• Title/Summary/Keyword: MORTALITY

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A Study for Investigating of Predictors of Compliance for Preventive Health Behavior. -centered on early detection of cervical cancer- (예방적 건강행위 이행의 예측인자 발견을 위한 연구-자궁암 조기발견을 중심으로-)

  • 이종경
    • Journal of Korean Academy of Nursing
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    • v.12 no.1
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    • pp.25-38
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    • 1982
  • As technological civilization and medical science has developed, standards of living have imp-roved and human life expectancy has been extended. But the incidence and mortality rate of cancer have been gradually increasing due to the pollution of the environment. Even though cancer is still a great threat to human beings, the etiology and appropriate cure forcancerhavenotyetbeendiscovered. The early detection and treatment of cancer is urgently needed. This study concentrates on the health behavior of woman regarding the papanicolau smear for early detection of cervical cancer. It was done in order to provide a direction for scientific health education materials by investigating predictors of preventive health behavior. The subjects for this study were made up of 54 woman, who comply with preventive health practices(compliant) who attended the Cervical Cancer Center of Y University Hospital in order to have tests for early detection of cervical cancer and 54 woman who did not comply with preventive health practices (noncompliant) selected from 100 housewives of I apartment, Kang Nam Ku, Seoul. The study method used, was a questionnaire for the compliance group and an interview for the noncompliance group. The period for data collection was from October 13th to October 24th. 1981. Analysis of the data was done using percentages, T-test, Pearson Correlation and Stepwise Multiple Regression. The results of study were as follows: 1. The hypotheses tested were based on the health belief model; 1) The first hypothesis,“The compliant may have more knowledge of the cervical cancer than the noncompliant”was rejected(T=-1.86, p>.05) 2) The second hypothesis,“The compliant may have a higher severity of cervical cancer than the noncompliant”was accepted (T=5.41, p<.001) 3) The third hypothesis, “The compliant may have a higher susceptability to cervical cancer than the noncompliant”was accepted(T=3.51, p<.01). 4) The fourth hypothesis,“The compliant may have more beneHt than cost'from the cervical cancer tests than the noncompliant" was accepted(T=7.46, p<.001). 5) The fifth hypothesis,“The compliant may have more health concern than the noncompliant”. was accepted(T=3.39, p<.01). These results show that severity, susceptability, benefit(over cost) and health concern influence the preventive health behavior in this Study. 2. In the correlation among variables, it was found that the knowledge of cervical cancer and the benefit(over cost) of preventive health behavior were negatively correlated(r=-2.75, p<.01), Severity of cervical cancer and benefit (over cost) of preventive health behavior were positively correlated(r=.280, p<.01), severity and susceptability of cervical cancer were positively correlated(r= .238, p<.01), benefit(over cost) and health concern were positively correlated(r= .299, p<.01). The benefit(over cost) may be raised by increasing the severity and health concern. Therefore the compliance rate of woman may be raised through health education by increasing the benefit(over cost) of the individual. 3. The Stepwise Multiple Regression between health behavior and predictors. 1) The factor“Benefit(over cost)”could account for preventive health behavior in 34.4% of the sample(F=55.6204 P<.01). 2) When the factor“Severity”is added to this, it accounts for 44.3% of preventive health behavior(F=41.679, p<.01). 3) When the factor“Susceptability”is also included, it accounts for 46.7% of preventive health behavior(F=30.373, p<.01). 4) When the factor “Health concern”is included, it accounts for 48.1% of preventive health behavior(F=23859, p<.05). This means that other factors appear to influence preventive health behavior, since the combination of variables explains only 48.1% of the Preventive health behavior. Therefore further study to investigate the predictors of preventive health behavior is necessary.

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Effects of Single Fetal Death on Mother and Live Co-twin in Twin Pregnancy (쌍태 임신에서 일측 태아의 자궁내 사망이 산모와 생존아에 미치는 영향)

  • Kim, So Youn;Chung, Hae Yul;Back, Hee Jo;Choi, Ic Sun;Cho, Chang Yee;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.45 no.12
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    • pp.1512-1518
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    • 2002
  • Purpose : Twins have a higher mortality and morbidity than singletons. Co-twin with one fetal death is particularly at risk. We investigated the neonatal outcome of live co-twins when one fetus had died after the 20th gestational week, and associated risk factors. Methods : A retrospective study was performed in fifteen cases of twin pregnancy with single intrauterine fetal deaths after the 20th gestational week during the period from January 1996 to December 2000 at Chonnam University Hospital. Results : Gestational age was $33.7{\pm}3.2weeks$, birth weight was $1,992{\pm}592g$. Interval between one fetal death being detected and the delivery of a live co-twin was $32.4{\pm}29.5days$. There were 11 cases(73.3%) of premature babies less than 37 gestational weeks. Main causes of preterm delivery were preterm labor and premature rupture of membranes. Hematologic findings suggesting disseminated intravascular coagulopathy(DIC) were not found in all mothers before delivery, and was not associated with DIC and encephalomalacia of the live co-twin. Perinatal outcome of fifteen live co-twins was as follows : six were normal(40%), three were DIC(20.0%), three were encephalomalacia(20.0%), one suffered intrauterine growth retardation, there was one case of twin to twin transfusion syndrome, and one of congenital heart disease(atrial septal defect with pulmonary stenosis). The occurrence of DIC and encephalomalacia in live co-twins was not related to placental chorionicity, birth weight, gestational week, and the interval between the detection one fetal death and the delivery of a live co-twin. Conclusion : We could not find any maternal hematologic problems in twin pregnancies complicated by one fetal death. Twenty percent of live co-twins showed DIC and encephalomalacia. However, its associated risk factors were not found. We need to investigate more closely the cases of live co-twins with one intrauterine fetal death.

The Effect of Postnatal Dexamethasone Treatment on Hypoxic-Ischemic Brain Injury in Neonatal Rats (신생쥐의 저산소성 허혈성 뇌손상에서 손상 후 덱사메타손의 투여 효과)

  • Park, Chang Ro;Park, Kyung Pil;Kim, Heng Mi;Sohn, Yoon Kyung
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.989-995
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    • 2003
  • Purpose : Dexamethasone is frequently administered to prevent or treat chronic lung disease in human neonates who are also prone to hypoxic-ischemic(HI) insults. Recently, meta-analysis of the follow-up studies reveals a significantly increased odd ratio for the occurrence of cerebral palsy or an abnormal neurologic outcome, and there is conflicting evidence regarding the impact of dexamethasone exposure on HI brain injury. This study was conducted to explore the effect of post-HI dexamethasone administration on neuronal injury in neonatal rats. Methods : HI was produced in seven-day-old rats by right carotid artery ligation followed by two hours of 8% oxygen exposure. At the end of HI, the animals were injected intraperitoneally either with dexamethasone(0.5 mg/kg) or saline. Neuronal injury was assessed seven days after the HI by the area of infarction, TUNEL reactivity, Bcl-2 and Bax expression in brain. Results : Post-insult dexamethasone administration resulted in reduction of weight gain and a higher mortality rate during seven days after HI. Dexamethasone treatment revealed no effect on the size of brain infarction induced by HI. Bax protein expression increased in dexamethasone treated brain but Bcl-2 protein expression and TUNEL reactivity revealed no significant differences between dexamethasone treated and non treated brain. Increased Bax protein expression suggest upregulation of the apoptosis by dexamethasone. Conclusion : The result suggests the adverse role of Post-HI administration of dexamethasone in neonatal HI.

A Five-year Epidemiologic Study of Childhood Leukemia in Busan City, 1996 to 2000 (최근 5년간(1996-2000) 부산지역 소아 백혈병 환자에 대한 역학적 연구)

  • Moon, Jae Hoon;Lee, Soon Yong;Sinn, Jong Beom;Park, Jae Sun;Lee, Young Ho;Lim, Young Tak;Park, Su Eun
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.972-976
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    • 2003
  • Purpose : For the control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. The authors analyzed the data from 133 new patients with childhood leukemia between 1996-2000 in Busan, Korea. Methods : The data were obtained from 133 new cases(87 males and 46 females from 0 to 15 years old) of childhood leukemia who were residents of Busan and who were admitted to the 4 university hospitals and 11 general hospitals from 1996 to 2000. Results : The total number of the new childhood leukemia patients was 133 between 1996-2000; the average annual number of new patients was 26.6. The age-and-sex adjusted annual incidence rate (/100,000) was in the range of 2.37-4.53(male 2.47-5.29, female 0.76-3.36) with an average of 3.29 (male 4.05, female 2.43). Age-specific annual incidence rate(/100,000) was 3.78 in the 0-4 year age group, 3.51 in the 5-9 year age group and 3.08 in the 10-14 year age group. Of the major types of childhood leukemia, the distribution of ALL was average 71.4%, of AML 23.3%, and of CML 4.5%. Of the major types of leukemia by age range, ALL showed highest in the 5-9 year age group, while AML in 0-4 and 10-14 year age groups. Sex-ratio(male to female) of major type of leukemia was 1.97 : 1 and 1.21 : 1, in ALL and AML groups, respectively, while all were male in CML. Conclusion : The average age-and-sex adjusted annual incidence rate(/100,000) of childhood leukemia in Busan from 1996 to 2000 was 3.29. Compared to data in related articles, this data suggests a steady increase in the incidence of childhood leukemia in the Busan area over the last 20 years since 1981.

Investigations on Daily Life and Consciousness of Longevous People in Korea -IV. On the Familial Organization the Marriage Life of Longevous People in the Past- (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) -IV. 장수자(長壽者)의 과거(過去) 가족상황(家族狀況)과 부부생활(夫婦生活)-)

  • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok;Kim, Mu-Nam
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.15 no.4
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    • pp.64-71
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    • 1986
  • The present study was conducted as a part of the research on the investigation on daily life and consciousness of the longevous people in Korea. Surveys were carried out on their familial organization and the marriage life of longevous people in order to achieve the purpose of the research. The materials for 121 males and 258 females aged more than 80 were collected and analyzed from June to November 1985. The results are summarized as follows: 1. As for parents' mortality age of longevous people, 49.5% of them showed 'both above 70'(20.3%) and/or 'either father or mother above 70' (29.2%). Consequently, a significant difference was found between tile life span and inherent factor. 2. By the birth order of longevous people, '1st' had the highest figure of 41.2%. and decreased in the order of '2nd'(25.1%) and '3rd'(13.7%). It was observed that the more the birth order of longevous people preceded, the more life span of the aged increased. 3. Three to five persons in the number of brother3 and sisters comprised 57.6% of total longevous people surveyed. while 63.9% of them were revealed to have three to six in the number of offsprings.

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Biological activity of shizukanols isolated from Chloranthus japonicus roots (홀아비꽃대(Chloranthus japonicus) 뿌리로부터 분리한 shizukanol들의 생물활성)

  • Park, Mi-Ran;Kim, Hae-Young;Choi, Gyung-Ja;Lee, Seon-Woo;Jang, Kyoung-Soo;Kim, Jin-Seog;Hong, Kyung-Sik;Park, No-Joong;Cho, Kwang-Yun;Kim, Jin-Cheol
    • The Korean Journal of Pesticide Science
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    • v.8 no.4
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    • pp.338-346
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    • 2004
  • The methanol extract of Chloranthus japonicus roots effectively controlled the development of rice blast(Magnaporthe grisea), rice sheath blight(Corticium sasaki), tomato pay mold(Btrytis cinerea), tomato late blight(Phytophthora infestans), and wheat leaf rust(Puccinia recondita). From the methanol extract of C. japonicus roots, three antifungal substances were isolated. Their chemical structures were determined to be shizukanols B, C, and D mainly by mass and NMR spectral data. Among the three substances, shizukanol C showed the strongest inhibitory activity against mycelial growth of the plant pathogenic fungi tested; it completely inhibited mycelial growth of M. grisea. Colletotrichum gloeosporioides, and C. acutatum at concentrations of more than $12.5{\mu}g$/ and P. infestans at concentrations of more than $3.13{\mu}g/m\ell$. They also controlled effectively the development of rice blast and wheat leaf rust. On the other hand, they caused phytotoxic symptoms on barley leaves and inhibited the growth of duckweed (Lemna paucicostata) with $EC_{50}$ values of $30.0{\mu}g/m\ell$ for shizukanol B, $49.9{\mu}g/m\ell$ for shizukanol C, and $154{\mu}g/m\ell$ for shizukanol D. In addition, shizukanol C showed an insecticidal activity against brown planthopper (Nilaparavata lugens), peen peach aphid (Myzus persicae), diamond-back moth (Plutella xylostella), and tobacco cutworm (Spodoptera litura) of the 5 arthropod pests tested with mortality values of more than 60% at a concentration of $1,000{\mu}g/m\ell$.

Toxicity Test of Carbosulfan and Phenthoate on Killifish (Carbosulfan과 Phenthoate의 송사리(Oryzias latipes, Medaka)에 대한 독성시험)

  • Bae, Chul-Han;Lee, Jeong-Seok;Cho, Kyung-Won;Park, Hyun-Ju;Cho, Dong-Hun;Shin, Kwan-Seop;Jung, Chang-Kook;Park, Yeon-Ki
    • The Korean Journal of Pesticide Science
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    • v.8 no.4
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    • pp.309-318
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    • 2004
  • Acute toxicity test and chronic toxicity test were conducted with killifish (Oryzias latipes, Medaka) to evaluate toxicity effect of pesticides. Acute toxicity test was investigated mortality in 48 hours and 96 hours after treatment, chronic toxicity test was examined with the early life stage of 30 days after hatching be started embryos of Medaka. The test substances were two pesticides, Carbosulfan and Phenthoate, applied to the paddy rice plant and well-known to the high fish toxicity. As the result of acute toxicity test, median concentration $(LC_{50})$ at 96 hours in Medata was Carbosulfan 0.102 mg/L and Phenthoate 0.167 mg/L, and Fish early life stage toxicity test was conducted on basis of the result of acute toxicity test and concluded from the investigation of hatching success, period of hatching, survival post hatching, length and weight of surviving fishes and abnormal fish. The results of early life stage toxicity test were represented by no observed effect concentration (NOEC), lowest observed effect concentration (LOEC) and maximum acceptable toxicant concentration (MATC). NOEC was Carbosulfan 0.0067ppm and Phenthoate 0.011ppm, LOEC of PCP-Na, Carbosulfan and Phenthoate were 0.017ppm and 0.029ppm, MATC of Carbosulfan and Phenthoate were 0.011ppm and 0.018ppm. These studies will be expected to supply more varied chronic toxicity effects at lower concentration than acute toxicity test. Therefore, evaluation data will be more realistic and the risk assessment of pesticide will be leveled up.

Clinical Features of Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Seo, Jung-Ho;Kim, Seong-Heon;Jeong, Sang-Geon;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.58-65
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    • 2010
  • Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

Comparison of Amphotericin B and Itraconazole as Empirical Antifungal Therapy in Children with Acute Leukemia with Neutropenic Fever (발열을 동반한 호중구감소 상태의 급성백혈병 환아에서 경험적 항진균제로 투여한 Amphotericin B와 Itraconazole의 효과와 이상 반응 비교)

  • Lee, Sang-Yun;Park, Jong-Sun;Kim, Sun-Young;Yang, Keum-Jin;Park, Kyung-Deok;Kim, Hack-Ki
    • Pediatric Infection and Vaccine
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    • v.12 no.1
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    • pp.75-85
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    • 2005
  • Purpose : Fungal infection is one of the important causes of morbidity and mortality in patients with hematologic malignancies. Amphotericin B(ABV) and itraconazole(ITZA) have been used as the standard empirical antifungal therapy in neutropenic patients with acute leukemia who have persistent fever that does not respond to antibiotic therapy. ABV is an antifungal drug associated with side effects such as fever and chills, symptoms which may be mediated by pro-inflammatory cytokines such as interleukin-$1{\beta}$(IL-$1{\beta}$) and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$). We assessed modulation of these pro-inflammatory cytokines as well as the anti-inflammatory cytokines(IL-4, IL-1Ra) by ABV and ITZA. Methods : From March 2004 to February 2005, a total of 30 episodes from acute leukemia patients with febrile neutropenia were analyzed for this study. They were randomly allocated to receive intravenous ABV or ITZA for 14 days. Clinical responses were evaluated at the completion of therapy, and cytokine IL-$1{\beta}$, TNF-${\alpha}$, IL-4, and IL-1Ra were measured for determination to know the correlation between two antifungal agents and inflammatory cytokines. Results : Empirical antifungal agents were given to 37 patients(ABV 20, ITZA 17), and 30 patients(ABV 15, ITZA 15) were evaluable for efficacy. White blood cell and absolute neutrophil count in the group treated with ITZA increased early days of treatment, so the duration of neutropenia in ITZA group is shorter. Serum creatinine level is lower in ITZA group than in ABV group but this is not statistically significant. There was no significant difference in response rate between two groups. The IL-$1{\beta}$ was increased in ABV treatment group and the ratio of IL-1Ra/IL-$1{\beta}$ is markedly decreased in ABV treatment group while increased in ITZA group. Conclusion : ITZA and ABV have at least equivalent efficacy as empirical antifungal therapy in neutropenic children with acute leukemia. However ITZA is associated with significantly less toxicity in clinical and molecular aspects.

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A Basie Health Survey of the Yonsei Community Health Service Area, Seoul (연세지역(延世地域)에 대(對)한 보건기초조사(保健基礎調査))

  • Yang, Jae-Mo;Kim, Myung-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.1 no.1
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    • pp.25-36
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    • 1968
  • Introduction In order to improve medical education through the introduction of a concept of comprehensive health care of a community, an area surrounding the University Campus was chosen for the Community Health Service Project. It has been on operation for last 4 years with its major emphasis on family planning services, and maternal and child health care. The major objectives of this survey at the area are to obtain: 1) The demographic data, 2) The health need and trend of medical care, 3) The attitude and practice in maternity care to be used for further improvement of the planning and the services of the project. Population and Survey Method Out of three Dongs of the Community Health Service Area, only two Dongs namely Changchun and Yonhee were selected for the survey. Total number of households and population in the area studied was 3,683 and 21,857 respectively. An interview was performed with questionnaire schedule which was recorded by interviewers. This includes the degree of utilization of health services provided by the Community Health Service Program such as family planning, prenatal care during their last pregnancy, delivery history and complications of the delivery as well as the incidence of illnesses in general. Prior to the interview, all interviewers were trained for interviewing technique for two days. The survey was carried out during the period from October December 1967. Results 1) Demographic Data : 41.3% of the population studied were children under age 15 and only 3.5% were over 60 years of age. Crude birth rate and crude death rate of this area studied during the period of November 1966-October 1967 were 20.5 and 7.7 respectively. Infant mortality rate during the same period was 35.9. 50.4% of the 2,832 households fell into the category of middle class, 39.8% to the lower class and 9.5% to the upper class in economic condition. 19.8% of 2,832 householders had no formal education, 22.7% primary school, and 57.5% middle or higher school education. 2) Health Status and Utilization of the Community Health Service: Those who suffered from many illnesses during the month of October, 1967 were 690(4.6% of 14,891 persons). Classification of these patients into the type of disease shown respiratory diseases 27.4%, gastrointestinal diseases 18.1%, tuberculosis 10.9%, skin and genitourethral diseases 4.5% and gynecologic patients 4.5%. Only 55.9% of the patients received medical care at hospital or doctor's clinic. But among TB and gynecologic patients, 70.7% and 72.4% were treated at medical facilities. 10.6% of 2,832 householders interviewed has ever utilized the Community Health Service Program provided by the Yonsei Medical School, Classifying these clients into the type of service, 35.9% utilized the wellbaby clinic, 31.0% the family planning clinic, 14.7% the home delivery care, and the rest utilized other services such as the premarital guidance cinlic and the sanitary inspection service. 3) Maternity Care: 23.6% of 2,151 deliveries were done at medical facilities such as hospital, private clinic, while 76.4% were done at home. Acceptance rate of prenatal care was 32.6% as whole, but 49.6 of 774 women who had the prenatal care service had their deliveries at medical facility. 45.1% of total deliveries were attended by medical and or paramedical personnel. 75.8% of the deliveries of those received prenatal care were attended by medical and or paramedical personnel while only 27.8% of the deliveries of those who did not have prenatal care attended by medical and or paramedical personnel. 49.8% of deliveries of the upper class, 29.8% of the middle class and 9.9% of the lower class were attended by medical and or paramedical personnel. 6.2, 3.3% and 24.8% of mothers reported about their xeperience of edema, coma and fever during the period of trimester of pregnancy and puerperium. 4) Family Planning: The rate of practice of family planning was 27.9%. 31.7% of them were by IUD, 2.9% by oral pill, 15.2% by sterilization and the rest by traditional methods. Those women who had 3 to 4 children had highest(30.2%). Practice rate among the various methods of family planning, oral pill was the most popular method to whom had 2 or less children. In relation between the practicing rate of family planning and living standard, the upper, middle and lower class practiced 37.5, 29.4 and 19.9% respectively.

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