• The Korean Journal of Legal Medicine
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• v.42 no.4
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• pp.159-163
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• 2018

Progressive muscular dystrophy (PMD) is a primary muscle disease characterized by progressive muscle weakness and wasting, which is inherited by an X-linked recessive pattern and occurs mainly in males. There are several types of muscular dystrophies classified according to the distribution of predominant muscle weakness including Duchenne and Becker, Emery-Dreifuss, facioscapulohumeral, oculopharyngeal, and limb-girdle type. Clinical manifestations of PMD are clumsy, unsteady gait, pneumonia, heart failure, pulmonary edema, hydropericardium, hydrothorax, aspiration, syncopal attacks, and sudden cardiac death. The deceased was a 34-year-old man, and the onset of the first clinical symptom, gait disturbance, was in his late teens. His elder brother had the same disease and experienced brain death after a head trauma and died after mechanical ventilation was discontinued. After an autopsy, we found contracture of the joints, pseudohypertrophy of the calf, wasting and fat replacement of the thigh muscle, pericardial effusion (80 mL), fibrosis and fat replacement of the cardiac ventricular wall, pulmonary edema, and froth in the bronchus. The cause of death was heart failure and dyspnea due to muscular dystrophy. There was no sign or suspicion of foul play in his death.

• Journal of Chest Surgery
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• v.17 no.4
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• pp.678-686
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• 1984

Between Jan. 1978, and Dec. 1983, a total and consecutive 117 patients have undergone cardiac valve replacement using various artificial tissue valve. Out of 117 patients, single valve surgery was 78 consisted of MVR 74, AVR 3 and AVR & supracoronary ascending aorta replacement 1. Multiple valve surgery was 39 cases consisted of MVR+TAP 20, MVR+AVR 13 and so on. Early death with 30 days after operation was 12 cases [early mortality 10.3%] and causes of death were cardiac origin 5, technical problem 4, and others 3. The 105 early survivors were followed-up for a total of 190.5 years over a period of 2 to 64 months [Mean\ulcornerD:21.9\ulcorner4.9 months]. During follow-up, 7 cases died [late mortality:6.7%]. The rate of thromboembolism was 2.1% episodes per patient-year and bleeding due to anticoagulant was 3.1% episodes per patient-year and valve failure was 1.6% episodes per patient-year. Actuarial analysis of late results indicated an expected survival rate at 5 years of 84.6% for patients with single valve surgery and 82.1% for patient with multiple valve surgery and overall was 83.8%. Symptomatically, 86.7% of patients were in NYHA class I or II at the end of follow-up.

• Korean Journal of Microbiology
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• v.9 no.2
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• pp.61-68
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• 1971

Borrelina virus was inoculated into Hyphantrea cunea DRURY in the labolatory and in the field. The pathogenecity of Borrelina virus upon Bompyx mori L. and Dendrolinus spectabilis BUTLER, too, was examined with following results. 1) $10^8$/ml, $10^7$/ ml, $10^6$/ml concentration of nuclear-polyhedrosis virus was inoculated into the larvae of H.cunea at various ages. The corrected mortality of the larvae were 97.4%, 95.2%, 94.7% in the 3rd instar, and 88.6%, 73.6%, 62.5% in the 6th instar, respectively, with three different concentration of NPV. 2) The symptom of disease of the larvae appeared on 4days after inoculation and most of the larvae were dead within 18 days. 3) The youngest larvae treated with the highest concentration of NPV showed the highest mortality. With older larvae and lower concentriton treated, it appeared that the time needed for death grew longer, marking slower death curve. 4) When we sprayed NPV of $10^6$/ml concentration to H. cunea in the field, the mortality was 94.8% in the first year, 84.6% in the second year and 78.3% in third year. By this, we could admit the continuous effects of the pathogens for several years. 5) About the larvae of B. mori of 3rd and 5th instar and D.spectabilis of 3rd instar inoculated with $10^8$/ml concentration of inoclum, we could not see any pathogenic effects.

• Korean Journal of Veterinary Research
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• v.53 no.2
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• pp.103-108
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• 2013

The objective of this study was to investigate the calf death and analyse the causes of the mortality by based on medical records and autopsy findings during 10 years in a large dairy farm. Total of 1,361 calf born and 146 calf dead during the invested period. Mortality rate was 10.7% and showed the big difference by year-specific mortality from 2.8% (4 calves) to 19.2% (28 calves). The highest rate of mortality was 1 week age (18.5%, 27 calves) and followed by 2 week age (11.6%, 17 calves) and mortality of more old calf tended to be reduced. The death less than 4 weeks and 8 weeks of age of the entire mortality accounted for 41.1% (60/146 calves) and 70.0% (102/146 calves), respectively. Causes of calf death were digestive diseases (53.4%), respiratory diseases (17.1%), musculoskeletal disease (8.2%), and systemic disease (8.2%) in order. Specific causes of calf death was highest in enteritis (43.2%), followed by pneumonia (14.4%), sepsis (8.2%) and fractures (3.4%). Seasonally, most of calf death happened in winter (48.6%) and then fall (21.2%). This results showed that enteritis and pneumonia are the main reason of calf death but other reasons were involved in calf death on the based on autopsy finding. On going research relating factors of calf mortality is needed.

• Advances in pediatric surgery
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• v.12 no.2
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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.

• Clinical and Experimental Pediatrics
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• v.57 no.3
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• pp.135-139
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• 2014

Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

• Atmosphere
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• v.24 no.2
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• pp.225-234
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• 2014

Analysis of the cause of death (Statistics Korea) showed that heat wave caused 442 deaths (21 per a year) from 1991 to 2011 in Korea. The number of summer heat-related deaths (heat disorders) increased exponentially as heat wave prolonged. In 1994 when the extreme heat wave prevailed, there were 92 heat-related deaths. Seasonally, heat-related deaths occurred most frequently in early August when air temperature is highest for a year, but it is frequent as well in late July when air temperature increases rapidly after withdrawal of Changma. The frequency of deaths by age has begun to increase from 40s and more than half of total deaths were occurred in the elderly (${\geq}60$). Except retired elderly, the most vulnerable group (job and age) was the elderly agricultural workers and the next was the jobless people in 40 s~50 s, assumed as homeless people. The most vulnerable regions were Hapcheon-gun, Uiryong-gun, and Sanchen-gun, which are inland rural area in Gyeongsang-do where the heat wave occurs most frequently in Korea. The heat-related death rate increased rapidly when air temperature exceeded $33^{\circ}C$ in both of the urban and rural area. Interestingly, the heat-related death were observed in the relatively lower temperature in the cities ($29^{\circ}C$), as compare to the rural area ($31^{\circ}C$).

• Journal of Preventive Medicine and Public Health
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• v.32 no.3
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• pp.355-360
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• 1999

Objectives: This 3-year longitudinal study was conducted to evaluate the influence of self-rating health perception on health care utilization and all cause-death risk. Methods: The hypothesis was tested using a community-based samples, among which subjects 3,414 were interviewed in 1995, Self-rating health perception was assessed by single-item question. Three components of health care utilization amount(number of visits, number of medications, yearly health care expenses) per year were measured using medical insurance data during 3-year follow-up period among subjects in district health care insurance. There were 123 deaths from all causes among 3,085 subjects interviewed. Results: The results showed that those who had poor health perception revealed more increases in the amount of health care utilization than good health perception group (p<0.05). After adjusting for age and sex, the poor health perception group had higher death risk over 3 years than good health perception group(hazard ratio=1.88). but, after adjusting health care utility, supplementary, was not significant. Conclusion: These results suggest that self-rating health perception was associated with difference in health care utilization and all cause-death risk.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.263-267
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• 1995

A total and consecutive 87 patients underwent aortic valve replacement[AVR with the St. Jude Medical prosthesis between 1984 and 1993. Age ranged from 14 to 66 years[mean:38.6$\pm$ 14.0 years .Twenty-one patients [24.1% had undergone previous valve replacement. There were 8 early deaths with an operative mortality rate of 9.2% [7.6% for primary AVR and 14.3 % for re-replacement AVR . Seventy-nine early survivors were,followed for a total of 309.1 patient-years[mean:3.9$\pm$ 2.5 years . A late mortality rate was 5.1% [4 patients or a linearized incidence of 1.294 %/patient-year. All were anticoagulated with coumadin to maintain the international normal ized ratio[INR between 1.5 and 2.5. One patient experienced thromboembolism[0.324%/patient-year , and none did bleeding. Endocarditis occurred in one[0.324%/patient-year . Paravalvular leak was the most frequent complication and was experienced by 8 patients[2.588%/patient-year , and 5 of them required re-replacement AVR[1.618 %/patient year of reoperation rate . There was no structural failure of the prosthesis. Actuarial survival including operative death was 83.9%$\pm$ 4.6% at 10 years.The actuarial estimates of freedom from thromboembolism and of freedom from late death and all complications were 95.1% $\pm$ 4.8 % and 81.4% $\pm$ 6.1%, respectively, at 10 years. These clinical results suggest that less intensive anticoagulation may be allowed for patients of AVR with the St. Jude Medical valve with low incidences of both thromboembolic and bleeding complications.