• Title/Summary/Keyword: death rate

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Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

Effects of Temperature and Nematode Concentration on Pathogenicity and Reproduction of Entomopathogenic Nematode, Steinernema carpocapsae Pocheon Strain (Nematoda: Steinernematidae) (온도 및 농도가 곤충병원성 선충, Steinernema carpocapsae 포천 계통 (Nematoda: Steinernematidae)의 병원성과 증식에 미치는 영향)

  • 추호렬;이동운;윤희숙;이상명;항다오싸이
    • Korean journal of applied entomology
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    • v.41 no.4
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    • pp.269-277
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    • 2002
  • Ecological studies on entomopathogenic nematodes are required to increase control efficacy against target insect pests and to obtain basic information for mass production. Thus, effect of temperature and nematode concentration on infectivity and reproduction of Steinernema carpocapsae Pocheon and that of exposure time and soil depth on infectivity were examined using Galleria mellonella larvae. Infectivity and reproduction were examined at five temperatures, 13, 18, 24, 30 and 35$^{\circ}C$ with seven concentrations, 0, 5, 10, 20, 40, 80 and 160 infective juveniles (IJs)/larva. Temperature and nematode concentration influenced infectivity and reproduction of S. carpocapsae Pocheon. Although G. mellonella larvae were killed by S. carpocapsae Pocheon at all given temperatures and nematode concentrations, mortality was higher at 24$^{\circ}C$ than other temperatures. Lethal time of G. mellonella by S. carpocapsae Pocheon was shorter with increasing temperature and nematode concentrations. S. carpocapsae Pocheon was not established in G. mellonella at 13 and $35^{\circ}C$. Time for the first emergence from G. mellonella cadaver was longer $18^{\circ}C$ (about 20 days) than 24 and $30^{\circ}C$ (about 5 days). The highest number of progenies was obtained at $24^{\circ}C$ with 80IJs/1arva, i.e., $18.8$\times$10^4$IJs were produced from a larva. In the exposure time assay, G. mellonella death was recorded in 10 minutes when 300 IJs were inoculated per larva. When S. carpocapsae Pocheon was inoculated at the rate of $10^{9}$ IJs/ha to G. mellonella at the depth of 0, 2, 5 and 10 cm of sand columns, 100% mortality and similar sex ratio were observed but number of established IJs in cadaver was decreased with deepening the soil depth. The results indicated that optimum temperature for infectivity and reproduction of S. carpocapsae Pocheon was $24^{\circ}C$ In addition, S. carpocapsae Pocheon was effective to target insects within 5 cm from the soil surface.

Single-Dose Oral Toxicity in Rat and Bacterial Reverse Mutation Assay of Psoralea corylifolia L. Extracts (파고지 추출물의 렛트에 대한 단회 경구 투여 독성 및 복귀돌연변이능 평가)

  • Kim, Sun-A;Lim, Sun-Hye;Ahn, Ji-Yun;Kim, Sung-Ran;Ha, Tae-Youl
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.8
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    • pp.960-964
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    • 2007
  • This study was performed to examine the toxicity of Psoralea corylifolia L. by the single-dose oral toxicity tests in rat and bacterial reverse mutation assay. In single-dose oral toxicity tests, 5 mL ethanol extract of P. corylifolia L. were directly injected into 10 rats (5 males and 5 females) at a dosage of 2 g/kg. Death practice was not detected during breeding periods (14 days), and $LD_{50}$ was calculated over 2 g/kg. No difference were observed with control group in the growth rate and histological observations. In bacterial reverse mutation assay, his(-) Salmonella Typhimurium TA98, TA100, TA1535, TA1537 and trp(-) Escherichia coli WP2uvrA (pKM101) were used for assessing the toxicity of ethanol extracts of P. corylifolia L.. No significant difference in formation of the colonies and no dose-dependent increase was observed regardless of the addition of S9 mix. The results showed that ethanol extracts of P. corylifolia L. did not have single-dose oral toxicity and mutagenic toxicity.

Toxicological Effects of Some Insecticides against Welsh Onion Beet Armyworm (Spodoptera exigua) (Metaflumizone을 포함한 몇 가지 약제의 파밤나방(Spodoptera exigua)에 대한 독성검정)

  • Kang, E.J.;Kang, M.G.;Seo, M.J.;Park, S.N.;Kim, C.U.;Yu, Y.M.;Youn, Y.N.
    • Korean journal of applied entomology
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    • v.47 no.2
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    • pp.155-162
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    • 2008
  • The Welsh onion beet armyworm, Spodoptera exigua (Hubner), has attacked Welsh onion and is now the most important pest of Welsh onion in southwestern Korea. The beet armyworm has a wide host range, occurring as a serious pest of vegetable and fields. The relatively high abundance of beet armyworm has stimulated frequent application of insecticides to foliage. Insecticide resistance is a major problem in management of this insect. Accordingly, pesticide application for the control of beet armyworm was tried in both the open field and in laboratory, using 4 synthetic compounds such as metaflumizone and chlorfenapyr, indoxacarb, flufenoxuron, emamectin benzoate. In the laboratory, each developmental stages from eggs, larva to pupa was tested against 4 insecticides. Against the eggs of welsh onion beet armyworm, there was no significantly different with each other. These tested chemicals no killing effect to eggs. However, the population of 1st larva hatched from eggs were reduced because they eaten the egg shell with residual insecticides. The tested insecticides were taken very high mortalities to 1st to 3rd larva of Welsh onion beet armyworm. Otherwise, there were decreased the death rate from 4th to 6th larva. On the other hand, their value of control effects were relatively good against Welsh onion beet armyworms in the field between 87.2 and 90.5% on 10 days after insecticide application.

Influence of Septic in Vibrio Vulnificus from Phytic Acid (피틴산(Phytic acid)이 비브리오(Vibrio vulnificus) 패혈증에 미치는 영향)

  • Chung, Young-Ho;Cho, Chun-Hwi;Lee, Sun-Woo;Lim, Chi-Hwan
    • Korean Journal of Agricultural Science
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    • v.32 no.1
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    • pp.71-80
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    • 2005
  • Phytic acid chelates excellently the metallic ions and the positive ions, especially has high affinity with $Fe^{2+}$ and $Ca^{2+}$. Merits of phytic acid can be taked in easily, edibile and harmless to body, so it was investigated that phytic acid can be substituted for EDTA in this study. 1. The Intensificative effect of chelating agent and disinfective osmotic shock of Vibrio vulnificus The number of initial existent fungi measured $1.7{\times}10^6$. The percentages of the survival fungi against the osmotic shock by distillated water were calculated at 1 minute, 3 minute and 5 minute after inoculation. The percentages of the survival fungi in $Mg^{2+}$ were 92.5%, 91.8% and 79.8% at each time, the average percentage was 88%. Also the sudden extinction was observed around 1 minute after inoculation and the survival fungi were not observed from 3 through 5 minute in spite of repeated experimentation. 2. Influence of Vibrio vulnificus on the survival of the mice. The first mouse started to die in 180 minute after inoculation in case that the inoculating number was $2.3{\times}10^7cfu/ml$. All died within 4.5 hour. The average of survival time was 226 minute. The first mouse started to die in 228 minute after inoculation in case that the inoculating number was $0.8{\times}10^6cfu/ml$. All died within 5 hour. The average of survival time was 300 minute and the survival time was 1.3 times high. The tendencies of death in two cases were similar, but the fatal rate were largely dependent on inoculating number.

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The Effect of Vitamin E on the Composition of inflammatory Cells in Alveoli after Paraquat Intoxication in Rats (Paraquat에 의한 급성 폐손상에서 Vitamin E처치가 기관지폐포 세척액내 세포조성에 미치는 영향)

  • Song, Kwang-Seon;Lee, Won-Yeon;Cho, Do-Yeun;Yong, Suk-Joong;Shin, Kye-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1332-1342
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    • 1997
  • Background : Acute pulmonary injury by paraquat are caused by multiple mechanisms including direct injury with oxygen free radicals and several mediators released from inflammatory cells. In order to clarify whether vitamin E could reduce tissue damages induced by intraperitoneal administration of paraquat and to investigate the pathogenetic mechanisms of paraquat-induced pulmonary injury, vitamin E as a free radical scavenger was administered. Method : Rats were divided into three groups (group 1 : control, group 2 : paraquat treated group, group 3 : paraquat and vitamin E treated group). Animals were sacrificed on day 1, day 2, day 3, and day 8 after the administration of saline, paraquat, or paraquat/vitamin E. Results : Treatment with vitamin E decreased the death rate of rats treated with paraquat. Comparing with control group ($1.37{\times}10^6/ml$), mean total cell counts recovered from the lavage fluid from animals treated with paraquat($1.65{\times}10^6/ml$) were increased(p=0.06). Magnitudes of increment of the total cell counts on the Day 8 in the vitamin E treated group were smaller than those of the animals treated with paraquat alone. The neutrophils began to appear in significant amounts in the lavage fluid on Day 8 after the administration of paraquat(37.0+12.7%). A significant decreasing neutrophil concentration at Day 8 was observed in the paraquat/vitamin E treated group(20.6+13.4%). Histologically the degree of pulmonary fibrosis was most prominent in the paraquat treated group while diffuse alveolar damage was continuously observed in the paraquat/vitamin E treated group and extensive interstitial lymphocytic infiltration was seen in the paraquat/vitamin E treated group. The paraquat/vitamin E treated group showed the less histologic changes. Conclusion : In this study vitamin E acting as a scavenger of neutrophil-derived free radicals and suppressant of lipid peroxidation, seemed to be the effective antioxidant in the inhibition of paraquat-induced pulmonary injury.

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Factors Influencing the Therapeutic Compliance of Patients with Lung Cancer (폐암환자의 치료순응도에 영향을 미치는 요인)

  • Chae, Sang-Chul;Park, Jae-Yong;Kim, Jeong-Suk;Bae, Moon-Seob;Shin, Moo-Chul;Kim, Keon-Yeob;Kim, Chang-Ho;Shon, Sang-Kyun;Kam, Sin;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.953-961
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    • 1998
  • Background : In recent years, lung cancer has been one of most common cause of death in Korea. Despite many physician's high degree of pessimism about the gains made in treatment, progressive improvement in the survival of lung cancer by treatment has occurred, particulary in the early stages of the disease. However, a lot of patients refuse treatment or give up in the fight against the disease. This study was done to evaluate factors influencing the compliance to therapy and to lead in the establishment of special programs to enhance compliance in patients with lung cancer. Methods: The medical records of 903 patients, whose ECOG(Eastern Cooperative Oncology Group) performance status was 3 or less and whose medical record was relatively satisfactory, among 1141 patients diagnosed with lung cancer between January 1989 and December 1996 were reviewed retrospectively. Compliance was classified into three groups based on the degree of compliance with physicians practice guideline: (a) compliants; (b) patients who initially complied but gave up of themselves midway during the course of treatment; (c) noncompliants who refused the treatment. Results: The overall compliance rate was 63.9%, which was progressively increased from 57.3-61.3% in 1989 and 1990 to 64.2-67.5% in 1995 and 1996. Age, education level and occupation of patients bore statistically significant relationship with the compliance but sex, marital status and smoking history did not. The compliance was significantly higher in patients without symptoms than with, and was also significantly higher in patients with good performance status. The compliance was significantly high in patients with NSCLC(non-small cell lung cancer) compared to SCLC(small cell lung cancer), but after exclusion of stage I and II, among NSCLC, which had higher compliance to surgery there was no significant difference of compliance by histology. The compliance was significantly lower in advanced stage. Conclusion: To enhance the compliance, special care including education programs about therapy including complication and prognosis are necessary, especially for educationally and economically disadvantaged patients.

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The Effects of Intra-Abdominal Hypertension on the Prognosis of Critically Ill Patients in the Intensive Care Unit (ICU) (복강 내압 항진증이 내과계 중환자의 예후에 미치는 영향)

  • Kim, Se Joong;Seo, Jeong-Su;Son, Myeung-Hee;Kim, Soo-Youn;Jung, Ki Hwan;Kang, Eun-Hae;Lee, Sung Yong;Lee, Sang Yeub;Kim, Je-Hyeong;Shin, Chol;Shim, Jae Jeong;In, Kwang Ho;Yoo, Se Hwa;Kang, Kyung Ho
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.46-53
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    • 2006
  • Background: Intra-abdominal hypertension (IAH) is defined as the presence of either an intra-abdominal pressure (IAP) ${\geq}12mmHg$ or an abdominal perfusion pressure (APP = mean arterial pressure - IAP) ${\leq}60mmHg$. Abdominal compartment syndrome (ACS) is defined as the presence of an IAP ${\geq}20mmHg$ together with organ failure. The purpose of this study was to investigate the prevalence of IAH and ACS on the day of admission and the effects of these maladies on the prognosis of critically ill patients in the ICU. Methods: At the day of admission to the ICU, the IAP was recorded by measuring the intravesicular pressure via a Foley catheter. The APACHE II and III scores were checked and SAPS II was also scored during the days the patients were in the ICU. The primary end point was the prevalence of IAH and ACS at the day of admission and the correlation between them with the 28-days mortality rate. The measurement of IAP continued until the 7th day or the day when the patient was transferred to the general ward before 7th day, unless the patient died or a Foley catheter was removed before 7th day. Patients were observed until death or the 28th day. Results: A total of 111 patients were enrolled. At the day of admission, the prevalence of IAH and ACS were 47.7% and 15.3%, respectively and the mean IAP was $15.1{\pm}8.5mmHg$. The rates of IAH for the survivor and the non-survivor groups were 56.5% and 71.4%, respectively, and these were not significantly different (p=0.593). Yet the rates of ACS between these two groups were significantly different (4/62, 6.5% vs. 13/49, 26.5%; Odds Ratio = 5.24, 95% CI = 1.58-17.30, p=0.004). Conclusion: In the present study, the prevalence of IAH was 47.7% and the prevalence of ACS was 15.3% on the day of admission. ACS was associated with a poor outcome for the critically ill patients in the ICU.

An Analysis of the Hail Damages to Korean Forests in 2017 by Meteorology, Species and Topography (2017년 우박에 의한 산림피해의 기상, 수종 및 지형 특성 분석)

  • Lim, Jong-Hwan;Kim, Eunsook;Lee, Bora;Kim, Sunhee;Jang, Keunchang
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.19 no.4
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    • pp.280-292
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    • 2017
  • Hail is not a frequently occurring weather event, and there are even fewer reports of hail damages to forest stands. Since the 2000s, an increase in hail incidence has been documented in Europe and the United States. In Korea, severe hails occurred in Jeollanam-do province on May 31 and in Gyeongsangbuk-do province on June 1, 2017. Hail size was ranged from 0.5 to 5.0 cm in diameter in Jeollanam-do, and from 1.5 to 3.0 cm in Gyeongsangbuk-do. This study was aimed to analyze the hail damages to forests by species and topography based on damage-categorized maps created by using drones and aerial photographs, and to analyze relationships of the damages with meteorological factors. The total damaged forest area was 1,163.1ha in Jeollanam-do, and 2,942.3ha in Gyeongsangbuk-do. Among the 'severe' damaged area 326.7ha, 91% was distributed in Jeollanam-do, and concentrated in the city of Hwasun which covers 57.2% of the total 'severe' damaged area. The most heavily damaged species was Korean red pine(Pinus densiflora S. & Z.) followed by P. rigida. Most broad-leaved trees species including oaks were recovered without any dead trees found. Liliodendron tulipifera was the most severely damaged in terms of the rate of 'severe' degree individuals which are needed to be checked whether they will die or be recovered. Cause of the death of pines was considered as the combination of physical damage caused by the hail and long-lasting drought with high air temperature that occurred before and after the hail event. No pathogens and insects were found which might have affected to tree deaths. We suggested a dieback mechanism of the pine trees damaged by hail and drought.

Comparison of the Reconstruction Routes after Esophagectomy for Esophageal Cancer (식도암 절제후 식도 재건경로의 비교)

  • Lee, Seung-Yeoll;Kim, Kwang-Taik;Choi, Young-Ho;Kim, Il-Hyun;Baik, Man-Jong;Sun, Kyung;Lee, In-Sung;Kim, Hyoung-Mook
    • Journal of Chest Surgery
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    • v.32 no.9
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    • pp.806-812
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    • 1999
  • Background: Selection of reconstruction route in esophageal cancer surgery is based on the patient's status, characteristics of tumor, surgeon's preference and experience. Of the various routes, it has been documented that subcutaneous or substernal route may prolong operation time and may be vulnerable to postoperative respiratory complications. This study was designed to evaluate whether the selection of reconstruction route affects the surgical outcomes. Material and Method: Of 131 patients who have undergone resection and reconstruction for esophageal cancer, posterior mediastinal route(Group I, n=34), substernal route (Group II, n=31), and subcutaneous route(Group III, n=21) were retrospectively reviewed in 86 patients. Results of early operations and morbidities were compared between the groups. Result: There was a male prevalence(79 of males vs. 7 of females). There were 81 squamous cell cancers and 5 adenocarcinomas. There were no differences between groups in weight, height, age, cancer staging and location, and in the preoperative anesthetic risk evaluation and pulmonary function test(p=NS). Postoperative mechanical ventilation time was longer in Group I(20.6 hours) than in Group II(7.8 hours) or III(3.4 hours)(p=0.005). Duration of stay in the intensive care unit was prolonged in Group III(6.4 days) compared to Group I (3.9 days) or II(3.1 days)(p=0.043). No differences were noted in the duration of hospital stay between the groups(p=NS). Blood transfusion was needed in 30 out of 34 patients in Group I compared to 14/31 in Group II or 15/21 in Group III(p=0.001). The mean amount of transfusion for each patient was also higher in Group I(3,833 mL) than in Group II(1535 mL) or Group III(1419 mL)(p=0.04), but there was no difference in the inreoperation due to bleeding. Ea ly mortality rate was substantially higher in Group I(17.6%) but the differences between the groups were insignificant(p=NS). Although sepsis was a more prevalent cause of death in Group I, it was not related to anastomotic leak. Other morbidities did not differ between the groups(p=NS). Conclusion: In above results show that the reconstruction route does not affect the outcome of esophageal cancer surgery. We believe that the selection of reconstruction route can be based on the surgeon's preference and experience.

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