• Title/Summary/Keyword: Premature death

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Biological Effect of Metronidazole Resistance in Helicobacter Pylori (Helicobacter pylori에서 metronidazole 내성이 미치는 생물학적 영향)

  • Lee Gin Hyug;Lee Sun-Mi;Nam Won-Hee;Kim Eun Sil;Kim Jin Ho;Kang Ho Young;Jeong Jin-Yong
    • Journal of Life Science
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    • v.15 no.6 s.73
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    • pp.955-960
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    • 2005
  • Resistance to metronidazole, a key component of therapies against Helicobacter pylori, is common in clinical isolates. Resistance generally requires inactivation of rdxA (HP0954), and sometimes also frxA (HP0642), two related nitroreductase genes. Here we studied the effect of resistance to metronidazole on fitness of the gastric pathogen H. pylori. The effect of metronidazole resistance for H. pylori in culture was assessed first by looking at colonies formed by freshly constructed mutant derivatives of H. pylori strain 26695. Mutations resulting in metronidazole resistance caused premature death of H.pylori in stationary phase, but had no significant effect on early exponential growth. The effect of nitroreductase deficiencies on fitness in vivo was tested by infecting C57BL/6 mice with 1:1 mixtures of SS1 wild type and its isogenic metronidazole resistant derivatives. Inactivation of rdxA caused an inability to colonize mice in SS1 H. pylori strain. Derivatives of a metronidazole resistant strain that survived better in stationary phase, although remaining metronidazole resistant, could again colonize mice. In conclusion, metronidazole resistance diminishes H. pylori's fitness, but their costs can be suppressed by additional mutation.

Mortality Burden Due to Short-term Exposure to Fine Particulate Matter in Korea

  • Jongmin Oh;Youn-Hee Lim;Changwoo Han;Dong-Wook Lee;Jisun Myung;Yun-Chul Hong;Soontae Kim;Hyun-Joo Bae
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.2
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    • pp.185-196
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    • 2024
  • Objectives: Excess mortality associated with long-term exposure to fine particulate matter (PM2.5) has been documented. However, research on the disease burden following short-term exposure is scarce. We investigated the cause-specific mortality burden of short-term exposure to PM2.5 by considering the potential non-linear concentration-response relationship in Korea. Methods: Daily cause-specific mortality rates and PM2.5 exposure levels from 2010 to 2019 were collected for 8 Korean cities and 9 provinces. A generalized additive mixed model was employed to estimate the non-linear relationship between PM2.5 exposure and cause-specific mortality levels. We assumed no detrimental health effects of PM2.5 concentrations below 15 ㎍/m3. Overall deaths attributable to short-term PM2.5 exposure were estimated by summing the daily numbers of excess deaths associated with ambient PM2.5 exposure. Results: Of the 2 749 704 recorded deaths, 2 453 686 (89.2%) were non-accidental, 591 267 (21.5%) were cardiovascular, and 141 066 (5.1%) were respiratory in nature. A non-linear relationship was observed between all-cause mortality and exposure to PM2.5 at lag0, whereas linear associations were evident for cause-specific mortalities. Overall, 10 814 all-cause, 7855 non-accidental, 1642 cardiovascular, and 708 respiratory deaths were attributed to short-term exposure to PM2.5. The estimated number of all-cause excess deaths due to short-term PM2.5 exposure in 2019 was 1039 (95% confidence interval, 604 to 1472). Conclusions: Our findings indicate an association between short-term PM2.5 exposure and various mortality rates (all-cause, non-accidental, cardiovascular, and respiratory) in Korea over the period from 2010 to 2019. Consequently, action plans should be developed to reduce deaths attributable to short-term exposure to PM2.5.

Analysis of Infant Mortality Rate in Korea Concerning According to Birth Weight and Gestational Age from 2005 to 2009 (한국의 2005-2009년도 영아사망률 중에서 출생체중, 임신나이 별 구분에 따른 신생아 사망률의 비율 관찰)

  • Cho, Mi-Jin;Ko, Jin-Hee;Chung, Sung-Hoon;Choi, Yong-Sung;Hahn, Won-Ho;Chang, Ji-Young;Bae, Chong-Woo
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.182-188
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    • 2011
  • Purpose: Recently in Korea, there have been significant improvements in neonatal mortality rate (NMR) and infant mortality rate (IMR). This study aimed to investigate the proportion of the NMR among IMR, with the goal of discerning the influence of improved NMR on the reduction of IMR in the last 5 years in Korea. Methods: All data were from Statistics Korea. Changes in the NMR percentage among IMR and the percentage of the death by the distribution of the birth weight and gestational were investigated. Results: The total birth rate decreased, but the total number of preterm and low birth weight infants increased. These was a large decrease in NMR and IMR. The proportion of NMR among INR exceeded 50%. Early NMR was higher than late NMR. Among the total infant death, the mortality of preterm and low birth weight infants was high. Conclusion: Between 2005 and 2009, the total birth has declined in Korea, but the frequency of low birth weight infants is trending upward. The improvements in NMR and IMR, and the downtrend of the NMR percentage in IMR, are encouraging. It seems that the continued decrease of mortality of preterm and LBWI is required for better improvements NMR and IMR in Korea. This result is expected to be used for the basic data to improve the management of the newborns in Korea.

Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

24 Hour Esophageal PH Monitoring in Preterm Infants (미숙아에서의 24시간 식도 PH 검사)

  • Park, Jeung-Hyun;Park, Beom-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.133-141
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    • 2001
  • Purpose: Gastroesophageal reflux (GER) has been found to be the causative factors of apnea, stridor, feeding intolerance, poor weight gain, and sudden infants death syndrome (SIDS) in infants. GER is a well-described in infants and children, but only scant mention of the premature infants with GER can be found in the literature. Methods: Esophageal pH was measured during 24 hour in 21 healthy preterm infants, using a silicone microelectrode with an external reference electrode connected to a portable recorder. The mean age of the patients was $29{\pm}8$ days, mean gestational age was $30^{+5}{\pm}2^{+0}$ weeks, mean birth weight was $1,468{\pm}329$ g, mean postconceptional age was $34^{+6}{\pm}1^{+4}$ weeks and mean weight was $1,750{\pm}329$ g. We evaluated the following reflux parameters; number of acid reflux, number of long acid reflux, longest acid reflux minutes, and reflux index. Results: Pathologic GER was detected in 12 (57%) subjects and most interesting parameters are reflux index and number of episodes with a pH<4 during 24 hour (high correlation with postprandial reflux index). Reflux was not correlated to gestational age, birth weight, age, postconceptional age, weight, sex and medication of the theophylline. Conclusion: Gastroesophageal reflux is common in preterm infants, but it is usually not apparent, even with severe reflux.

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Screening Test for Heart Diseases in the First Grade Elementary School Children in Busan (부산 지역 초등학교 1학년 학생들의 심장질환의 집단검진에 관한 연구)

  • Oh, Jae Min;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.490-494
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    • 2003
  • Purpose : We'd like to determine the incidence of congenital heart disease and arrhythmia in elementary school children in Busan, and to provide adequate prevention and treatment. Methods : A total of 23,802(male 12,909, female 10,893) 1st grade elementary school children living in Busan were studied. All children were 7-8 years old. We obtained their medical history by questionnaire and checked elecrocardiography(ECG). Subsequent screening tests including a 2nd ECG, chest X-ray, phonocardiogram and CBC for the students who had abnormal findings at the first screening test. The third screening test was done for students who had cardiac murmurs or abnormal ECG findings in the second screening test by echocardiogram, treadmill test and 24-hour Holter monitoring. Results : Among 23,802 children participants, 605(2.54%) had abnormal ECG findings at the first screening test. Q wave abnormality(0.58%) was observed most frequently, and complete right bundle branch block(RBBB)(0.26%), sinus tachycardia(0.24%), right axis deviation(0.22%) and ventricular premature contraction(VPC)(0.21%) followed in order. Four hundred and twenty four children participated in the second ECG screening test. Two hundred and two children(47.6%) had an abnormality such as sinus tachycardia(18.8%), VPC(17.8%), or complete RBBB(17.3%). After completing the third examination including echocardiogram, we couldn't find the students with ventricular tachycardia (VT) or SVT at the third arrhythmia screening test. Conclusion : A high incidence of arrhythmia was found in the 1st grade elementary school children in Busan despite their healthy appearances, although fatal heart diseases were not noted. Early diagnosis, adequate preventative measures and treatment will prevent and decrease the frequency of emergent situations like syncope and sudden death.

Extubation Time by Birth Weight and the Predictors for Success/Failure at the First Extubation in Extremely Low Birth Weight Infants (초극소저출생체중아에서 출생체중별 발관시기 및 첫 발관 시의 성공/실패 예측인자)

  • Choi, Chang Won;Park, Sung Eun;Jeon, Ga Won;Yoo, Eun Jung;Hwang, Jong Hee;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.488-494
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    • 2005
  • Purpose : To outline the aspects of extubation by birth weight and find the predictors for success/failure at the first extubation in extremely low birth weight infants. Methods : One hundred thirteen extremely low birth weight infants(<1,000 g) who were admitted to NICU at Samsung Seoul Hospital between Jan. 2000 and Jun. 2004 were enrolled. Clinical characteristics that are thought to be related with extubation success or failure were compared with the success and the failure of the first extubation. Results : As the birth weight decreased, extubation success day was significantly delayed : $16{\pm}3day(d)$ in 900-999 g; $20{\pm}3d$ in 800-899 g; $35{\pm}4d$ in 700-799 g; $37{\pm}9d$ in 600-699 g; $49{\pm}12d$ in ${\leq}599g$. 25 out of 113 infants(22%) failed the first extubation. Preterm premature rupture of membrane was associated with extubation success, and air leak was associated with extubation failure, with a borderline significance. Postnatal and corrected age and body weight at the first extubation, nutritional status, and ventilator settings were not associated with extubation success or failure. Extubation success day was significantly delayed, and the incidence of late-onset sepsis and mortality was significant higher in the failure of the first extubation. Conclusion : We could not find significant predictors for success/failure at the first extubation. The failure of the first extubation had an increased risk of late-onset sepsis and death. Further studies are needed to find the predictors for extubation success/failure.

A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Serum Immunoglobulin levels in Coal Worker's Pneumoconiosis Patients (진폐증 환자에서의 혈청 면역 글로불린의 변화)

  • Yoo, Kwang-Ha;Ahn, Chul-Min;Kim, Hyung-Joong;Kim, Young-Ho;Lee, Yong-Kyoo;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.2
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    • pp.165-174
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    • 1999
  • Background: Coal-worker's pneumoconiosis(CWP) is radiologically divided into two major groups: simple pneumoconiosis (SP), in which small, rounded or irregular opacities smaller than 1cm are observed, and progressive massive fibrosis(PMF), which is characterized by opacities larger than 1cm. SP has a life expectancy equivalent to miners with no radiographic evidence of CWP, but PMF is associated with more obvious impairments of ventilatory capacity and premature death. But only minority of workers develop PMF when exposed to dust concentrations similar to those experienced by workers who develop only SP. In this study, immune status in patients with CWP were evaluated by measurement of the serum immunoglobulin levels between control, SP and PMF groups. Method: Coal workers selected for this study were emplyees of the Tae-Baek and Dong-Hae Hospital. All the patients were men of 45-76 years old and the mean duration of exposure to coal dust were 23.2 years. By X-ray examination, 51 patients were classified in SP, 59 in PMF category. The normal controls examined were 58 men of 26-70 years old. Serum Ig levels were estimated by using Nephelometer(Behring Nephelometer : Germany) and serum were collected 51 in SP, 49 in PMF and 57 cases in control group. Results: The levels of IgG were increased but the levels of IgM were decreased with increasing age in control groups. There were no statistical difference of immunoglobulin levels between smokers and nonsmokers in control groups. There were no statistical difference of immunoglobulin levels between Control, SP and PMF groups. Multiple regression analysis were undertaken to determine the statistical significance of the apparent trends and estimate the effects associated with age, smoking habit and radiological category of CWP. According to this analysis, the levels of IgG were decreased significantly in SP group and had decreasing tendancy, but not statistically significant in PMF group. Conclusion : From the observations described, CWP patients had decreased IgG concentration compared to control gorup. Therefore, there was some relation between CWP and immunoglobulin concentration.

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Effects of Resveratrol and Resveratryl Triacetate on The Inflammatory Responses of Human Epidermal Keratinocytes Exposed to Airborne Particulate Matter PM10 (대기 미립자 물질 PM10에 노출된 인간 표피 각질형성세포의 염증 반응에 대한 레스베라트롤과 레스베라트릴 트라이아세테이트(RTA)의 영향)

  • Choi, Min A;Seok, Jin Kyung;Lee, Jeong-won;Lee, Shin Young;Kim, Young Mi;Boo, Yong Chool
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.44 no.3
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    • pp.249-258
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    • 2018
  • Airborne pollution causes oxidative damage, inflammation, and premature aging of skin. Resveratrol is a polyphenol compound that has various biological activities such as antioxidant, anti-inflammation, and anti-melanogenic activities but it is unstable to heat and light. Resveratryl triacetate (RTA) is a new cosmetic ingredient that is more stable than resveratrol and its skin safety and whitening efficacy have been reported previously. The purpose of this study was to examine the effects of resveratrol and resveratryl triacetate (RTA) on the inflammatory responses of human epidermal keratinocytes (HEKs) exposed to airborne particulate matters with a diameter of < $10{\mu}m$ (PM10). Cultured HEKs were exposed to PM10 in the absence or presence of resveratrol and RTA. Assays were undertaken to determine cell viability, the production of reactive oxygen species (ROS), and the expression of inflammatory cytokines. PM10 treatment decreased cell viability, and increased the expression of pro-inflammatory cytokines such as tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), $interleukin-1{\beta}$ ($IL-1{\beta}$), interleukin-6 (IL-6), and interleukin-8 (IL-8). Resveratrol and RTA reduced cell death and ROS production induced by PM10. PM10-induced mRNA expression of the inflammatory cytokines was either attenuated (IL-6), or enhanced ($IL-1{\beta}$), or unaffected ($TNF-{\alpha}$ and IL-8) by resveratrol and RTA. PM10-induced IL-6 protein expression was attenuated by resveratrol and RTA. This study suggests that resveratrol and RTA have activities regulating cell damage and inflammatory responses of the skin exposed to airborne particulate matters.