• Title/Summary/Keyword: cause-specific mortality

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A New Sterol Regulatory Element Binding Protein, SrbB Is Critical for Hypoxia Adaptation and Virulence in the Human Fungal Pathogen Aspergillus fumigatus

  • Chung, Dawoon;Barker, Bridget M.;Carey, Charles C.;Merriman, Brittney;Werner, Ernst R.;Lechner, Beatrix E.;Dhingra, Sourabh;Cheng, Chao;Xu, Wenjie;Blosser, Sara J.;Morohashi, Kengo;Mazurie, Aurelien;Mitchell, Thomas K.;Haas, Hubertus;Mitchell, Aaron P.;Cramer, Robert A.
    • 한국균학회소식:학술대회논문집
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    • 2015.05a
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    • pp.15-15
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    • 2015
  • Aspergillus fumigatus is a major cause of invasive aspergillosis (IA), a significant health issue worldwide with high mortality rates up to 95%. Our lab is interested in how A. fumigatus adapts to low oxygen conditions 'hypoxia', which is one of the important host microenvironments. A. fumigatus SrbA is a basic helix-loop-helix (bHLH) transcriptional regulator and belongs to sterol regulatory element binding protein (SREBP) family members. Loss of SrbA completely blocks growth in hypoxia and results in avirulence in murine models of IA suggesting an essential role of SrbA in hypoxia adaptation and virulence in A. fumigatus. We conducted chromatin immunoprecipitation sequencing (ChIP-seq) with A. fumigatus wild type using a SrbA specific antibody, and 97 genes were revealed as SrbA direct targets. One of the 'SrbA regulons' (AFUB_099590) was a putative bHLH transcriptional regulator whose sequence contained a characteristic tyrosine substitution in the basic portion of the bHLH domain of SREBPs. Therefore, we designated AFUB_099590 SrbB. Further characterization of SrbB demonstrated that SrbB is important for radial growth, biomass production, and biosynthesis of heme intermediates in hypoxia and virulence in A. fumigatus. A series of quantitative real time PCR showed that transcription of several SrbA regulons is coordinately regulated by two SREBPs, SrbA and SrbB in hypoxia. This suggests that SrbA and SrbB have both dependent and independent functions in regulation of genes responsible for hypoxia adaptation in A. fumigatus. Together, our data provide new insights into complicated roles of SREBPs in adaptation of host environments and virulence in pathogenic fungi.

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Respiratory Hospital Infections of Patients with a Tracheostomy (기관절개술 환자의 호흡기계 병원감염양상에 관한 연구)

  • 양숙자;최영희;김문실
    • Journal of Korean Academy of Nursing
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    • v.19 no.3
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    • pp.240-248
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    • 1989
  • The increase in size and numbers of general hospitals in the process of conspicuous development of modem medicine has been accompanied by a serious increase in hospital acquired infections. Hospital aquired infections cause pain and discomfort, may threaten life, adds an economic burden, and delays recovery and return to society. Even though respiratory hospital infection rates resulting for tracheostomy and respiratory inhalation therapy, may be low, they are serious because of their bad prognosis and high mortality rates. This study was designed to assess certain aspects of respiratory infections of patients with a tracheostomy and thus provide baseline data for further research related to preventive or therapeutic nursing interventions. The specific objectives were to determine the incidence of colonization in the trachea, clinical signs, type of colonized bacteria and sensitivity to antibiotics. Data were collected from July 1 to December 10, 1989 at two university Hospital in Seoul. Subjects were 20 patients with a tracheostomy admitted to the Intensive Care Unit or Cerebral Vascular Accident Center. Clinical signs related to respiratory infection were observed using a checklist based on previous study outcomes. Bacterial culture, sensitivity test to antibiotics, WBC counts and chest X-ray were also performed. Cultures were done on the day of tracheostomy, and on the third, fifth and seventh day. Cultures were then done on seventh days after the first colonization. The results were as follows : 1. The incidence of bacteria colonization in a week was 90%(18 patients) 50% (10/20 patients) on the day of tracheostomy, 70%(7/10 patients) on the third day, and 0% on the fifth day, and 33%(1/3 patient) on the seventh day. 3 of 18 patients (16.7%) were colonies of mixed growth isolated. 2. The observed clinical signs related to respiratory infection were high fever 38.9%(7 patients), prulent secretion 16.7%(12 patients) and infiltration seen on chest X-ray 33.3%(6 patients). 3. The total number of types of bacteria isolated among the 18 subjects was 21 ; gram negative 71.4%, gram postive 28.6%. The dominant bacteria type was Staphylococcus aureus(5 cases) for gram(equation omitted) and Pseudomonas aeruginosa(3 cases), Klebsiella (4 cases), Enterobacter(3 cases) for gram (equation omitted). The results of culture on 7th day after the first colonization, 6 cases showed same type of bacteria, 3cases showed different type of bacteria and 1 cases showed no growth. 4. The sensitivity tests to antibiotics showed that Pseudomonas aeruginosa and Staphylococcus were strongly resistant to most kinds of antibiotics, but Klebsiella and the rest of gram negative bacteria were moderately sensitive to antibiotics.

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The Hope of the Stroke Patients (뇌졸중환자의 희망)

  • 김이순
    • Journal of Korean Academy of Nursing
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    • v.27 no.1
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    • pp.212-227
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The stroke causes physical function disorder due to hemiparalysis and emotional disorder, and stroke patients experience helplessness, powerlessness. sense of alienation and loss of hope. These feelings make the rehabilitation difficult because they lose the will of life. The subjects of the study were seven citizens who live in Pusan, are over 50 years old and belong to low income-level. The data were collected from Jan. to Sep. 1995. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi, which is as follows ; as an unit of description which include the subject' expressions and the researcher's observation, it is examined the theme that express the hope experience with the subject's language(underlining), and the focal meanings are identified. The focal meaning is the crystalization of the theme, which is written in the language of the researcher. After intergrating the focal meaning and make the situated structural description as the meaning of the hope experience identified on each subject's point. After intergrating the situated structural description and make the general structural description as the meaning of the hope experience identified on total subject's point then the systemizing of the structure of the hope experienced phenomena and the flowing of the conciousness was researched. The conclusions of this study was as follows : The ten sources of hope which the subjects experienced were sorted as under 〈mutual relations to others : spouse, children, relatives, fellow believer. health professioner. associate patient group〉, 〈spiritual dependence〉. 〈recovery of physical function〉. 〈rumination of the past life〉, 〈expectation of the future〉. 〈economic power〉, 〈belief〉, 〈ability〉. 〈spontaneous participation〉 and 〈recovery of roles〉. Their hope was spoken out by the following two kinds of linguistics. First. the hope was expressed in the affirmative expression as follows : 〈 to be dependable〉, 〈to make efforts〉, 〈to keep under control〉, 〈to desire〉, 〈to be pleasant〉, 〈to be peaceful〉, 〈to be grateful〉, 〈to give help〉, 〈self-confidence. Courage〉, 〈to be happy〉, 〈to satisfy oneself〉, 〈to share with others〉, 〈to understand〉 and 〈to be affected, be impressed〉 Second, the hope was expressed in the negative on pression as under : 〈to be distressed〉, 〈to be uneasy〉, 〈to be sorry, be unsatisfied〉 〈despair〉, 〈to abandon〉, 〈to be fearful〉, 〈to suffer〉, 〈to bear a burden〉 〈to be confused〉, 〈to be solitary〉, 〈chest trouble〉, 〈to feel heavy〉 〈grief〉, 〈to be daunted〉, 〈to get angry〉, 〈to be uncomfortable〉, 〈to have something regretable〉 and 〈to feel guilty〉. And their hope was expressed by the following four behavioral expressions : 〈physical sphere〉, 〈psychological sphere〉, 〈social support sphere〉 and 〈spiritual sphere〉. The reaction patterns of their hope experience appeared in the following 4 coping method : 〈conquest type〉, 〈dependence type〉, 〈adaptation type〉 and 〈fate type〉. Finally, in the hope structure the sense of certainty don't always coexict with the sense of uncertainty, When the stroke patients try to search for the best quality of life, the senses of certainty and uncertainty make a continual cyclic system in the hope structure.

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The Experience of the Stroke Patients about the Use of Oriental Medicine (뇌졸중 환자의 한방의료 이용 경험)

  • Kim Lee Sun
    • Journal of Korean Public Health Nursing
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    • v.11 no.1
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    • pp.82-92
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    • 1997
  • Cerebrovascular diseases in Korea is an important health problem since mortality and mobidity have been increased rapidly. It marked the 2nd cause of specific death rates in 1993. The subjects of the study were seventeen citizens who are using to the Oriental Medicine. The data were collected from Apr. to Oct. 1996. The researcher as a caregiver and volunteer made confidence of them and asked for their agreement on the purpose of the study. The subjects expressed their experience as openheartedly as possible. The researcher described closely the experiences of using to the Oriental Medicine with there words themselves and under the observation of the reseacher. A tape-recorder was used under the permission of the subjects to prevent the leakage of the spoken information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Van Kaam, which is as follows; as an unit of description which include the subject' expressions and the researcher's observation. The conclusions of this study was as follows : one hundred eighteen descriptive expression found and they were grouped eighteen common factors. These are ${\ulcorner$to effect needle${\lrcorner}$ ${\ulcorner$to effect Chinese medicine${\lrcorner}$ ${\ulcorner$treatment method${\lrcorner}$ ${\ulcorner$attitude of herb doctor${\lrcorner}$ ${\ulcorner$recommendation of family and other person${\lrcorner}$ ${\ulcorner$what one sold to${\lrcorner}$ ${\ulcorner$traditional custom${\lrcorner}$ ${\ulcorner$experience of the past use${\lrcorner}$ ${\ulcorner$to be desolate${\lrcorner}$ ${\ulcorner$negative recognition${\lrcorner}$ ${\ulcorner$Ineffective drug${\lrcorner}$ ${\ulcorner$Unfaithful of doctor${\lrcorner}$ ${\ulcorner$positive recognition${\lrcorner}$ ${\ulcorner$Oriental medical hospital surroundings${\lrcorner}$ ${\ulcorner$to build up one's health${\lrcorner}$ ${\ulcorner$to be clear blood${\lrcorner}$ ${\ulcorner$economic burden${\lrcorner}$ ${\ulcorner$deficit of profession${\lrcorner}$ Finally. eighteen common factors were grouped under six highter categories. These are ${\ulcorner$Belief to oriental medicine${\lrcorner}$ ${\ulcorner$motivation of use${\lrcorner}$ ${\ulcorner$distrust to western medicine${\lrcorner}$ ${\ulcorner$stability of emotion${\lrcorner}$ ${\ulcorner$Alteration of positive physical function${\lrcorner}$.

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Requirements for Cerebrovascular Surgery in Comprehensive Stroke Centers in South Korea

  • Kim, Tackeun;Oh, Chang Wan;Park, Hyeon Seon;Lee, Kunsei;Lee, Won Kyung;Lee, Heeyoung
    • Journal of Korean Neurosurgical Society
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    • v.61 no.4
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    • pp.478-484
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    • 2018
  • Objective : Cerebrovascular disease (CVD) was the third most common cause of death in South Korea in 2014. Evidence from abroad suggests that comprehensive stroke centers play an important role in improving the mortality rate of stroke. However, surgical treatment for CVD is currently slightly neglected by national policy, and there is still regional imbalance in this regard. For this reason, we conducted a survey on the necessity of, and the requirements for, establishing regional comprehensive cerebrovascular surgery centers (CCVSCs). Methods : This investigation was performed using the questionnaire survey method. The questionnaire was consisted with two sections. The first concerned the respondent's opinion regarding the current status of demand and the regional imbalance of cerebrovascular surgery in South Korea. The second section asked about the requirements for establishing regional CCVSCs. We sent the questionnaire to 100 board members of the Korean Society of Cerebrovascular Surgeons. Results : Most experts agreed that cerebrovascular surgery patients were concentrated in large hospitals in the capital area, and 83.6% of respondents agreed that it was necessary to alleviate the regional imbalance of cerebrovascular surgery. With regards to personnel, over 90% of respondents answered that at least two neuro-vascular surgeons and two neuro-interventionists are necessary to establish a CCVSC. Regarding facilities, almost all respondents stated that each CCVSC would require a neuro-intensive care unit and hybrid operating room. The survey asked the respondents about 13 specific neurovascular surgical procedures and whether they were necessary for a regional CCVSC. In the questions about the necessity of cerebrovascular surgical equipment, all seven pieces of equipment were considered essential by all respondents. A further five pieces of equipment were considered necessary on site: computed tomographic angiography, magnetic resonance angiography, conventional angiography, surgical microscope, and surgical navigation. Our results may provide a basis for future policy regarding treatment of cerebrovascular disease, including surgery. Conclusion : Raising the comprehensiveness of treatment at a regional level would lower the national disease burden. Policies should be drafted regarding comprehensive treatment including surgery for cerebrovascular disease, and related support plans should be implemented.

Anti-protozoal effect of organic acids against Azumiobodo hoyamushi that causes soft tunic syndrome to Halocynthia roretzi (멍게 물렁증의 원인충인 Azumiobodo hoyamushi에 대한 유기산의 살충효과 연구)

  • Lee, Ji Hoon;Park, Kyung Il;Park, Kwan Ha
    • Journal of fish pathology
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    • v.28 no.3
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    • pp.117-123
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    • 2015
  • Economic loss by soft tunic syndrome of edible ascidian, Halocynthia roretzi has become a serious problem. Recently, it has discovered that the cause of this syndrome is infection by a protozoan parasite Azumiobodo hoyamushi. However, only a few studies have been conducted to control this parasitic disease. In a previous research, non-specific disinfectants have been found to be effective in controling the causative parasite. In an attempt to eradicate this causative parasite, organic acids were tested in this study to evaluate their in vitro and in vivo efficacy. In vitro tests showed that 8 different organic acids used in this study were moderately or highly effective with protozoan-killing effects ($EC_{50}=153{\sim}275{\mu}g/ml$). Despite weak in vivo penetration of organic acids into the tunic tissues, treatment with high concentration reduced the mortality of ascidian caused by infection the parasite, indicating that we might be able to develop a disinfection method using environmentally-friendly organic acids.

Evaluation of Drugs for Suicide Attempt and Antidote Uses in Emergency Room of a Hospital in Korea (응급실 내원한 자살 시도 환자의 자살시도용 약물 및 해독제 사용 현황에 대한 평가)

  • Lee, Ok Sang;Cheon, Young Ju;Kim, Jung Tae;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.304-315
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    • 2012
  • Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

Use of a Postoperative Hepatic Arterial Embolization in Patients with Postoperative Bleeding due to Severe Hepatic Injuries (외상성 대량 간 손상 환자에서 수술 후 간 동맥 색전술의 유용성)

  • Cha, Soo Hyun;Jung, Yong Sik;Won, Jae Hwan;Kim, Wook Whan;Wang, Hee Jung;Kim, Myung Wook;Lee, Kug Jong
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.59-66
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    • 2006
  • Purpose: Acute liver failure after massive partial hepatectomy is critical condition with high mortality. To prevent postoperative liver failure from being induced by a massive partial hepatectomy, many doctors do a minimal resection on the single lobe of the liver that might cause postoperative bleeding from the remaining ruptured parenchyma. The objective of this study was to assess clinical experience with postoperative hepatic arterial embolization to control bleeding from the remaining ruptured liver during the postoperative period. Methods: This retrospective 4-year study was conducted from May 2002 to April 2006 and included consecutive patients who had sustained massive hepatic injuries and who had undergone a laparotomy, followed by postoperative hepatic arterial angiographic embolization to control bleeding. Data on the injury characteristics, the operative treatment and embolization, and the amount of transfused packed red cells (PRBC) were gathered and analyzed. In addition, data on the overall complications and survival rate were collected and analyzed. Results: Every case showed severe liver injury, higher liver injury scaling grade IV. Only ten cases involved a ruptured bilateral liver lobe. A lobectomy was done in 6 cases, a left lobectomy was done in 3 cases, and a primary suture closure of the liver was done in 2 cases. Suture closure was also done on the remaining ruptured liver parenchyma in cases of lobectomies. The postoperative hepatic arterial embolizations were done by using the super-selection technique. There were some cases of arterio-venous malformations and anomalous vessel branches. The average amount of transfused PRBC during 24 hours after embolization was $2.36{\pm}1.75$, which statistically significantly lower than that before embolization. Among the 11 cases, 9 patients survived, and 2 died. There was no specific complications induced by the embolization. Conclusion: In cases of postoperative bleeding in severe hepatic injury, if there is still a large amount of bleeding, postoperative hepatic arterial embolization might be a good therapeutic option.

Two Cases of Tension Pneumopericardium in Mechanically Ventilated Preterm Infants (미숙아에서 인공호흡기 치료 중 발생한 긴장성공기심장막증 2예)

  • Maeng, Se-Hyun;Seo, Hyun-Joo;Shin, Jeong-Hee;Jung, Ji-Mi;Kim, Jin-Kyu;Yoo, Hye-Soo;Ahn, So-Yoon;Kim, Eun-Sun;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.153-157
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    • 2011
  • Pneumopericardium is a rare form of neonatal air leakage. Tension pneumopericardium is much more infrequent, but can cause a cardiovascular deterioration with high mortality up to 80% and neurodevelopmental morbidity in half of the cases. We report two cases of preterm infants who successfully recovered from tension pneumopericardium that developed during mechanical ventilator assistance. The patients displayed a sudden increase in oxygen demand and subsequent cardiovascular deterioration. Immediate needle aspiration of the pneumopericardium performed after checking X-ray images rescued each of patient. Since the clinical symptoms are non-specific, clinicians' suspicion is most important when patients show sudden refractory cardiovascular collapse, especially in ventilator-assisted neonates. This life threatening complication demands instant diagnosis and intervention.

Blood Malignancies in Mazandaran Province of Iran

  • Tahmasby, Bahram;Marnani, Ahmad Barati;Maleki, Mohammadreza;Barouni, Mohsen;Mousavi, Seyyed Hamid;Naseriyan, Behjat;Nazarnezhad, Mirzaali;Alizadeh, Ali;Sabermahani, Asma
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1053-1056
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    • 2013
  • Background: Leukemia and lymphoma demonstrate significantly incidence rates throughout the world and particularly in Iran they cause serious mortality and diagnosis and treatment expenditures for both families and the health system. Combined they account for about 11 percent of cancers in Mazandaran province, ranking number 2 in prevalent cancers. The purpose of this study was to provide a first general and specific description of leukemia and lymphoma in Mazandaran province. Materials and Methods: In this descriptive retrospective study, entire patient's data were reviewed which had confirmed diagnosis of leukemia and lymphoma with valid laboratory or pathology reports in the period 2001-2008. The data were collected by Babol health research site related to Tehran University of Medical Science. Incidence rates based on age groups, gender, city of residence and type of malignancy were calculated and analyzed. Results: In Mazandaran province, 1,146 cases of leukemia and lymphoma were encountered, 5.9 in 100,000 persons on average annually. The highest incidence rates were obtained at age of 70 or above (26.4) and the lowest at age of 0-9 (2.3).The incidence rates in males and females were 7.1 and 4.8 respectively with a ratio of 1.5. The highest incidence rate was in Babol (7.3) and the lowest was calculated in Neka and Tonekabon equally (1.5). According to the type of malignancy, non Hodgkin lymphoma, with 2.5/100,000 have the most incidence rate and myeloid leukemia with 1.8 had the lowest. Conclusions: The obtained findings indicate clear differences in incidence rates based on age, gender, residence, and type of malignancy. Therefore it's suggested that in addition to promote data collecting programs, research projects should be programmed to define leukemia and lymphoma risk factors in this province.