• The Korean journal of internal medicine
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• 제39권1호
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• pp.160-171
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• 2024

Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85-1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77-1.00; 6 studies; I² = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59-0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilator support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

• 한국유기농업학회지
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• 제12권1호
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• pp.81-92
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• 2004

The effect of feeding extracts from rhus trees on performance of broiler were performed to investigate development of natural antibiotic in process of broilers production. A total of 320 broiler chicks at 7 day of age were fed the commercial diet and water, water containing 0 ppm (control), 300 ppm (T1), 600 ppm (T2) and 1000 ppm (T3) of extracts from rims trees for 7 weeks. The body weight gain and feed conversion ratio were improvement by feeding extracts from rims trees at 7 to 21 days of age (P<0.05), but amount of feed intake and mortality were not different among the four group. When 21 to 35 days of age, body weight gain, amount of feed intake, feed conversion ratio and mortality were almost same results when 7 to 21days of age, but it was not significantly different. When 35 to 49 days of age, body weight gain in T1 and T3 group was significantly improvement than control group (P<0.05), also feed conversion ratio was improve by feeding extracts from rhus trees. There was a decrease in the microflora population of both E coli. and salmonella in the cecum contents and feaces in broilers by feeding extracts from rhus trees. Emission of ammonia and VFA gas from excreta were significantly decreased at 5 to 10 days of storaged period (P<0.05). The digestibility of dry matter, crude fat, and crude ash of feed were tend to increased in broiler feeding extracts from rims trees. Digestibility of crude protein of feed in broiler three treatmental groups was significantly improved (P<0.05) as compared with those in control group. These results indicated that the feeding extracts from rhus trees of 300 to 1000 ppm of broiler production were improvement in th6 body weight gain, feed conversion ratio, and mortality due to increasing nutrients digestibility from feed, decreasing of microflora population of both E coll. and salmonella in the cecum contents and feaces, decreasing emission of ammonia and VFA gas from excreta.

• Journal of Chest Surgery
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• 제25권5호
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• pp.518-525
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• 1992

50 months experience with St-Jude Medical Cardiac Valve Prosthesis The St. Jude Medical valve has become our mechanical valvular prosthesis of choice because of favorable hemodynamic results that associated with marked clinical improvement and low incidence of thromboembolism. The data for this study was collected from April 1986 to May 1990, four years period. There were total of 110 patients[female 53, male 58] in this series with 22 isolated aortic valve, 66 isolated mitral valve, 20 double valve, 2 tricuspid valve replacement. The mean follow up time was 23 months. Postoperatively, 77% of cases were in New York Heart Association[NYHA] functional class I, and mild and moderate symptoms[NYHA II ] were present in 20% and there were very few patients remaining in higher functional classifications. In postoperative echocardiographic study showed marked improved cardiac function. The overall early mortality was 5.4% and was higher after double[13.3%] and mitral valve replacement[5.6%] and the late mortality was one case after mitral valve replacement due to endocarditis. The cause of death in early mortality was attributed to heart failure, acute renal failure, sepsis, etc.

• Journal of Chest Surgery
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• 제24권2호
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• pp.115-122
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• 1991

From April 1986 to December 1989, 25 infants under the age of 12 months with tetralogy of Fallot were operated on. Age ranged from 3 to 12 months[mean 8.9$\pm$4.9 months] and mean body weight was 7.8$\pm$ 2.6kg. All the patients were deeply cyanotic, 12 of them experienced anoxic spell. Transannular patch was laid down in 19 patients, in 7 of them monocuspid patch was utilized. Postrepair P RV/LV was measured at operation room in 17 patients[mean 0.48$\pm$0. 14]. Hospital mortality was 20Yo. Causes of deaths include right ventricular failure and low cardiac output. The mortality was closely related with patient`s age and body surface area at operation. Also higher mortality was noticed in patients having major associated anomaly or previous palliative operation, preoperative management with propranolol and transannular repair. 18 patients were followed up for 12 to 50 months with a mean follow-up time of 24 months after operation. There were no late deaths and late ventricular arrhythmia or congestive heart failure was not detected as yet. Redo operation was performed in one case because of residual pulmonic stenosis. Considering several advantages of early primary repair, primary repair of symptomatic infants with tetralogy of Fallot should be encouraged despite somewhat high mortality rate as yet and better results could be anticipated along with improvement of myocardial protection method and postoperative care.

• Journal of Preventive Medicine and Public Health
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• 제46권4호
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• pp.155-164
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• 2013

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.

• Tuberculosis and Respiratory Diseases
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• 제82권1호
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• pp.6-14
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• 2019

Sepsis is a life-threatening condition caused by infection and represents a substantial global health burden. Recent epidemiological studies showed that sepsis mortality rates have decreased, but that the incidence has continued to increase. Although a mortality benefit from early-goal directed therapy (EGDT) in patients with severe sepsis or septic shock was reported in 2001, three subsequent multicenter randomized studies showed no benefits of EGDT versus usual care. Nonetheless, the early administration of antibiotics and intravenous fluids is considered crucial for the treatment of sepsis. In 2016, new sepsis definitions (Sepsis-3) were issued, in which organ failure was emphasized and use of the terms "systemic inflammatory response syndrome" and "severe sepsis" was discouraged. However, early detection of sepsis with timely, appropriate interventions increases the likelihood of survival for patients with sepsis. Also, performance improvement programs have been associated with a significant increase in compliance with the sepsis bundles and a reduction in mortality. To improve sepsis management and reduce its burden, in 2017, the World Health Assembly and World Health Organization adopted a resolution that urged governments and healthcare workers to implement appropriate measures to address sepsis. Sepsis should be considered a medical emergency, and increasing the level of awareness of sepsis is essential.

• 한국병원경영학회지
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• 제27권1호
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• pp.20-30
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• 2022

Purposes: This study purposed to evaluate the effect of a value incentive program(VIP) on the in-hospital mortality of acute stroke. Methodology: Study period was from January 2010 to December 2018. This study included 63 hospitals for acute hemorrhagic stroke that the mortality rate per month was more than one during study period. Independent variables were time variables and hospital characteristics such as hospital type, district and bed number. Interrupted time series analysis was applied to analyze the data. Findings: In case of general hospitals, the in-hospital mortality rate per month for acute hemorrhagic stroke tends to be increased by 0.03% in overall study periods but decreased by 0.32% after the implementation of the policy. On the other hand, tertiary hospital changes are not statistically meaningful. Conclusion: This study provides evidences how the VIP was effective in improving quality of acute hemorrhagic stroke care. General hospitals showed higher policy effect compare to that of tertiary hospitals.

• Nuclear Engineering and Technology
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• 제30권1호
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• pp.75-82
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• 1998

Development and implementation of food irradiation was driven by needs pertaining to food safety improvement, food spoilage reduction, and quarantine/trade. The need for food safety is caused by the increasing morbidity and mortality caused by food-borne diseases worldwide, and it affects national economy and world-trade. Radiation technology can serve to ameliorate the vulnerability of our food supply system.

• 한국물환경학회지
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• 제26권3호
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• pp.518-524
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• 2010

Continuous removal of organic matters (CROM) using freshwater bivalve Anodonta woodiana was operated to evaluate the effect of water current on the water quality improvement (clearance) of eutrophic lake. The CROM system comprised three treatment steps such as flow control, treatment and analysis, and operated at the two different currents ($24L\;h^{-1}$ and $48L\;h^{-1}$) with mussels at density of $312.5indiv.\;m^{-2}$ for 12 consecutive days. Water quality including suspended solids (SS) and chlorophyll-a (Chl-a) was daily measured at the same time. Results indicate that although both the system strongly decreased the concentration of SS and chl-a, a slow CROM system was more effective to diminish the SS contents than a fast CROM system; 82% and 66%, respectively (ANOVA, P<0.0001). Clearance rates, based on chl-a, were also significantly higher in a slow system than a fast system (ANOVA, P<0.0001), although the mussel mortality was conversely. In both systems, there showed a remarkable excretion of dissolved inorganic nutrients (i.e. $NH_3-N$ and $PO_4-P$), while a slow CROM system was higher than a fast system, significantly (ANOVA, P<0.0001). Therefore, it may suggest that a slow current CROM system is more suitable to maximize the efficacy of water quality improvement, but further study is needed to diminish the mortality of mussel and to reuse the nutrient released during the operation.

• 한국병원경영학회지
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• 제22권4호
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• pp.87-101
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• 2017

[Purpose] This study aims to classify of healthcare decline and analyze the corresponding health outcomes among cities in Korea. In pursuing the above, this paper gives the particular attention to draw policy implications. [Methodology/Approach] Public healthcare data of 81 cities between 2014 and 2015 was obtained from the National Medical Center of Korea. A matrix analysis, t-test, ANOVA and multivariate regression were applied. [Findings] The study results indicated that declining cities tend to have the most healthcare resources, compared to growing or maintaining cities. However, accessibility to healthcare appeared to be lower in declining cities. Based on the classification of cities on healthcare decline, 42 out of 81 cities were categorized as a maintain/improvement group, while 39 cities were characterized as decline/depression. The group with a decline/depression type has significantly more healthcare facilities than maintain/improvement type. In contrast, maintain/improvement cities indicated lower incidence of morbidity and mortality than decline/depression cities. Lastly, according to the multivariate regression analysis for the healthcare outcomes by the type of healthcare decline, incidence of morbidity and mortality tended to decrease as the number of healthcare workers, the proportion of people who have healthcare accessibility, and the Timely Relevance Index increased regardless of the number of medical facilities including hospital beds and special beds. [Practical Implications] In conclusion, focusing on the improvement of healthcare accessibility as well as staffing, rather than expanding facilities is essential to set the healthcare policies.