• Journal of Gastric Cancer
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• v.14 no.3
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• pp.173-179
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• 2014

Purpose: The prevalence of gastric cancer in the elderly is increasing. The purpose of this study was to clarify factors related to morbidity following gastric cancer surgery in elderly patients. Materials and Methods: For this study, data from 411 patients who underwent curative gastrectomies with lymph node dissections between March 2010 and January 2013 were retrospectively studied using a prospectively designed database. Patients were divided into 2 groups (<70 years vs. ${\geq}70$ years). For each group, perioperative factors were analyzed to determine if they were associated with postoperative morbidity and mortality. Results: Comorbidities were more prevalent in the elderly group (${\geq}70$ years). Intraoperative and postoperative transfusions were also more frequently required in the elderly group. There was no significant difference in the number of retrieved lymph nodes between the 2 groups (44.3 vs. 46.6 nodes). In a comparison of the elderly versus non-elderly groups, the postoperative morbidity rates were 22.7% versus 8.9% (P<0.001) and the postoperative mortality rates were 4.2% versus 0% (P=0.002), respectively. Of the possible non-surgical complications, pulmonary problems were predominately found in the elderly group (P<0.001). Surgical complications were evenly distributed between the 2 groups (P=0.463). Postoperative morbidity was significantly associated with older age and postoperative transfusion. Multivariate analysis showed that higher body mass index (BMI) and postoperative transfusion were important factors associated with postoperative complications in the elderly group. Conclusions: Pulmonary complications were frequently problematic in elderly patients. Higher BMI and postoperative transfusion were significant risk factors for postoperative complications in elderly patients with gastric cancer.

• Journal of Korean Neurosurgical Society
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• v.55 no.4
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• pp.195-199
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• 2014

Objective : Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods : We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3--8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results : Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion : Ethical training and developing decision-making skills are necessary including shared decision making.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.199-207
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• 2021

Objectives: Physical inactivity is the fourth leading global risk factor for mortality, followed by obesity. The combination of these risk factors is associated with non-communicable diseases, impaired physical function, and declining mental function. The World Health Organization recommends physical activity to reduce the mortality rate. Thus, this study examined the effects on anthropometric measurements of a 12-week walking program for elderly people in Samarahan, Sarawak, Malaysia with a 7000-step goal and weekly group walking activities. Methods: A quasi-experimental study was conducted involving 109 elderly people with a body mass index (BMI) ≥25.0 kg/m². BMI, body composition, and average daily steps were measured at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS version 26.0, and repeated-measures analysis of variance with the paired t-test for post-hoc analysis was conducted. Results: In total, 48 participants in the intervention group and 61 participants in the control group completed the study. A significant interaction was found between time and group. The post-hoc analysis showed a significant difference between pre-intervention and post-intervention (within the intervention group). The post-intervention analysis revealed an increase in the mean number of daily steps by 3571.59, with decreases in body weight (-2.20 kg), BMI (-0.94 kg/m²), body fat percentage (-3.52%), visceral fat percentage (-1.29%) and waist circumference (-2.91 cm). Skeletal muscle percentage also showed a significant increase (1.67%). Conclusions: A 12-week walking program combining a 7000-step goals with weekly group walking activities had a significant effect on the anthropometric measurements of previously inactive and overweight/obese elderly people.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.4-8
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• 2022

Obesity hypoventilation syndrome (OHS) is defined as the triad of obesity (body mass index, [BMI] ≥ 30 kg/m²), daytime hypercapnia (PaCO2 ≥ 45 mm Hg), and sleep breathing disorder, after excluding other causes for hypoventilation. As the obese population increases worldwide, the prevalence of OHS is also on the rise. Patients with OHS have poor quality of life, high risk of frequent hospitalization and increased cardiopulmonary mortality. However, most patients with OHS remain undiagnosed and untreated. The diagnosis typically occurs during the 5th and 6th decades of life and frequently first diagnosed in emergency rooms as a result of acute-on-chronic hypercapnic respiratory failure. Due to the high mortality rate in patients with OHS who do not receive treatment or have developed respiratory failure, early recognition and effective treatment is essential for improving outcomes. Positive airway pressure (PAP) therapy including continuous PAP (CPAP) or noninvasive ventilation (NIV) is the primary management option for OHS. Changes in lifestyle, rehabilitation program, weight loss and bariatric surgery should be also considered.

• Journal of Aquaculture
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• v.13 no.4
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• pp.339-351
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• 2000

Optimal environmental conditions, that sustained fastest growth, lowest mortality and abnormality of the scallop Patinopecten yessoensis, were identified from field experiments undertaken at Chumunjin during 1991-1998. Temperature within the water column 10~30 m depth ranged between 5 and 23$^{\circ}C$; high temperature and daily fluctuation resulted in growth retardation and heavy mortality of the scallop. Optimal salinity range was between 31.5 and 34.5%0 and water transparency 6.0 and 18.1 m, which was significantly affected by phytoplankton density. Chlorophyll concentration ranged between 0.04 and 3.51 f.lgfL. Low temperature and high chlorophyll concentration appear to support faster growth of the scallop. Optimal periods of transplantation for intermediate culture were between mid July and early November: cultured under high density during July-August as a first step and under low density during mid September through early November as a second step. Optimal stocking density in square net cage (<35${\times}$35 em) for intermediate culture was 30-40 individuals per cage for main culture using lantern net and 80 -100 individuals of the size of 1.5 ~ 3.0 em shell height per cage for sowing culture. During the intermediate culture, the highest growth was realized, when the cage was held at water depth between 10 and 15 m. Water depth below 25 m, however, was best to avoid mass mortality during the periods of abnormally high water temperature and high variation of water temperature. The daily growth rate during the intermediate culture was between 0.019~0.381 mm; low in January and February but high in March and April. It is suggested that the main culture is commenced before June under low stocking density to avoid the possibility of mass mortality during summer by high water temperature.

• Journal of the Korean Society of Marine Environment & Safety
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• v.23 no.5
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• pp.513-523
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• 2017

We evaluated the viability of phytoplankton along the salinity gradient in the flood and ebb tides of spring tide of February and the ebb tide of neap tide of March 2017 in the Seomjin River Estuary. Additional laboratory experiments were also conducted to determine the reason of the pH changes along the salinity gradient using the field natural sample in February. In field, saltwater was well mixed at downstream vertically and the salinity gradient was horizontally appeared toward upstream of freshwater zone. There were strong negative correlations between salinity and nutrient (nitrate + nitrite R=0.99, p<0.001, and silicate R=0.98, p<0.001), implying that those two nutrients of freshwater origin were gradually diluted with mixing the saltwater. On the other hands, relatively high phosphate concentration was kept in the stations of saltwater over 15 psu, indicating that it was caused by resuspended sediments of Gwangyang Bay and downstream by tidal water mixing.Among phytoplankton community structure in winter, Eucampia zodiacus have occupied to be c.a. 70 % in the most stations. Based on the field survey results for survivability of phytoplankton by phytoPAM instrument, there was positive correlations between salinity and chlorophyll a (R=0.82, p<0.001) and, salinity and active chlorophyll a (R=0.80, p<0.001), implying that the dominant marine diatom species may have significantly damaged in low salinity conditions of upstream. Also, maximum mortality rate of phytoplankton caused by low salinity shock was appered to be 75% in the upstream station. In particular, the pH in spring tides of February had tended to increase with high phytoplankton accmulated stations, suggesting that it was related with absorption of $CO_2$ by the photosynthesis of dominant diatom. In laboratory experiments, phytoplankton mass-mortality caused by low salinity shock was also occurred, which is confirmed with reducing the photosynthetic electron transport activity. Following the phytoplankton mass-mortality, bacteria abundance was significantly increased in 24 hours. As a result, the mass-proliferating bacteria can produce the $CO_2$ in the process of biodegradation of diatoms, which can lead to pH decrease. Therefore, marine phytoplankton species was greatly damaged in freshwater mixing area, depending on along the salinity gradient that was considered to be an important role in elevating and reducing of pH in Seomjin River Estuary.

• Korean Journal of Ichthyology
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• v.30 no.3
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• pp.131-136
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• 2018

Decrease in seawater temperature during winter is one of the most important and serious issues confronted by fish net-cage aquaculture farms. This can become the cause of the manifestation of diseases and ensuing mass mortality. The present study was conducted to assess the survival rate, the range of limited low-temperature, the response of oxidative stress in the blood of red sea bream Pagrus major with decrease of water temperature. Low-lethal temperature for 7 days of P. major ($7day-LT_{50}$) was $6.54^{\circ}C$ (confidence limit: $6.31{\sim}6.71^{\circ}C$). Oxygen consumption rate was decreased with lower temperature. It showed the minimum value at the range of low-lethal temperature. Osmolality at $5^{\circ}C$ and $6^{\circ}C$ experimental group was higher significantly than control group. SOD (superoxide dismutase) activity was increased significantly at $5^{\circ}C$ experimental group compared to control group. This study data will be used to determine the appropriate area for aquaculture of red sea bream. It also manage fish net-cage farm to cope with the mass mortality occurring frequently during winter season.

• Journal of fish pathology
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• v.11 no.2
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• pp.97-104
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• 1998

Since 1989, mass mortality has repeatly occurred in cage-cultured sevenband grouper, Epinephelus septemfasciatus along the southern coast of Korea in the summer season and usually reached over 80% within a few months. Diseased fish showed the clinical signs of anorexia, dark coloration, loss of eqilibrium, spinal swimming behaviour, vertebral deformity and inflation of swim bladder. Histopathologically, necrosis and/or vacuolation of the nerve cells in the brain and retina were observed. We previously reported that the causative agent was filtrable. The causative agent was not culturable in various fish cells; RTG-2, CHSE-214, BF-2, EPC and FHM. However, electron microscopic observation revealed unenveloped icosahedral viral particles with about 30 nm in diameter in the cytoplasm of nerve cells of the brain. The characteristics of the virus was tested by an artificial infection with the filtrate of the homogenate of diseased fish. The pathogenicity of the virus was retained after treatment with ether or heat ($50^{\circ}C$, 30 min) but partly lost by pH 3 or 11 treatment. These results suggest that the causative agent are similar to the fish nodavirus. In order to compare the causative agent with a fish nodavirus, Striped Jack Nervous Necrosis Virus (SJNNV), a polymerase chain reaction (PCR) was performed with primers specific to SJNNV. As a result, about 430 by PCR products were detected from the brain and the eye of both naturally and artificially infected sevenband grouper. All these results represent that the mass mortality in the cultured sevenband grouper is caused by the infection of a nodavirus similar to SJNNV and this is the first report of a fish nodavirus from the cultured sevenband grouper in Korea.

• 한국해양학회지
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• v.22 no.3
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• pp.207-215
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• 1987

The Keum River Estuary was investigated two times in April and July, 1986, to study process controlling chlorophyll distribution in estuarine waters. During the surveys, distribution patterns were studied for chlorophyll-a, nutrients, ph, SPM (Suspended Particulate Matter), DO (Dissolved Oxygen), temperature, salinity, etc. During April survey(low-discharge period), sea water penetrated to Kangkyung, about 35km upstream from the constructing weir, while in July (high-discharge period) only to 3 km upstream from the weir,In April SPM showed very high concentrations (500mg/l)on the average. But very low concentrations(about10mg/l)were observed in July due to high discharge of fresh water.Chlorophyll-a concentrations showed large variations both in time and space :much higher concentraations in July than in April and sharp decrease in concentrations at the fresh water-sea water interface (April:$6.5\mu\textrm{g}/{\ell}$ for fresh waters and 41.4\mu\textrm{g}/{\ell}$ forestuarine waters). Differebce ub chlorophyll-a concentrations for these two surveys appear to be caused mainly by the difference in effectiveness of penetrating lights controlled by SPM in the waters. Sharp decrease in chlorophll-a at the fresh water-sea water interface is believed to be resulted from mass mortality of fresh water phytoplankton caused by changes in osmotic pressure in the region. Observations in the same regions such as increase in AOU(Apparent Oxygen Utilization)and ammonia, decrease in PH,probably resulted through decomposition processes of dead planktons,furtuer support the idea.

• Journal of fish pathology
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• v.13 no.2
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• pp.121-127
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• 2000

From August to October 1998, over 60% mortality of cultured striped beakperch Oplegnathus fasciatus was occurred in net cages along the southern coast of Korea. Moribund fish showed some clinical signs of lethargic behavior, dark coloration or decoloration, severe gill anemia and enlargement of spleen. Also enlarged basophilic cells showing Feulgen -positive reaction were observed in the tissue section of spleen, kidney, liver and heart of the diseased fish. GF cells inoculated with spleen homogenate of diseased fish produced cytopathic effect of enlarged and rounded cells, therefore the causative virus was isolated from diseased fish. Striped beakperch fingerlings intraperitoneally inoculated with the causative virus ($10^4TCID_{50}$/0.1 ml) revealed symptoms similar to those of naturally infected fish and died from 7 to 14 days post injection. Transmission electron microscopy revealed that the causative virus was enveloped icosahedral particle with 120~130 nm in diameter. PCR products of the expected size (500 bp) were amplified with a primer set based on the ATPase gene of RSIV(red sea bream iridovirus) using template DNAs which were extracted from the spleen of diseased fish and GF cells inoculated with the causative virus. According to the analysis of nucleotide sequence of these PCR products, the sequence from ATPase cDNA gene of the causative virus showed 95% homology with that of RSIV. These results indicate that the mass mortality in the cultured striped beakperch was caused by the infection of iridovirus similar to RSIV.