• 한국산업보건학회지
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• 제31권4호
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• pp.510-520
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• 2021

Objective: This paper aimed to provide estimates the burden of cancer attributable to occupational exposures in South Korea and to review the processes of estimating the population attributable fraction(PAF). Methods: The PAFs of occupational cancer were reviewed from previous studies. The number and proportion of cancer cases attributable to occupational carcinogens were estimated by multiplying the PAFs by recent Korean cancer data(up to 2016 for incidence and 2017 for death) obtained from the Statistics Korea. The estimation of PAFs included occupational exposures defined as definite or probable human carcinogens by the International Agency for Research on Cancer. Results: In South Korea, an estimated 10,769 new cancer cases(9,017 among men, 1,752 among women) in 2016, and 7,030 cases of death from cancer(6,047 in men, 983 in women) in 2017, were attributable to occupational exposures, representing 1.5-4.7% of all new cancer cases(2.1-7.5% and 0.3-1.6% among men and women, respectively) and 2.7-8.9% of all cancer death cases(3.4-12.4% and 0.5-3.3% among men and women, respectively). Among men and women, lung cancer was the most impactful. The estimation process of PAFs, however, has a variety of uncertainties. Conclusions: Occupational exposures contribute to a substantial burden of cancer in South Korea. PAFs for cancer provide useful information for prevention initiatives and prioritizing health policies for workers. However, PAFs need to be interpreted cautiously and updated regularly.

• Journal of Chest Surgery
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• 제16권1호
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• pp.121-126
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• 1983

8 cases of the esophageal perforations were treated at the department of thoracic surgery, Chungnam National University Hospital during the period from July, 1980 to Dec., 1982. The causes of the perforation were various; swallowed a piece of glass, stocking pin, coiled wire, compressed air blow, strenuous vomiting, dog bite, tiller accident, and endoscopic procedure. The perforation sites were cervical esophagus in 3 cases, upper thoracic in 2 cases and lower thoracic in remains. We have performed following surgical procedure; Incision and drainage for cervical abscess, closed thoracostomy, thoracotomy and debridement, esophagoscopy and gastrostomy. Two cases were died. The causes of death were massive bleeding and sepsis.

• 대한골관절종양학회지
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• 제5권1호
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• pp.63-69
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• 1999

Recently we experienced four cases of soft tissue Ewing sarcoma, developed in the calf muscles in two cases, and one case each in the foot and suprascapular region. We also found that the clinical course in all cases was rather rapid, because of local recurrence and metastatic lesions developing within a few months, followed by the patients' death in about 2 years after the primary tumor was excised. These cases were improperly treated initially as some kind of benign soft tissue tumor. The delay led to missed early accurate diagnosis and was thought to be one of the main causes for the rapid local recurrence and metastasis after tumor excision. The pulmonary metastasis was the most common cause of death.

• Journal of Chest Surgery
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• 제17권3호
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• pp.346-355
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• 1984

77 cases of Aortic Valve Replacement, which were composed of 64 rheumatic valvular heart disease and 13 combined congenital heart disease, were operated at Seoul National University Hospital for Aortic valvular disease during the period from June 1968 to December 1983. Among these 64 rheumatic aortic valvular heart disease cases, 8 patients were expired during and immediate after operation and overall mortality rate was 12.5%. For more precise remarks, these patients were divided into two periodic groups, 1st period [from 1968 to 1976] and 2nd [from 1977 to 1983] when annual open heart surgery were over 100 cases, and in 1st period three of four patients were died and in 2nd period five of sixty patients were died and its mortality rate was 8.3%. There were 12 cases of postoperative complication, which were 3 cases of remaining other valvular heart disease required MVR, 2 paravalvular leaks [one of them got Redo AVR], 4 thromboembolism or problem of anticoagulant therapy, 2 late death due to SBE with replaced valve failure and one functional AS with small sized valve. Operative death was affected by pump-time and aortic cross-clamping time, heart size, Ejection Fraction, LVEDP and symptom duration, and other many factors may influence the survival rate. Improved operative technique and myocardial protection and meticulous evaluation of the preoperative patient status will make the AVR safer.

• Journal of Chest Surgery
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• 제28권4호
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• pp.355-359
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• 1995

A clinical analysis was performed on 48 cases with mitral stenosis who received open mitral commissurotomy from December 1983 to June 1991 at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital. Fifteen patients were men and 33 were women. the mean age was 35.6 years with the range of 16 to 61 years. The distribution of preoperative NYHA Functional Classes was as follows; class II, 25 patients; class III, 20 patients; class IV, 3 patients. Three patients had cerebral emboli preoperatively, all of whom were in atrial fibrillation. The preoperative electrocardiographic studies revealed that 32 patients had sinus rhythms and 16 had atrial fibrillations. Twenty-six patients had open mitral commissurotomy alone and 22 patients had additional cardiac procedures. Intraoperatively, there were 6 cases of left atrial thrombosis. There was no perioperative death but early postoperative complications were found in 3 cases. The patients were followed up from 2 to 99 months[mean 33.7 months . There was one case of late unexplained sudden death. There was a case of late postoperative cerebral infarction, 5 cases of mitral restenosis and 3 cases of congestive heart failure and/or arrhythmia. Mitral valve replacements were required in 3 patients.But, it is evident that open mitral commissurotomy has many advantages beyond mitral valve replacement concerning the results of the mitral valve replacement underwent during the same period at the Department of Thoracic & Cardiovascular Surgery, Chungnam National University Hospital.

• Journal of Chest Surgery
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• 제14권3호
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• pp.247-253
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• 1981

A total and consecutive 46 patients have undergone cardiac valvular surgery including 8 open mitral commissurotomy and 38 mitral, aortic, mitral-aortic, mitral-tricuspid, tricuspid valve replacements using 46 artificial valves in a period between September 1976 and July 1981. They were 19 males and 27 females with the age ranging from 16 to 50 (mean 32.6) years. Out of 46 valves replaced, 6 were prosthetic valves and 40 were tissue valves, and 33 were replaced in mitral, 9 in aortic and 3 In tricuspid position. Isolated replacements were 33 mitral valves, 6 aortic valves and 1 tricuspid valve; double valve replacements were 6 mitral-aortic valves and 2 mitral-tricuspid valves. . Early mortality within 30 days after operation was noted in 4 cases; 3 after MVR and 1 after open mitral commissurotomy. Causes of death were thrombus obstruction of Beall-Surgitool, Cerebral air embolism, acute renal shut down due to low output syndrome, and left upper pUlmonary vein rupture after open mitral commissurotomy (early mortality 8.7%). 3 late deaths were noted during the follow-up period from 2 to 59 months; 1 due to cerebral hemorrhage from warfarin overdose 3 months, 1 due to miliary tuberculosis 9 months, and another 1 due to cardiac failure after open mitral commissurotomy 42 months postoperatively. Total survival rate 59 months after valvular surgery was 84.8%; there were no early and late death in the group of AVR, TVR and double valve replacements. Preoperative NYHA Class III & IV were 35 cases (76%) out of total 46 cases, and 38 cases (94.8%) out of 39 survival cases were included In NYHA Class I & II during the follow-up period.

• 한국의료질향상학회지
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• 제11권1호
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• pp.4-14
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• 2004

Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

• Advances in pediatric surgery
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• 제12권2호
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• pp.137-146
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• 2006

Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.

• 농촌의학ㆍ지역보건
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• 제47권2호
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• pp.109-120
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• 2022

Objectives: The purpose of this study was to identify the effectiveness of COVID-19 vaccinations on deaths of the COVID-19 cases in some elderly long-term care facilities (LTCF) in Gwangju Metropolitan City. Methods: The study subjects were 659 COVID-19 cases in residents of 7 elderly LTCF, Gwangju, from 21 Dec. 2021 to 28 Jan. 2022. The used variables were confirmed dates for COVID-19, demographic characteristics, co-morbidities, presentation of symptoms, death and vaccination related characteristics including type of vaccine, doses and dates. Vaccination status were classified as not vaccinated, partially and fully vaccinated. The associations of vaccination status and deaths of COVID-19 cases were tested by chi-square test and multiple logistic regression analysis. Results: The rates of not vaccinated, partially vaccinated and fully vaccinated were 19.4%, 10.2% and 70.4%, respectively. The mortality rate of the cases was 6.4%. The death rate by vaccination status was 16.4% in not vaccinated, 15.4% in partially vaccinated and 2.6% in fully vaccinated, showing a statistically significant difference. The adjusted odds ratios (ORs) (95% confidence intervals, CIs) of death compared to fully vaccinated were 7.64 (3.87-16.34) in non-vaccinated, and 6.97 (3.44-14.14) in partially vaccinated. Conclusions: COVID-19 vaccination seems to work effectively in preventing deaths of COVID-19 cases of elderly LTCF residents. This finding support that fully vaccinations in high risk group such as elderly LTCF residents is very important for one of strategies of COVID-19 management.

• Journal of Chest Surgery
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• 제27권2호
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• pp.148-152
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• 1994

We have experienced 21 cases of traumatic diaphragm injury between October, 1989 and September, 1993. Of these patients, 17 cases were caused by blunt trauma and 4 by penetrating injury. Among 17 blunt traumas, 10 cases developed at left side, 6 at right and 1 at central subpericardial diaphragm, and among penetrating injuries, 3 cases developed at right side and 1 at left. Overall mortality rate was 21% and one due to blunt trauma was 29%. Initial hypotension was a predisposing factor to presume future death. When associated injuries involved 4 or more organs, mortality rate was high.