• Title/Summary/Keyword: Retrospective Study

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The evaluation for Clinical usefulness and Safety of Sirolimus-eluting stent and Paclitaxel-Eluting Stents In Patients With Acute Myocardial Infarction (급성심근경색증 환자의 일차적 관동맥 스텐트 삽입술 시 삽입된 Sirolimus-eluting stent 와 Paclitaxel-eluting stent의 임상적 안정성 및 유용성 평가)

  • Min, Gye-Sik;Han, Man-Seok
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.5-10
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    • 2012
  • There is a still unsettled issue about the comparison of long-term clinical effects between sirolimus-(SES) and paclitaxel-eluting stents (PES) for the patients with acute myocardial infarction (AMI). Therefore, we performed a retrospective analysis to evaluate the 4-year clinical outcome of SES as compared with PES after percutaneous coronary intervention (PCI) in patients with AMI. From January 2004 to August 2006, all consecutive patients with acute ST-segment elevation myocardial infarction (STEMI) underwent primary PCI and acute NSTEMI underwent PCI by implantation either SES or PES were enrolled. The occurrence of death, cardiac death, recurrent infarction, target vessel revascularization (TVR) and stent thrombosis were analyzed. The composite of major adverse cardiac events (MACE; death, recurrent infarction and TVR) were also analyzed. During the study period, total 668 AMI patients had visited. Of them, total 522 patients (299 with SES and 223 with PES) were enrolled. During 4-year clinical follow-up, there were similar occurrences of death ($18.3{\pm}3.0%$ vs. $14.6{\pm}2.2%$, p=0.26), cardiac death ($11.2{\pm}2.6%$ vs. $6.8{\pm}1.52%$, p=0.39), re-infarction ($6.4{\pm}1.8%$ vs. $3.3{\pm}1.1%$, p=0.31), and stent thrombosis ($5.4{\pm}1.7%$ vs. $3.2{\pm}1.1%$, p=0.53) between the two groups, consecutively. The occurrences of TVR ($10.0{\pm}3.0%$ vs. $4.0{\pm}1.2%$, p=0.008) and MACE ($29.4{\pm}3.5%$ vs. $19.4{\pm}2.5%$, p=0.003) were significantly higher in patients treated with PES than SES. In AMI patients treated with either SES or PES implantation, SES had a significantly lower risk of TVR and MACE during 4-year clinical follow-up. Rates of death, cardiac death or recurrent infarction, and stent thrombosis were similar.

Clinical Analysis of the Belsey Mark IV Operation in Hiatal Hernia with Gastroesophageal Reflux and Achalasia (위 식도 역류를 가진 열공 헤르니아 환자와 식도 무이완증 환자에서 시행한 Belsey Mark IV 수술의 임상적 고찰)

  • 최영호;조원민;류세민;황재준;손영상;김학제;김광택
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.217-222
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    • 2002
  • Background: The incidence of gastroesophageal reflux disease(GERD) is increasing recently, but medical management for GERD has many limitations. Therefore, variable surgical treatments have been introduced. Material and Method: A retrospective study was done in 10 patients who underwent the Belsey Mark IV operation at Korea university Guro hospital between 1996 and 2001. Preoperative diagnoses were hiatal hernia with gasroesophageal reflux in 8 patients and achalasia in 2 patients. Result: Mean age of the patients was 54.3$\pm$19.0 years. Belsey Mark IV operation was performed on patients where preoperative medical failed and mean hospital days were 13.1$\pm$2.6 days. We routinely practiced follow-up endoscopy on postoperative 3rd, 6th, 9th, and 12th months. After remission for reflux and esophagitis, they were transferred to internal medicine department. Six patients of hiatal hernia with reflux (one patient who lost follow-up and the other patient who didn't practice the follow-up endoscopy due to short postoperative follow-up period were excluded) had lowered endoscopic gradings and two patients of achalasia did not complained of reflux symptoms, postoperatively. We experienced 10% operation failure rate. Conclusion: We experienced satisfactory operation results with Belsey Mark IV in hiatal hernia with GERD and achalasia patients.

Perfusion Impairment in Infantile Autism on Brain SPECT Using Tc-99m ECD : Comparison with MR Findings (유아 자폐증 환아에서의 Tc-99m ECD를 이용한 뇌 단일 광전자 방출 전산화 단층 촬영술상의 관류 저하: 자기 공명 영상과의 비교 분석)

  • Ryu, Young-Hoon;Lee, Jong-Doo;Yoon, Pyeong-Ho;Kim, Dong-Ik;Oh, Young-Taik;Lee, Sun-Ah;Lee, Ho-Bun;Shin, Yee-Jin;Lee, Byung-Hee
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.320-329
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    • 1997
  • Neuroanatomic substrate of autism has been the subjects of continuing investigation. Because previous studies had not demonstrated consistent and specific neuroimaging findings in autism and most studies comprised adults and school-aged children, we performed a retrospective review in search of common functional and anatomical abnormalities with brain SPECT using Tc-99m ECD and correlative MRI The patient population was composed of 18 children aged 28 to 89 months(mean age : 55 months) who met the diagnostic criteria of autism as defined in the DSM-IV and CARS. Brain SPECT was performed after intravenous injection of 185-370MBq of Tc-99m ECD using brain dedicated annular crystal gamma camera. MRI was performed in all patients including T1, T2 axial and T1 sagittal sequences. SPECT data were visually assessed. Thirteen patients had abnormal SPECT scan revealing focal areas of decreased perfusion. Decreased perfusion of cerebellar vermis(12/18), cerebellar hemisphere(11/18), thalami(13/18), basal ganglia(4/18), posterior parietal(7/18), and temporal(4/18) area were noted on brain SPECT. Whereas, only 3 patients had abnormal MR findings which were subtle volume loss of parieto-occipital white matter in 3 and mild thinning of posterior body of corpus callosum in 2 and slightly decreased volume of cerebellar vermis in 1. Comparison of the numbers of abnormal findings revealed that regional cerebral blood flow (rCBF) abnormalities seen on SPECT were more numerous than anatomical abnormalities seen on MRI. In conclusion, extensive perfusion impairment involving cerebellum, thalami and parietal lobe were found in this study. SPECT may be more sensitive in reflecting pathophysiology of autism than MRI. However, further studies are mandatory to determine the significance of thalamic and parietal perfusion impairment in autism.

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Value of the Serum Thyroglobulin Level Alteration at the First High Dose Radioiodine Treatment in Patients with Differentiated Thyroid Carcinoma (분화성갑상선암에서 최초 고용량 방사성요오드 치료시 혈청 갑상선글로불린 수치 변화의 의의)

  • Nam, Hyun-Yeol;Kim, In-Joo;Kim, Yong-Ki;Kim, Seong-Jang;Jun, Sung-Min;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.294-300
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    • 2009
  • Purpose: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. Materials and Methods: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. Results: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P = 0.03, the THW group; P = 0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0$\leq$5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. Conclusion: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.

Causative Organisms of Neonatal Sepsis (신생아 패혈증의 원인 병원체에 대한 조사)

  • Kim, Kyung-Ah;Shin, Son-Moon;Moon, Han-Ku;Park, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.60-68
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    • 1999
  • A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

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Analysis of Ecological Index of Plant Using Flora Distributed in Temple Forest (사찰림에 분포하는 식물상을 이용한 식물생태지수 분석)

  • Oh, Hyunkyung;Choi, Yeonho;You, Juhan
    • Journal of Environmental Impact Assessment
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    • v.23 no.4
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    • pp.251-270
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    • 2014
  • The purpose of this study is to offer the basic data and method for assessing the naturaliness of temple environment by applying the ecological index of plant to quantitatively and objectively assess the flora and to understand the flora distributed in major temple forest. The ecological index of plant was based in the surveyed flora. The whole flora were summarized as 535 taxa including 103 families, 310 genera, 426 species, 5 subspecies, 82 varieties and 22 forms. And, the numbers of taxa in the Beopheungsa were 267 taxa, 314 taxa of the Daeseungsa and 296 taxa of the Seongjusa. The rare plants were 9 taxa including Aristolochia contorta, Viola albida, Arisaema heterophyllumand so forth, and the Korean endemic plants were 11 taxa including Clematis trichotoma, Stewartia pseudocamellia, Vicia chosenensis and so forth. The specific plants by floristic region were 51 taxa including Wistaria floribunda, Celtis aurantiaca, Angelica gigas and so forth, and the pteridophyta were 26 taxa including Osmunda japonica, Polystichum braunii, Onoclea orientalis and so forth. The naturalized plants were 35 taxa including Fallopia dumetorum, Conyza canadensis, Xanthium strumarium and so forth, the invasive alien plants were 3 taxa including Ambrosia artemisiifolia, Aster pilosus and Eupatorium rugosum. In the results of analysing the ecological index of plant in whole temple forests, RI(Rare Index) was 1.7%, 2.1% of EI(Endemic Index), 9.5% of SI(Specific Index), 1.2 of PI(Pteridophyta Index) and 6.5% of NI(Naturalized Index) in narrow sense. In broad sense, FI(Flora Index) was 11.0%, 1.5% of RI, 3.4% of EI, 4.8% of SI, 10.1% of PI, 10.9% of UI(Urbanized Index) and 25.0% of DI(Disturbed Index). The FI of the Daeseungsa was the highest among the three temple forests. In narrow sense, the RI, SI, NI and DI of the Beopheungsa was high, the seongjusa was higher the EI and SI. In broad sense, the RI and SI of the Beopheungsa, the EI, SI and PI of the Seongjusa, the UI is high in the Daeseungsa. In future, if we will analyze ecological index of plant in other temple forests, we will offer the help to establishing the plan of conservation and restoration on ecosystem in whole temple forests.Environmental Specimen Banks (ESBs) are playing pivotal role in monitoring the effect of environmental pollution on the ecosystem based on the retrospective analysis of the representative samples collected regularly and stored in cryogenic condition.

A retrospective statistical analysis of dental implants (치과 임플란트 환자의 통계 분석에 관한 후향적 연구)

  • Zhao, Chun-Ri;Cho, In-Ho;Moon, Eun-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.266-272
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    • 2009
  • Statement of problem: The number of edentulous patients is increasing due to an aging society, which leads to increased demands and interests on implant restorations. Implant restorations are an effective treatment method for both complete and partially edentulous patients, and the success rate has been reported to be high. But because of the increased use of implants in various situations have resulted in frequent reports of failures on implant restorations. Various efforts to overcome these failures have been made. Purpose: The aim of this study was to investigate the statistic survival rate of dental implants on patients who were treated at Dankook University Dental Hospital during the past 10 years based on their charts. Materials and methods :The research was made for two different periods of time; The first investigation was for patients from August, 1998 to August, 2003 and the second was for patients from September, 2003 to April, 2007. Information on the number of implants placed, the location and distribution of implants, the duration between the first and second surgery, and the survival rate of implants were investigated from the patients'charts. Results: 1. According to the first investigation, 1680 implants were placed on 612 patients and the second investigation showed 2438 implants placed on 933 patients. Thus a total of 4118 implants on 1545 patients. 2. Among the 1545 patients, 884 patients were male (57.2 %) and 661 patients were female (42.8%). Out of 4118 implants, 1739 implants (42.2%) were placed on the maxilla, and 2379 implants (57.8%) on the mandible. Implants were placed most frequently in the posterior region of the mandible. A total of 2043 implants (53.2%) were placed in this region. 3. According to the first investigation, 57 out of 1680, implants failed, while from the second investigation, 17 out of 2438 implants were reported as failure. In total, 74 implants failed, which results in a 98.2% survival rate. 4. The average duration between the first and the second surgeries in maxillas decreased from 7.4 months to 6.8 months. The duration also decreased from 5.6 months to 5.0 months in mandibles. Conclusion: As shown in the results, the number of placed implants and the survival rate of implants were higher in the second investigation than that of the first investigation. And the time spent after the first surgery to the second surgery was less in the second investigation. Consequently, it can be presumed that the demand and consumption of dental implants as well as the survival rate will increase in the future.

Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Retrospective Study about Medical and Surgical Combination Therapy for Advanced Cervical Tuberculous Lymphadenitis (항결핵제와 수술적 병합치료를 시행한 진행된 결핵성 경부 임파선염 환자에 대한 연구)

  • Song, Ha Do;Kim, Chong Kyung;Cho, Dong Il;Hong, In Pyo;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.277-284
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    • 2008
  • Background: In principle, cervical tuberculous lymphadenitis (CTBL) is a medical disease that may require surgical treatment, particularly in young women who complain of psychosocial and cosmetic problems. We encountered 13 cases of aggravated CTBL treated surgically despite the appropriate course of antituberculous chemotherapy. We report the clinical characteristis of these cases. Methods: The clinical data of 13 patients with aggravated CTBL requiring surgical treatment from January 2000 to December 2006 at the Department of Chest Medicine, Internal Medicine and Plastic Surgery, National Medical Center was reviewed retrospectively. Results: Twelve of the 13 cases (92%) were female. The most common age was 21~30 years (69%). Multiple nodes were palpated in 11 cases (85%). The supraclavicular lymph nodes were sites the most commonly involved (54%). The other involved sites in the order of decreasing frequency were the jugular chain, posterior cervical, submandibular and infraauricular lymph nodes. A palpable mass was the most commonsymptom. Neck pain was reported in 3 cases (23%). General symptoms such as weight loss, fatigue, anorexia and night sweats were noted in 5 cases (38%). Respiratory symptoms such as cough, sputum, hemoptysis, dyspnea and chest pain were observed in 4 cases (31%). Pulmonary tuberculosis was noted in 11 cases (85%). Other extrapulmonary tuberculosis coexisted in 4 cases (31%). This suggests that surgical CTBLs may be manifestations of a systemic disease and might be difficult to treat. Most cases (92%) were stages 2 and 3 at the initial diagnostic period but all cases fell into stage 4 and 5 when reassesed before surgery. The average duration of anti-TB chemotherapy before and after surgery was 10.2 and 15.2 months, respectively. The 13 patients were followed up until June. 2008. Among them, 2 cases had newly developed CTBL and the other 11cases showed no recurrence. Conclusion: In principle, CTBL is the medical disease. However, despite the appropriate course of anti-TB chemotherapy, CTBL can progress to a more advanced stages and grow rapidly to a large-sized or fistulous mass with a persistent abscess. Surgical treatment may be inevitable for patients with psychosocial and cosmetic problems caused by these masses, particularly in young women.

Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital (한 대학병원 내과계 중환자실의 기계환기 시행 환자의 현황 및 예후인자의 분석)

  • Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.292-300
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    • 2008
  • Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.