• Journal of Chest Surgery
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• 제19권1호
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• pp.83-91
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• 1986

The Carpentier-Edwards porcine xenograft valve was used in 21 patients at Seoul National University Hospital during the period between 1977 and 1979. Twenty-four Carpentier-Edwards valves were implanted along with 2 others. Three patients died within 30 days of operation, an operative mortality rate of 14.3%. Eighteen early survivors were followed up for a total 67.5 patient-years [mean, 45.0$\pm$32.0 months]. There were 2 late deaths with a linealized late mortality rate of 2.96%/patient-year; one died from cerebral bleeding [1.48% bleeding/patient-year] and the other from prosthetic valve endocarditis [1, 48% endocarditis/patient-year]. There was no case of thromboembolism. Two patients developed mitral regurgitation [2.96% failure/patient-year]. Symptomatic improvement was excellent. The actuarial survival rate and the probability of freedom from overall valve failure were 75.3$\pm$9.6% and 80.7$\pm$12.9% at 9 years after surgery respectively. During the period from October, 1968, through June, 1985, 1, 190 substitute heart valves were used in a total of 967 patients at Seoul National University Hospital; of which, 90.9% were either porcine aortic or bovine pericardial xenograft valves. For the evaluation of the xenograft tissue valves, the consecutive patients with lonescu-Shiley valve in the mitral, aortic and both positions, Angell-Shiley valve and Carpentier-Edwards valve were recently studied on the clinical ground. They were 531 patients, and 643 xenograft valves were used. The operative mortality rate was 6.97% and a linealized late mortality rate 2.94%/patient-year. A total of 490 early survivors were followed up for 917.6 patient-years [mean, 22.5 months], and 70% of patients completed the follow-up. The linealized incidences of complications were: 2.29% emboli/patient-year, 1.98% bleeding/patient-year, 1.20% endocarditis/patient-year, and 3.49% failure/patient-year. These clinical resutls are fully comparable with those in the major reports. The durability of the glutaraldehydepreserved xenograft heart valves remains as a great concern and a continuing debate, expecially for the group of patients in the pediatric age. The need of more durable material for the improved tissue valves was also discussed.

• Journal of Ecology and Environment
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• 제44권4호
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• pp.241-255
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• 2020

Background: The stem exclusion stage is a stage of forest development that is important for understanding the subsequent understory reinitiation stage and maturation stage during which horizontal heterogeneity is formed. Over the past 11 years (2009-2019), we observed a deciduous broad-leaved forest in the Albongbunji Basin in Ulleungdo, South Korea in its stem exclusion stage, where Fagus engleriana (Engler's beech) is the dominant species, thereby analyzing the changes in the structure (density and size distributions), function (biomass and species richness), and demographics. Results: The mean stem density data presented a bell-shaped curve with initially increasing, peaking, and subsequently decreasing trends in stem density over time, and the mean biomass data showed a sigmoidal pattern indicating that the rate of biomass accumulation slowed over time. Changes in the density and biomass of Fagus engleriana showed a similar trend to the changes in density and biomass at the community level, which is indicative of the strong influence of this species on the changing patterns of forest structure and function. Around 2015, a shift between recruitment and mortality rates was observed. Deterministic processes were the predominant cause of tree mortality in our study; however, soil deposition that began in 2017 in some of the quadrats resulted in an increase in the contribution of stochastic processes (15% in 2019) to tree mortality. The development of horizontal heterogeneity was observed in forest gaps. Conclusions: Our observations showed a dramatic shift between the recruitment and mortality rates in the stem exclusion stage, and that disturbance increases the uncertainty in forest development increases. The minor changes in species composition are likely linked to regional species pool and the limited role of the life-history strategy of species such as shade tolerance and habitat affinity. Our midterm records of ecological succession exhibited detailed demographic dynamics and contributed to the improvement of an ecological perspective in the stem exclusion stage.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.96-100
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• 2007

Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

• 대한한방내과학회지
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• 제25권3호
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• pp.684-689
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• 2004

One of the serious long-tenn complications of diabetes mellitus is the diabetic foot lesion. Diabetic foot lesions are a major cause of morbidity, mortality, disability in patients with diabetes and frequent cause of lower-extremity amputations. The treatment of diabetic foot lesions is based on the strict control of diabetes mellitus. A patient with diabetic foot lesions was treated with Cheunhwasangamibang and improvement was seen. Results in this case support a role for Cheunhwasangamibang in controlling diabetes mellitus, and are here reported to encourage further study.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.127.2-128
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• 2003

Sepsis remains common surgical problems with high morbidity and mortality despite improvement in the management for septic patient. Although hepatocellular dysfunction occurs during sepsis, the mechanism responsible for this remains unclear. In sepsis, a state of severe oxidative stress is encountered, with host endogenous antioxidant defenses overcome. Therefore, the aim of this study was to determine whether specific abnormality exists in cytochrome P450 (CYP)-mediated metabolizing function associated with polymicrobial sepsis and whether role of ascorbic acid (AA) in the alterations during sepsis. (omitted)

• Journal of Chest Surgery
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• 제4권2호
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• pp.101-106
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• 1971

Forty-seven cases of bronchiectasis were admitted in this department, of which 38 cases were reviewed. Pulmonary tuberculosis was the most frequent associated disease and encountered in 42% in this series. Preoperative bronchogram performed in 38 cases revealed left lung involvement in 21 cases,right lung in 14 cases, both lungs in 3 cases, and multilobar involvement in 10 cases. Various types of pulmonary resection were performed on 32 patients. Complication developed in 3 cases [9.4%]. One patient died of intraoperative hypoxia on the second post-operative day. Second case was Complicated with hydrothorax, and third case was with hemothorax. In 81% of this series, the result was satisfactory and 3 cases [10%] showed slight improvement of symptoms, and 2 cases show no improvement. The mortality rate was 3 percent(1case).

• Journal of Chest Surgery
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• 제25권8호
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• pp.844-849
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• 1992

Between 1979 and 1991 thymectomy was performed on 31 patients with myasthenia gravis at the department of thoracic and cardiovascular surgery, Keimyung University medical school. All patients were treated by transsternal thymectomy. During follow-up period that ranged from a month to 10.7 years[mean 2 years], the remission rate for the entire group was 16.1 percent and an additional 71.0 percent had improvement [87.1 percent benefited]. In those 8 patients with thymoma, the remission rate was 12.5 percent with 75.0 percent of the patients benefiting from operations The remainimg 23 patients fared better the operations: 17.4 percent had remission and a total of 91.4 percent benefited. There was no mortality, I concluded that most patients with myasthenia gravis will benefit from thymectomy, and that the improvement persists over an extended period of time in a high percentage of patients.

• Asian-Australasian Journal of Animal Sciences
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• 제21권8호
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• pp.1164-1170
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• 2008

In this study, the effects of propolis and vitamin C (L-ascorbic acid) supplementation in diets were investigated on feed intake (FI), body weight (BW), body weight gain (BWG), feed conversion rate (FCR) and digestibility and on egg production and qualities (weight, mortality, shell thickness) in laying hens exposed to heat stress. A total of 150 Hyline White Leghorn, aged 42 weeks, hens was divided into five groups of 30 hens. Chicks were randomly divided into 1 positive control, 1 control and 3 treatment groups. The chicks were kept in cages in temperature-controlled rooms at $22^{\circ}C$ for 24 h/d (positive control, Thermoneutral, TN group) or $34^{\circ}C$ for 9 h/d from 08.00-17.00 h followed by $22^{\circ}C$ for 15 h (control, heat stress, HS group) and fed a basal diet or basal diet supplemented with vitamin C (250 mg/kg of L- ascorbic acid/kg of diet) or two levels of propolis (2 and 5 g of ethanol extracted propolis/kg of diet). Increased FI (p<0.05) and improvement in FCR (p<0.05), hen day egg (p<0.05) and egg weight (p<0.05) were found in Vitamin C and propolis-supplemented laying hens reared under heat stress conditions. Mortality rate was higher in the control group than TN, vitamin C and propolis groups (p<0.05). Digestibility of dry matter, organic matter, crude protein and ether extract improved with increasing of both dietary vitamin C and propolis (p<0.05). Vitamin C or propolis supplementation did not affect either the percentage shape index, yolk index or haugh unit and albumen index (p>0.05). However, the egg shell thickness and egg shell weight appeared to be increased in Vitamin C and propolis groups in comparison to HS group birds (p<0.05). In conclusion, dietary supplementation of laying hens with anti-oxidants (vitamin C and propolis) can attenuate heat stress-induced oxidative damage. These positive effects were evidenced by increased growth performance and digestibility, improvement of egg shell thickness and egg weight in comparison to non-supplemented birds. Moreover, supplementation with propolis (5 g/kg diet) was the most efficient treatment.

• Journal of Chest Surgery
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• 제44권6호
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• pp.399-405
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• 2011

Background: Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function. Materials and Methods: Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was $63.2{\pm}10$ years (30~85 years). Results: There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2~167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death. Conclusion: After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

• 한국의료질향상학회지
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• 제27권2호
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.