Premature birth is the single largest cause of perinatal mortality and morbidity nonanomalous infants in developing countries. Advances in neonatal care have lead to increase survival and reduced short and long term morbidity for preterm infants, but the rate of preter birth has actually increased. This review provides recent multifactorial approaches to treatme and prevention of preterm birth.
Lee, Taik Jong;Noh, Hyung Joo;Kim, Eun Key;Eom, Jin Sup
Archives of Plastic Surgery
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v.39
no.4
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pp.384-389
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2012
Background Numerous procedures are available for nipple reconstruction without a single gold standard. This study presents a method for reducing donor-site morbidity in nipple reconstruction using a composite nipple graft after transverse rectus abdominis musculocutaneous flap breast reconstruction. Methods Thirty-five patients who underwent nipple reconstruction using a composite nipple graft technique between July of 2001 and December of 2009 were enrolled in this study. To reduce the donor site morbidity, the superior or superior-medial half dome harvesting technique was applied preserving the lateral cutaneous branch of the fourth intercostal nerves. The patients were asked to complete a previously validated survey to rate the color and projection of both nipples, along with the sensation and contractility of the donor nipple; and whether, in retrospect, they would undergo the procedure again. To compare projection, we performed a retrospective chart review of all the identifiable patients who underwent nipple reconstruction using the modified top hat flap technique by the same surgeon and during the same period. Results Thirty-five patients were identified who underwent nipple reconstruction using a composite nipple graft. Of those, 29 patients (82.9%) responded to the survey. Overall, we received favorable responses to the donor site morbidity. Projection at postoperative 6 months and 1 year was compared with the immediate postoperative results, as well as with the results of nipples reconstructed using the modified top hat flap. Conclusions The technique used to harvest donor tissue is important. Preserving innervation of the nipple while harvesting can reduce donor site morbidity.
To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.
Background The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. Methods We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC flap (n=14) between 1995 and 2013. Morbidity was classified into hospitalization, medical, or flap-related complications. Functional outcomes were classified into oral re-alimentation and decannulation time. Results The overall flap-related complication rate was higher in the PMMC flap group (n=8, 57.1%; P=0.019), but the medical morbidity rate was higher in the cutaneous free flap group (n=68, 80%; P=0.006). The rate of pneumonia was higher in the cutaneous free flap group (n=48, 56.5%; P=0.020). Pulmonary premorbidity was the variable most significantly associated with pneumonia (odds ratio=3.012, P=0.012). There was no statistically significant difference in oral re-alimentation and decannulation time between the two groups. Conclusions Although the functional superiority of free flaps has been reported in many studies, our results do not support this hypothesis. One limitation of our study is the relatively smaller flap size and fewer PMMC flap cases compared with the cutaneous free flap group. The low postoperative medical morbidity incidence rate in the PMMC flap group was clinically significant; however, the free flap group had more flap-related complications. Thus, PMMC flaps should be considered a viable option, especially for patients with pulmonary premorbidities.
Retrospective study on the comparison of outbreaks of food poisoning for food hygiene in Korea and Japan. The average value of morbidity rate by year in Korea during the period of 1971 to 1992 was 2.9 per 100,000 population, and that of Japan was 29.1. The mean value of mortality rates in case of food poisoning by year in Korea was 2.33%, and that of Japan was 0.07%. When compared the rates of morbidity and mortality between Korea and Japan during the same period, the morbidity rates of Japan were much higher than those of Korea (p<0.01). However, mortality rate of patients in Korea were much higher then those of Japan(p<0.01). Resulting from comparative observation of food poisoning by preparing facilities between Korea and Japan. The highest list the places where the outbreaks occurred was home-made foods accounted for 48.8% of the total cases in Korea and that of Japan was restaurants accounted for 33.0%. Causative foods in Korea, the most common incrimination vehicles were seafood, meat and animal products and grain and vegetables, including mushroom. However, in the case of the common incrimination vehicles Japan were unknown and other foods, seafood, vegetables and meat and animal products etc.. Food poisoning of pathogenic substance in Korea were 60.9% of bacterial food poisoning of the total cases showing that Vibrio species, Salmonella spp., Staphylococcus spp., pathogenic E. coli, Clostridium spp. and other spp. were 33.3%, 26.2%, 16.3%, 5.3%, 0.4% and 18.5%, respectively. On the other hand, in Japan, major causes were Vibrio spp. (45.7%), Staphylococcus spp. (23.7%), Salmonella spp. (16.8%), pathogenic E. coli (3.8%), Clostridium spp. (0.2%) and other spp. (9.6%).
Background: Although operative outcome is progressing due to the development of operative techniques and myocardial protection, some patients face an increased morbidity and mortality. Therefore, it has become increasingly important to predict the operative morbidity and mortality. Material and Method: This retrospective study reports the results of risk factor analysis of morbidity and mortality of 137 consecutive patients who were underwent coronary artery bypass graft surgery(CABG). Preoperative variables were age, sex, preoperative myocardial infarction, operative priority, left ventricular ejection fraction, obesity and triple vessel disease. Postoperative morbidities were arrhythmia, wound infection, cerebral infarction, prolonged postoperative hospitalization, pneumonia, acute renal failure, prolonged use of ventilator and operative death. Result: The mean age of total patients was 56.7 years, from 27 to 74. The overall mortality was 6.6%(9 of 137) with the mortality of 3.9%(5 of 128) for elective operation, and 44.4%(4 of 9) for emergent or urgent cases. The morbidity of patients over 65 years was stastistically higher than that of under 65 years. Sex distribution showed no difference in morbidity, however operative mortality rate was slightly higher in women (5/41, 12.19%) than in men(4/96, 4.17%). Morbidity of emergent or urgent operation was 100%, much higher than that of the elective operation. Mortality of the patients whose left ventricular ejection fraction was under 50% was higher than that of those over 50%. Conclusion: We concluded that the risk factors of morbidity after CABG were old age above 65 years and emergent or urgent operation, and that risk factors of mortality were low left venticular ejection fraction under 50% and emergent or urgent operation.
The purpose of this study was to compare the difference of two survey methods for health services research. Data were collected by means of two types of household survey conducted from March 11 to September 19, 1985. A probability sample of 30,613 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. The sample was divided into two groups systematically. One group was surveyed by the self-administered questionnaire and the other group was interviewed. Response rates were 81.4% and 90.6% respectively. The data were analysed by the ratio of the results of the self-administered survey to those of the interview survey. No difference was observed in sex, age, residence, or occupation between the two groups. However the respondents' characteristics were statistically different between the two groups. The major findings of this study are as follows : 1. The morbidity rate was 142.5 per 1,000 persons during the two week period by the self-administered questionnaire survey and 74.3 per 1,000 persons with the interview survey method. The ratio of the morbidity rate by the self-administered questionnaire to that by the interview was 1.92, and the difference between the two rates were due to the personal characteristics. 2. The out-patient utilization rate was 10.2 visits per person per year by the self-administered questionnaire survey and 5.4 by the interview survey, and the ratio was 1.89; the admission rate was 3.2 times per 100 persons per year by the self-administered questionnaire survey and 1.9 times by the interview survey, and the ratio was 1.68. Differences due to the sociodemographic characteristics were greater in the out-patient utilization rates than in the adimssion rates. 3. Percentages of effective medical care demand were 90.2% in the self-administered survey and 92.3% in the interview survey; the ratio was 0.98 which was less than that of the morbidity rate and medical care utilization. But, differences of effective medical care demand occurred in persons with no occupation, and aged or low educated respondents. 4. Respiratory illness had the highest frequency in the two survey methods. But there was a slight difference between the two survey methods in morbidity composition. 5. It was concluded that data collected by the interview survey were inclined to be underestimated and this problem can be corrected by a modified self-administered survey.
Purpose: Emergency operations for perforated peptic ulcer are associated with a high incidence of postoperative complications. While several studies have investigated the impact of perioperative risk factors and underlying diseases on the postoperative morbidity after abdominal surgery, only a few have analyzed their role in perforated peptic ulcer disease. The purpose of this study was to determine any possible associations between postoperative morbidity and comorbid disease or perioperative risk factors in perforated peptic ulcer. Materials and Methods: In total, 142 consecutive patients, who underwent surgery for perforated peptic ulcer, at a single institution, between January 2005 and October 2010 were included in this study. The clinical data concerning the patient characteristics, operative methods, and complications were collected retrospectively. Results: The postoperative morbidity rate associated with perforated peptic ulcer operations was 36.6% (52/142). Univariate analysis revealed that a long operating time, the open surgical method, age (${\geq}60$), sex (female), high American Society of Anesthesiologists (ASA) score and presence of preoperative shock were significant perioperative risk factors for postoperative morbidity. Significant comorbid risk factors included hypertension, diabetes mellitus and pulmonary disease. Multivariate analysis revealed a long operating time, the open surgical method, high ASA score and the presence of preoperative shock were all independent risk factors for the postoperative morbidity in perforated peptic ulcer. Conclusions: A high ASA score, preoperative shock, open surgery and long operating time of more than 150 minutes are high risk factors for morbidity. However, there is no association between postoperative morbidity and comorbid disease in patients with a perforated peptic ulcer.
Kim Jae-Ho;Jeong Eun-Seok;Moon Serng-Bae;Kim Jeong-Gon;Lee Sang-Woo
Journal of Navigation and Port Research
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v.30
no.5
s.111
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pp.405-414
/
2006
The purpose of this study was to find out morbidity rate and pattern of occupational disease and affect of variables related disease of Fishing crew The subjects this study were 624 Fishing crew who took education course in Korea Institute of Maritime and Fisheries Technology. This questionnaire was focused on finding the basic data for prevention of occupational disease and promotion health on the Fishing crew The collected data were analyzed by using descriptive statistics, Chi-square, cross tab by SPSS package. The result of this study are as follow. 1)The morbidity rate within recent 12 months was 70.2%. there were significant differences of occurred disease in age, rank, perceived health status, fatigue symptoms, rest time, workload, overtime duration 2) the more aging(p<0.01), perceived fatigue(p<0.01), workload(p<0.01), overtime(p<0.05) and the less perceived health status(p<0.01), rest time(p<0.01), the higher morbidity rate 3) Considering disease unable to work more than 4 hour, the number of those who had musculoskeletal disease were 20.9%, which revealed the highest rate, digestive disease 14.3%, traumatic disease 13.5%.
Kim Jae-Ho;Jeong Eun-Seok;Moon Serng-Bae;Kim Jeong-Gon;Lee Sang-Woo
Proceedings of the Korean Institute of Navigation and Port Research Conference
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2006.06b
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pp.29-38
/
2006
The purpose of this study was to find out morbidity rate and pattern of occupational disease and affect of variables related disease of Fishing sailors' The subjects this study were 624 fisheries sailors' who took education course in Korea Institute of Maritime and Fisheries Technology. This questionnaire was focused on finding the basic data for prevention of occupational disease and promotion health on the fishing sailors' The collected data were analyzed by using descriptive statistics, Chi-square, cross tab by SPSS package. The result of this study are as follow. 1)The morbidity rate within recent 12 months was 70.2%. there were significant differences of occurred disease in age, rank, perceived health status, fatigue symptoms, rest time, workload, overtime duration 2) the more aging(p<0.01), perceived fatigue(p<0.01), workload(p<0.01), overtime(p<0.05) and the less perceived health status(p<0.01), rest time(p<0.01), the higher morbidity rate 3) Considering disease unable to work more tlnn 4 hour, the number of those who had musculoskeletal disease were 20.9%, which revealed the highest rate, digestive disease 14.3%, traumatic disease 13.5%.
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