Jang, Min Seok;Lee, Young Mee;Yang, Hyun;Lee, Jeong-Ho;Noh, Jae Koo;Kim, Hyun Chul;Park, Choul-Ji;Park, Jong-Won;Hwang, In Joon;Kim, Sung Yeon
    • Journal of fish pathology
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    • v.26 no.3
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    • pp.255-263
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    • 2013
  • The innate immune response is fundamental defense response of vertebrates and invertebrates. Especially, the innate immune response important for larvae that lack of resistance to infectious diseases in the early stages. Galectin is one of the kinds of lectin and presents in the fish mucous that involves innate immune response. Galectin have been studied from various fishing species, but expression analysis of galectin is still unclear during early developmental stage in olive flounder. In this study, we investigated gene expression of galectin-1 from various developmental stage and tissues. We excised several tissues including the muscle, fin, eye, gill, brain, stomach, intestine, kidney, spleen and liver from adult olive flounder and confirmed gene expression of galectin-1 using RT-PCR and quantitative real-time PCR. Expression of galectin-1 was significantly higher in muscle, stomach and intestinal tissue than other tissue in adult fish (5 and 29 months). Also, galectin-1 gene was detected from 0 DAH and gradually increased to 35 DAH and since then decreased after stomach development period. Induction of galectin-1 during the early developmental stage suggest that muscle, fin and eye tissue is formed and begins the secretion of galectin this period. In addition, increased expression levels at 35 DAH suggest that due to complete formation of stomach and intestine, increase of secretion and activation of enzyme. This study shows that expression of galectin-1 during early developmental stages and adult period in olive flounder and can be expect that galectin-1 play essental role in the innate immune system throughout the whole life time. Galectin-1 is primary barrier such as skin and digestive tissue against pathogen infection, also digestive tract developmental period is important for pathogen invasion can be expected that it will serve. Mass mortality due to the disease in seed production is continuing damage, therefore these result will be meaningful about infectious disease during early developmental stages as a basic data for the study.

Reduction of dissolved hydrogen sulfide and mortality of white leg shrimp, Litopenaeus vannamei by Bacillus spp. microorganisms (Bacillus속 미생물의 용존황화수소 저감효과와 흰다리새우(Litopenaeus vannamei)에의 영향)

  • Choi, Jun-Ho;Lee, Ji-Hoon;Park, Jung-Jin;Lee, Min-Sun;Bae, Jun-Sung;Shin, Dong-Hun;Park, Kwan Ha
    • Journal of fish pathology
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    • v.31 no.1
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    • pp.41-48
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    • 2018
  • The utility of Bacillus spp. organisms for reduction of dissolved hydrogen sulfide ($H_2S$) in white leg shrimp (Litopenaeus vannamei) culture was tested with different combinations of Bacillus spp. microorganisms: combination A (B. subtilis + B. licheniformis); combination B (B. licheniformis + B. amyloliquefaciens); combination C (B. subtilis + B. licheniformis + B. amyloliquefaciens). Of these 3 combinations, C was effective in few hours after addition whereas B needed longer time to be effective. The $H_2S-reducing$ effect of combination C was dependent on the amount of microorganisms added to $H_2S-containing$ test solution. Exposure of white leg shrimp to $H_2S$ at 8 mg/L for 7 days led to survival of 80% and 1 mg/L for 14 days it was 82.5%. The survival rate was 97.5% when combination C was simultaneously added to shrimp tanks during $H_2S$ exposure at 1 mg/L for 14 days. It was demonstrated that combination C microorganisms (B. subtilis + B. licheniformis + B. amyloliquefaciens) can reduce dissolved $H_2S$ concentrations, and this effect can be utilized to protect white leg shrimp from $H_2S$ toxicity.

Effects of Supplementation of Macsumsuk and Herb Resources on Growth Performances and Meat Quality of Broiler Chickens (맥섬석과 한방제재의 첨가급여가 육계의 성장과 육질에 미치는 영향)

  • Kim, Byung-Ki;Jung, Dae-Jin;Hwang, Eun-Gyeong;Choi, Chang-Bon
    • Food Science of Animal Resources
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    • v.32 no.4
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    • pp.512-519
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    • 2012
  • The current study was conducted to investigate the effect of macsumsuk and herb resources on the performances and meat quality of broiler chickens. Six hundreds (600) broiler chickens were randomly allocated into four groups (4 groups${\times}$50 chickens/group${\times}$3 replica), Control, Treatment 1 (T1; 0.3% macsumsuk), Treatment 2 (T2; 0.3% herb resources), and Treatment 3 (T3; 0.3% macsumsuk + 0.3% herb resources) and fed for 5 wk. T2 group showed higher total body weight gain and average daily gain of 1,812.5 g and 51.79 g, respectively, than the other groups. Control group showed the highest (p<0.05) mortality (8%) and total blood cholesterol (111.8 mg/dL) among experimental groups. T3 group (6.71 mg/dL) showed the highest (p<0.05) while control group (4.50 mg/dL) showed the lowest (p<0.05) in blood IgG levels. Cooking loss was 17.08, 16.14, 16.55, and 15.25%, shear force value was 1.91, 1.52, 1.55, and 1.47 $kg/cm^2$, and water holding capacity (WHC) was 54.40, 55.97, 56.01, and 55.70% for Control, T1, T2, and T3, respectively. Cholesterol contents in breast meat of Control (88.91 mg/100 g) chickens showed the highest (p<0.05) levels comparing to either T1 (83.59 mg/dL), T2 (82.41 mg/dL), or T3 (80.81 mg/dL) chickens. In conclusion, the current study implies that feeding macsumsuk and herb resources to broiler chickens could decrease cholesterol contents in breast meat.

Womans experience of Risk Situation on the High-Risk Pregnancy (여성의 고위험 임신에 대한 경험)

  • Kim, Kyung-Won;Lee, Kyung-Hye
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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Mulberry leaf yield and optimal amount of silkworms rearing in different mulberry cultivars for mulberry fruit production (오디 생산용 뽕나무 품종별 뽕잎 생산량 및 적정 누에 사육량)

  • Lim, Ju Rak;Moon, Hyung Cheol;Kwon, Suk Ju;Kim, Dong Wan;Kwak, Dong Ok
    • Journal of Sericultural and Entomological Science
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    • v.53 no.2
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    • pp.82-86
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    • 2015
  • This study was carried out to develop the silkworm rearing technique in unused mulberry leaves after harvesting mulberry fruit. The growth of Gwasang No. 2 and Suhyang was very good compared to control cultivar Chungil in leaves size and new branch growth, but new branch and leaves of Daeshim was similar or small to control cultivar Chungil. The number of leaves of Gwasang No. 2 and Suhyang was lower than Chungil, but weight of leaves per tree was heavyer than Chungil. Mulberry leaf yield was Gwasang No. 2 521 kg/10a, Suhyang 189 kg/10a, Daeshim 73 kg/10a, Chungil 1,095 kg/10a. Content of mineral element of all three mulberry cultivars leaf for mulberry fruit production was higher than Chungil in N, P, K, Ca etc. Feeding quantity of silkworm of Gwasang No. 2 and Suhyang was much more than Chungil. Feeding quantity was highest at Suhyang in 96 kg/box. Growth duration of silkworm larvae was not different in all four mulberry culivars but weight of silkworms (5th instar 3rd day) was heavy at Gwasang No. 2 (2.07 g/head) and Suhyang (2.11 g/head) compared to control cultivar Chungil (1.92 g/head). Mortality of silkworms was 14.6% (Gwasang No. 2), 13.3% (Suhyang), 13.9% (Daesim), 12.6% (Chungil) and than higher at elder instar stage. The production amount of silkworm (5th instar 3rd day) was 35.4 kg/box (Gwasang No. 2), 36.6 kg/box (Suhyang), 35.0 kg/box (Daeshim), 33.6 kg/ box (Chungil). Amount of possible rearing silkworms was estimated 3.4box/10 a (Gwasang No. 2), 1.3box/10a (Suhyang), 0.5box/10a (Daeshim), 8.7box/10a (Chungil).