• Title/Summary/Keyword: mortality improvement

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Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019

  • Lee, Jang Hoon;Youn, YoungAh;Chang, Yun Sil
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.284-290
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    • 2020
  • Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

The Analysis of Surgical Results to the Lumbar Spinal Disorders of Aged Persons (노령인구의 요추질환에 대한 수술적 치료결과의 분석)

  • Lee, Sei-Young;Youn, Seung-Hwan;Cho, Joon;Moon, Chang-Taek;Chang, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.12
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    • pp.1612-1619
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    • 2000
  • Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

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Effectiveness of Tobacco Education for Pharmacy Students in Indonesia

  • Kristina, Susi Ari;Thavorncharoensap, Montarat;Pongcharoensuk, Petcharat;Montakantikul, Preecha;Suansanae, Thanarat;Prabandari, Yayi Suryo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10783-10786
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    • 2015
  • Background: Smoking remains the major preventable cause of death worldwide, especially cancer-related death. Evidence clearly indicates that tobacco-related morbidity and mortality is reduced by smoking cessation. Pharmacists are well-positioned to provide tobacco cessation services an involvement of pharmacists in smoking cessation is encouraged by several organizations. While Indonesia's prevalence of smoking is in the first rank in Asian countries, none of the pharmacy schools in Indonesia are currently offering tobacco-related courses in their existing curricula at present. Our study aimed to develop and to evaluate the effectiveness of tobacco education (TE) for pharmacy students in Indonesia. Materials and Methods: A 6-hour TE was developed and evaluated using pre-test/post-test with control group design. A total of 137 fifth-year pharmacy students at Gadjah Mada University (GMU), Yogyakarta, were chosen as an intervention group while a total of 105 fifth-year students of Islamic University of Indonesia, (UII) served as the control group. Knowledge, perceived-role, self-efficacy, and ability to perform counseling using the 5A's framework were evaluated. Results: A significant improvement (P < 0.001) in knowledge, perceived-role, and self-efficacy was found in the intervention group but not in the control group. In addition, we revealed that 89.7% of the intervention group were able to perform counseling using 5A's. Conclusions: The developed TE significantly improved student knowledge, perceived-rolse, self-efficacy, and created an ability to perform cessation counseling. Integration of TE education in curricula of Indonesian pharmacy schools nation-wide should be encouraged.

Study on Kidney Toxicities of WK-38 for Treatment Vascular Diseases in Rats (혈관질환 억제 효능이 있는 WK-38의 백서 신장 독성연구)

  • Kim, Eun-Ju;Lee, An-Sook;Shin, Sun;Kim, Sung-Yeon;Chang, Bo-Yoon;Lee, Ho-Sub;Kang, Dae-Gill
    • Herbal Formula Science
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    • v.17 no.2
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    • pp.187-194
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    • 2009
  • The kidney toxicities of WK-38 used for improvement of the vascular diseases, was examined using male and female Sprague-Dawley rats. The male and female rats were divided into 4 groups for intragastrical treatment with doses of 0, 5, 50, and 500 mg/kg/day for 13 weeks, respectively. In all male and female rats treated with WK-38, no mortality and gross pathological findings were shown for 13 weeks. There was substantially no change in body weight in all rats with treatment of WK-38. Urine osmolality as renal functional parameters were not exchanged in all rats treated with WK-38. The renal functional parameters including electrolytes excretory rate, creatinine clearance, and solute-free water reabsorption were significantly augmented on account of increase in urinary volume in female rats treated with WK-38, but not male. In summary, this study demonstrates that WK-38 exhibits no toxicity on kidney in all male and female rats.

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Mitral Valve Reconstruction (승모판 재건술)

  • 이현우
    • Journal of Chest Surgery
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    • v.28 no.12
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    • pp.1107-1112
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    • 1995
  • Between December 1993 and December 1994, fifty-eight percent of the mitral valve patients[33/57 had undergone mitral valve repair. Their mean age was 49[SD-16 years[range 11 - 75 and they were consisted with 15 males and 18 females. The causes of mitral disease in 33 patients were classified as follows: 19 cases[58% were degenerative, 9[27% were rheumatic, 3[9% were congenital and 2[6% were infectious. Carpentier`s functional classification was consisted with Class I 4 cases[12% , II 25 [76% and III 4 [12% . Surgical techniques included prosthetic annuloplasty in 32 cases[97% , leaflet resection in 16[48% , chorda shortening in 13[39% , chorda transfer in 9[27% , new chorda formation in 7[21% , commissurotomy in 7[21% , leaflet mobilization in 4[12% , chorda resection in 3[9% , papillary muscle splitting in 2[6% , cleft repair in 2[6% , leaflet patching in 1[3% and vegetation removal in 1[3% . Average number of mitral anatomical lesions per patient was 3.3 and We used average 3.0 procedures upon mitral valve apparatus per patient. Intraoperative transesophageal echocardiography was carried out in 27 patients[82% for providing an immediate and accurate assessment of the adequacy of the reconstruction before closure of the chest. Operative mortality was absent. The mean functional class[NYHA was 2.87 preoperative and improved to 1.03 postoperatively. Postoperative Doppler echocardiography showed much improvement from grade II MR[5 , grade III[5 , grade IV[21 to no MR[26 , only trace MR[3 , grade III MR[2 . Postoperative mean mitral valve area was 2.4$\pm$0.6cm2[range 1.5 - 4.0 . We conclude that cautiously evaluated mitral valve reconstruction is stable and predictable operation with minimal postoperative left ventricular dysfunction.

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Effects of 12 Week Regular Aerobic Exercise on ST-segment and QTc Interval in Type 2 Diabetes Mellitus Patients (12주 규칙적인 유산소 운동이 제 2형 당뇨환자의 ST 분절과 QTc 연장에 미치는 영향)

  • Kim, Young-Il;Paik, Il-Young;Jin, Hwa-Eun;Suh, Ah-Ram;Kwak, Yi-Sub;Woo, Jin-Hee
    • Journal of Life Science
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    • v.19 no.1
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    • pp.81-86
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    • 2009
  • The purpose of the present study was to examine effect of 12 week regular aerobic exercise on ST-segment and QTc interval in middle age type 2 diabetes mellitus (T2DM) patients. The subjects consist of 13 type 2 diabetes mellitus (T2DM) patients in middle age men and all of them had no other complications. Subjects participated in aerobic exercise training for 12 weeks. They started to exercise for $20{\sim}60$ min at $60{\sim}80%$ of $HR_{max}$, (exercise intensity has been increased gradually) per day, $3{\sim}5$ times a week. The results were compared before and after. Weight and BMI, % body fat, fasting glucose, HOMA-IR, $_{peak}DBP$ were significantly decreased and $_{peak}HR$, $_{peak}VO_2$, exercisre time were significantly increased after 12 week aerobic exercise. Also, QTc interval and ST-segment were significantly decreased during at rest, peak exercise after 12 week aerobic exercise. Conclusionally, 12 week aerobic exercise may be improvement in decreased cardiovascular mortality factors (ST-segment) and abnormal autonomic dysfunction (QTc interval) and potentially increased exercise capacity.

Long-term Effectiveness of Enzyme Replacement Therapy in Fabry Disease (파브리병에서 효소대치요법의 장기적 효과)

  • Kim, Ja Hye;Cho, Ja Hyang;Choi, Jin-Ho;Lee, Beom Hee;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.37-41
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    • 2014
  • Fabry disease is an X-linked disease caused by deficiency of the lysosomal enzyme alpha-galactosidase A. Affected males present anhydrosis, acroparesthesia and angiokeratoma, and subsequently cardiac, cerebral and renal complications are followed. Females and atypical variants show heterogeneous clinical symptoms. In 2001, two recombinant enzymes were approved for Fabry disease: agalsidase alpha and agalsidase beta. Since the introduction of enzyme replacement therapy (ERT), the number of long-term follow-up studies has been reported. Long-term ERT showed effectiveness on renal function in patients with chronic kidney disease, decrease or stabilization of left ventricular mass, and improvement of pain and quality of life. However, there were limited effects on cerebrovascular events and their mortality. Current literatures on the clinical effect of ERT have reported limited datain adult patients who have already advanced disease. Therefore, further study for pre-symptomatic patients and atypical variants is needed to verify the impact of ERT. This review summarized recent progresses in ERT and limitations of long-term effect of ERT in patients with Fabry disease.

dissecting aortic aneurysm (DeBakey Type III) -Report of two cases- (박리성 대동맥류(DeBakey Type III)의 외과적 치험 -2예보고-)

  • 문경훈
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.443-448
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    • 1986
  • Aortic dissection is a serious disease that mortality does not approach to zero despite of medical and surgical improvement. Recently two cases of aortic dissection were treated with good results by the two other methods. Case 1 [57-Y-0-Male]; Chief complaint was chest pain radiating to the back. Preoperatively he was controlled by Minipress, dichlotride, & sodium nitroprusside. Aortography showed DeBakey Type III aortic dissection extending from just below the Lt. subclavian artery to the proximal portion of the origin of the renal artery. Through the midline long incision Flow reversal & Thrombo-exclusion method was used, and bypass course was proximal anastomosis at the ascending aorta - through the Rt. thoracic cavity - midportion of the diaphragm - posterior to the liver, stomach, & pancreas - distal anastomosis at the abdominal aorta proximal to its bifurcation. Bypass graft was preclotted 20 mm Dacron Woven Graft, and the aortic arch between the Lt. subclavian artery & Lt. common carotid artery was divided and meticulously sutured. Control aortogram which was done at 4th postoperative month revealed obstruction of the false lumen by thrombosis, and complications were not noticed. Case 2 [53-Y-0-Male]; Chief complaint was chest pain radiating to the abdomen. DeBakey Type III aortic dissection which was similar to the case 1 was detected by the aortography, and involvement of the Lt. subclavian & common carotid arteries was suspicious. Through the Lt. posterolateral thoracotomy the Ringed Intraluminal Sutureless Graft, No. 22 mm, was inserted from just below the Lt. common carotid artery to the midportion of the descending thoracic aorta under total circulation arrest using a F-F bypass, and the Lt. subclavian artery was ligated. Postoperatively hospital course was uneventful with antihypertensive drugs, and any specific complications were not noticed.

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The Surgical Treatment of Choice for Patients with Differentiated Thyroid Cancer(DTC) (분화성 갑상선암 환자에서 수술범위의 선택)

  • Cha Seong-Jae;Park Sung-Jun;Lim Hyen-Muck
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.200-205
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    • 1997
  • Background: There is considerable controversy concerning the most appropriate surgical treatment of patients with DTC. Objectives: In order to selection of the appropriate surgical treatment for DTC, we have analyzed the outcome of the different types of surgical treatment in low and high risk groups of DTC. Materials and Methods: From January 1968 through december 1980, a total of 71 patients with DTC were treated surgically at our institution. According to Cady and Rossi's scoring system, the patients were divided into low risk and high risk groups. Results: Seventy percent of patients were defined as low risk group with a 4% death rate whereas 30% of patients at high risk with a death caused by thyroid cancer in 38%(p<0.05). There was no difference in mortality between ipsilateral lobectomy and total thyroidectomy in both low and high risk groups(p>0.1). Conclusion: In our study, total thyroidectomy was not benefit in high risk group. These results suggested that total thyroidectomy must be selected carefully and based on clear evidence of major improvement in outcome or absence of other suitable surgical approaches. However, follow up study of more cases will be needed for accurate determination of the efficacy of total thyroidectomy in high risk group.

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Comparison of Growth Parameters in Selected and Unselected Strains of Olive Flounder Paralichthys olivaceus (선발 육종넙치 Paralichthys olivaceus 및 일반넙치의 성장비교)

  • Min, Byung-Hwa;Kim, Hyun-Chul;Lee, Jeong-Ho;Noh, Jae-Koo;An, Hye-Suck;Park, Choul-Ji;Choi, Sang-Jun;Myeong, Jeong-In
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.43 no.5
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    • pp.457-461
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    • 2010
  • To estimate the effect of selective breeding on the improvement of growth in olive flounder Paralichthys olivaceus, we compared the growth of a strain selected for rapid growth to that of an unselected strain from a commercial hatchery. The fish strains were fed with either moist pellets (MP) (dry matter, 59.8% crude protein; 14.1% lipid) or extruded pellets (EP) (dry matter, 50.4% crude protein; 13.8% lipid) for 190 days and were reared under similar conditions. The mortality rates were less than 2% and were not significantly different among the experimental groups. The growth rate of the selected fish was significantly greater than that of the unselected fish regardless of the diet type, and both strains fed MP grew significantly faster than those fed EP. The selected fish consumed more feed than the unselected fish. However, there was no significant difference in the feed efficiency between the selected and unselected fish. These results demonstrate that the selected fish exhibited superior growth rates, and that this was associated with a greater intake of food. Thus, selective breeding may be useful for improving the growth of commercial olive flounder.