• Title/Summary/Keyword: Fatality Rate

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Studying the Comparative Analysis of Highway Traffic Accident Severity Using the Random Forest Method. (Random Forest를 활용한 고속도로 교통사고 심각도 비교분석에 관한 연구)

  • Sun-min Lee;Byoung-Jo Yoon;WutYeeLwin
    • Journal of the Society of Disaster Information
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    • v.20 no.1
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    • pp.156-168
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    • 2024
  • Purpose: The trend of highway traffic accidents shows a repeating pattern of increase and decrease, with the fatality rate being highest on highways among all road types. Therefore, there is a need to establish improvement measures that reflect the situation within the country. Method: We conducted accident severity analysis using Random Forest on data from accidents occurring on 10 specific routes with high accident rates among national highways from 2019 to 2021. Factors influencing accident severity were identified. Result: The analysis, conducted using the SHAP package to determine the top 10 variable importance, revealed that among highway traffic accidents, the variables with a significant impact on accident severity are the age of the perpetrator being between 20 and less than 39 years, the time period being daytime (06:00-18:00), occurrence on weekends (Sat-Sun), seasons being summer and winter, violation of traffic regulations (failure to comply with safe driving), road type being a tunnel, geometric structure having a high number of lanes and a high speed limit. We identified a total of 10 independent variables that showed a positive correlation with highway traffic accident severity. Conclusion: As accidents on highways occur due to the complex interaction of various factors, predicting accidents poses significant challenges. However, utilizing the results obtained from this study, there is a need for in-depth analysis of the factors influencing the severity of highway traffic accidents. Efforts should be made to establish efficient and rational response measures based on the findings of this research.

Clinical Characteristics of Pneumococcal Bacteremia in Adults : The Effect of Penicillin Resistance on the Mortality of Patients with Pneumococcal Bacteremia (폐렴구균 균혈증에서 폐렴구균의 페니실린 내성 여부가 사망률에 미치는 영향)

  • HwangBo, Bin;Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, You-Young;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.184-194
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    • 1999
  • Backgrounds : The advent of penicillin has led to the marked reduction in the mortality from pneumococcal bacteremia, however, the mortality is still relatively high in this post-antibiotic era. Actually the prevalence of infection due to penicillin-resistant penumococci is increasing worldwide, and it is especially high in Korea due to irrelevant use of antibiotics. So, the high mortality of pneumococcal sepsis might be related to the emergence of penicillin-resistant strains, however, many other antibiotics, which eradicate pneumococci effectively, are available in these days. This has led us to suspect the role of penicillin-resistance in the high mortality rate. In this study, we evaluated the effect of penicillin resistance on the mortality of patients with penumococcal bacte remia. Methods: The study population consisted of 50 adult patients with penumococcal bacteremia who were admitted between Jan, 1990 and July, 1997. Medical records were analyzed retrospectively. Results: Most of the patients (96%) had underlying diseases. The most common local disease associated with pneumococcal bacteremia was pneumonia (42%), which was followed by spontaneous bacterial peritonitis (14%), cholangitis (10%), meningitis (8%), liver abscess (4%), pharyngotonsillitis (4%), sinusitis (2%) and cellulitis (2%). While the overall case-fatality rate in this study was 24%, it was higher when peumococcal bacteremia was associated with pneumonia (42%) or meningitis (50%). The rate of penicillin resistance was 40%, which was increased rapidly from 1991. The rate of penicillin resistance was significantly higher in patients with the history of recent antibiotics use and hospitalization within 3 months respectively. The clinical manifestations, that is, age, severity of underlying diseases, nosocomial infection, associated local diseases, and the presence of shock or acute renal failure were not statistically different between the patients with penicillin-resistant and -sensitive pneumococcal bacteremia. The mortality of patients infected with penicillin-resistant pneumococci was not statistically different from those with penicillin-sensitive pneumococcal bacteremia. Conclusion: Penicillin resistance is not associated with high mortality in adult patients with pneumococcal bacteremia. As the overall mortality is high, active penumococcal vaccination is recommended in patients with high risk of infection.

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.

A Study on Risk Factor Identification by Specialty Construction Industry Sector through Construction Accident Cases : Focused on the Insurance Data of Specialty Construction Worker (건설재해사례 분석에 의한 전문건설업종별 위험요인 탐색 : 전문건설업 근로자 공제자료를 중심으로)

  • Lee, Young Jai;Kang, Seong Kyung;Yu, Hwan
    • Journal of Korea Society of Industrial Information Systems
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    • v.24 no.1
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    • pp.45-63
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    • 2019
  • The number of domestic construction company is expanding every year while the construction workers' exposure to disaster risk is increasing due to technological advancements and popularity of high-rise buildings. In particular, the industry faces greater fatalities and severe large scale accidents because of construction industry characteristics including influx of foreign workers with different language and culture, large number of aged workers, outsourcing, high place work, heavy machine construction. The construction industry is labor-intensive, which is to be completed under given timeline and consists of unique working environment with a lot of night shifts. In addition, when a fixed construction budget is not secured, there is less investment in safety management resulting in poor risk management at the construction site. Taking account that the construction industry has higher accident risk rate and fatality rate, risky and unique working environment, and various labor pool from foreign to aged workers, preemptive safety management through risk factor identification is a mandatory requirement for the construction industry and site. The study analyzes about 8,500 cases of construction accidents that occurred over the past 10 years and identified risk factor by construction industry sector to secure a systematic insight for risk management. Based on interrelation analysis between accident types, work types, original cause materials and assailing materials, there is correlation between each analysis factor and work industry. Especially for work types, there is great correlation between work tasks and industry type. For reinforced concrete and earthwork are among the most frequent types of accidents, and they are not only high in frequency of accidents, but also have a high risk in categories of occurrence.

Etiological agents isolated from blood in children with hemato-oncologic disease (2002-2005) (소아 혈액 종양 환자에서 발생한 균혈증의 원인균(2002-2005년))

  • Kim, So-Hee;Lee, Young-Ah;Eun, Byung-Wook;Kim, Nam-Hee;Lee, Jin-A;Kang, Hyoung Jin;Choi, Eun-Hwa;Shin, Hee Young;Lee, Hoan-Jong;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.56-64
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    • 2007
  • Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : One hundred and ninety-seven episodes of bloodstream infections that developed in 128 pediatric cancer patients were analyzed, which were identified at the Seoul National University Children's Hospital during a 4 year-period from 2002 to 2005. Results : A total of 214 pathogens was isolated, of which 64.0 percent were gram-negative, 31.3 percent were gram-positive bacteria, and 4.7 percent were fungi. The most common pathogens were Klebsiella spp. (21 percent) and Escherichia coli (16.8 percent), and coagulase-negative staphylococci (CNS, 7.9 percent) and viridans streptococci (7.5 percent) emerged as important pathogens. Neutropenic patients were more often associated with gram-negative bacteria than non-neutropenic patients (67.5 percent vs. 51.1%, P=0.018) and patients with central venous catheters were more often associated with CNS and viridans streptococci than those without. Resistance rates of gram-positive bacteria to penicillin, oxacillin and vancomycin were 83.3 percent, 48.5 percent and 0.5 percent, respectively, and those of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin and amikacin were 24.1 percent, 17.2 percent, 6.6 percent, 21.6 percent, and 14.2 percent, respectively. Gram-negative bacteremias were more often associated with intensive care than gram-positive bacteremias (26.5 percent vs. 10.3 percent, P=0.016), and patients with catheters were more often associated with intensive care (34.4 percent vs. 10.8 percent, P<0.001) and higher fatality rate (16.7 percent vs. 4.8 percent, P=0.012) than those without. Conclusion : This study revealed that gram-negative bacteria are still a dominant organism in bloodstream infections, especially in neutropenic patients, and confirmed that gram-positive bacteria are emerging as important etiological agents in bloodstream infections of pediatric hemato-oncologic patients.

Epidemiology and Clinical Features of Invasive Pneumococcal Infections in Children (소아 침습성 폐구균 감염증의 역학적 특성과 임상 양상)

  • Song, Eun-Kyung;Lee, Jun-Ho;Kim, Nam-Hee;Lee, Jin-A;Kim, Dong-Ho;Park, Ki-Won;Choi, Eun-Hwa;Lee, Hoan-Jong
    • Pediatric Infection and Vaccine
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    • v.12 no.2
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    • pp.140-148
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    • 2005
  • Purpose : To characterize the epidemiology and clinical features of invasive pneumococcal infections in Korean children. Methods : One hundred ninety four cases of invasive pneumococcal infections diagnosed at the Seoul National University Children's Hospital from October 1985 to December 2003 were analysed retrospectively. All isolates were screened for resistance to penicillin by oxacillin disc diffusion test. Serotypes were determined for 125 isolates. Results : The types of infection were bacteremia without focus 84/194(43%), meningitis 36/194(19%), pneumonia with bacteremia 36/194(19%), peritonitis 24/194(12%), other focal infections 3/194(2%). Fifty seven percent(110/194) of the episodes developed in the immunocompromised and 20%(37/194) were nosocomially acquired. The patients younger than 2 years of age was 60% in the immunocompetent patients and 25% in the immunocompromised patients. The overall case fatality rate was 7%. All the isolates by 1988 were susceptible to penicillin screened by oxacillin disk. Penicillin resistance was first detected in 1989(20%), and then increased rapidly; 89% in 1995, 69% in 1996, and 80~100% thereafter. The seven most frequently isolated serotypes were 23F, 19F, 14, 6B, 6A, 9V and 19A, which accounted for 70% of total isolates. Conclusion : S. pneumoniaeis an important cause of morbidity and mortality in children. Invasive infections caused by S. pneumoniae most often occurred in infants and young children, while they are frequent in older immunocompromised children as well. This is the largest case series on invasive pneumococcal infections in Korean children.

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A Study on the Influence of Conflict on the Performance and Validity of Organization (갈등이 조직성과 및 조직 유효성에 미치는 영향에 대한 연구)

  • 기호익
    • The Journal of Information Technology
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    • v.1 no.2
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    • pp.81-102
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    • 1998
  • It is common description that modern society is In the era of limitless competition. In order to challenge the change of economy and its management at home and abroad, organization should be changed anew, and in this case, there accompanies conflict or trouble whether the subject of change wants it or not. Therefore, according to change, we should concern with settlement of small troubles as well as big ones, and by managing the conflict or trouble productively and originally, it should be utilized as new fatality and chance to develop something in organization. In the system organized by people, there exist various conflicts in accordance with the target and want of the system, therefore giving no freedom to each Individual member of the system, and this is an unavoidable tate in consideration of the modem society where the survival of mankind and human systems should be guaranteed. Therefore, it determines the coordinates of success of any of organizations to manage conflict or trouble well, and so, when decreasing or increasing conflicts so that the organization exerts its full influence, it is note worthy that conflict itself should be rationally and efficiently managed. In a view point of the theory of organization and its behavior, relating job satisfaction with the performance and validity of organization, the influence of individual conflict is so great on the rate of job transfer within an organization or nonattendance, even on the productivity of the organization. So, the manager to cope with conflict within an organization should devise following three plans to manage conflict for job satisfaction and conflict settlement. In conclusion, it is suggested that in order to manage conflict within an organization well, some plans to control conflict should be well utilized while giving more efforts to improving management of individual conflict, job satisfaction, validity of organization, productivity, etc and all the members of organization should remember that the Issue of conflict within an organization be recognized ad an opportunity of new development and a way to settle a trouble within an organization, and a direction of conflict management should be suggested so that new innovation ca be created.

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Clinical Entities and Etiology of Invasive Bacterial Infections in Apparently Healthy Children (기저 질환이 없는 소아에서 발생한 침습성 세균 감염의 임상 양상과 원인균)

  • Lee, Joon Ho;Song, Eun Kyoung;Lee, Jin A;Kim, Nam Hee;Kim, Dong Ho;Park, Ki Won;Choi, Eun Hwa;Lee, Hoan Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1193-1200
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    • 2005
  • Purpose : Invasive bacterial infection is a major cause of morbidity and mortality in children. Previously, we reported etiology of invasive infections in healthy children in 1985-1995. This study was performed to update etiology of invasive bacterial infections in the previously healthy children. Methods : We reviewed medical records of 98 episodes of invasive bacterial infections in immunocompetent children at the Seoul National University Children's Hospital in 1996-2004. Results : The frequent pathogens identified over all age groups were Streptococcus pneumoniae (33%) and Staphylococcus aureus(33%). The proportion of Salmonella species and Haemophilus influenzae has been declined to 4% each from 23% and 14%, respectively, compared to previous study. S. agalactiae was the most common isolate in the infants ${\leq}3$ months. Among the infants and children aged 3 months to 2 years and children of 2-5 years, S. pneumoniae(57%, 52%, respectively, in each group) was the most common isolates followed by S. aureus(17% and 24%, respectively). S. aureus was the most common isolates(73%) in children >5 years. Primary bacteremia was the most common clinical diagnosis(27%). S. pneumoniae was responsible for 42% of primary bacteremia, 50% of meningitis, and 69% of bacteremic pneumonia and empyema. S. aureus accounted for 80% of bone and joint infections. The case fatality rate was 8.1% for all invasive infections. Conclusion : We reviewed frequency of bacterial agents of invasive infections in children. The data may be useful for pediatricians to select adequate empirical antibiotics in the management of invasive bacterial infections.

An experimental study on prednisolone-induced interstitial pneumonia caused by Pneumocystis carinii (프레드니솔론 투여에 의한 조폐포자충(Pneumocystis carinii)성 간질성 폐염에 대한 실험적 연구)

  • 신대환;이영하;나영은
    • Parasites, Hosts and Diseases
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    • v.27 no.2
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    • pp.101-108
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    • 1989
  • This study was performed to observe the role of Pneumocystis carinii as an etiologic agent of interstitial pneumonia in immunocompromised hosts. Total 90 male Sprague-Dawley rats, approxi. mately 150-180 g, were used. Fifteen of them were used as control group and remaining 75 (5 groups) were as immunosuppression groups; group 1 received prednisolone (25 mg/kg twice weekly) only; group 2 Prednisolone and tetracycline (75 mk/kg/day) ; group 3 Prednisolone, tetracycline and trimethoprim-sulfamethoxasole (50~250 mg/kg/day) : group 4 prednisolone and trimethoprim-sulfamethoxasole; and group 5 prednisolone and griseofulvin (300 mg/kg/day) until death. The survival days of each group rat were calculated, and upon death their lungs were removed immediately and then stamp smears were prepared and stained by Giemsa or toluidine blue O. For histopathologic observation, lungs were fixed in 10% formalin, cut into sections and stained with Gomori's methenamine silvei, hematoxylin-rosin, and Brovkn & Brenn stain. The results obtained were as follows: 1. The mean survival time of each group rat was 19.3$\pm$5.2 days (group 1), 41.1$\pm$14.0 days (group 2), 50.5$\pm$18.4 days (group 3), 43.0$\pm$22.9 days (group 4) or 21.8$\pm$5.1 days (group 5). Significant differences were noted between group 1 and group 2(p<0.01), group 1 and group 3 (p<0.01), and group 1 and group 4 (p<0.01), which represented bacterial infections were most fatal in immunocompromised rats. Group 5 revealed no difference in the survival day from group 1, while significant differences were noted between group 2 and group 5(P<0.01), group 3 and group 5(p<0.01), and group 4 and group 5(p<0, 01), which represented little importance of fungal infection as the cause of death of the rats. 2. The first fatality due to p. carinii pneumonia occurred 17 days after the beginning of the immunosuppression. The occurrence rate of P. carinii pneumonia in the decreasing order was 92.9% (group 3), 80.0% (group 2 and group 5), 78.6% (group 4) and 33.3% (group 1). With regard to the pathological stage of P. carinii pneumonia, the stage 1 was 11.3%, the stage 2, 28.3%, and the stage 3, 60.4%. 3. Viewing from the duration of immunosuppression, bacterial pneumonia chieay appeared in 1 month, mixed infections (P. carinii and bacteria, or p. carinii and fungi) in 1~2 months, and pure P. carinii pneumonia after 2 months. The present study revealed that P. carinii pneumonia was the most important cause of death of immunocompromised rats later than 1 month after the start of immunosuppression.

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Study on Development Effect on Zebrafish Embryo by Alacholr, Butachlor and Fipronil (농약 alacholr, butachlor 및 fipronil이 제브라피쉬 배아 발생에 미치는 영향)

  • Park, Soo Jin;Jeong, Mihye;Paik, Min-Kyoung;Lee, Je-Bong;You, Are-Sun;Hong, SoonSung;Ihm, Yang Bin
    • The Korean Journal of Pesticide Science
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    • v.18 no.1
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    • pp.14-20
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    • 2014
  • This study is aimed to search the possibility of developmental toxicity test using the zebrafish from the pesticide. We selected herbicides alachlor and butachlor, reported for fish toxicity, and insecticide fipronil reported for the high fish toxicity and the honey bee risk among the pesticides with high usability for the examples of the pesticides in this experiment. In this study, we showed those effects on the zebrafish embryo development by exposing different kinds of pesticide with different concentration and exposed time periods. As a result, the rates of hatching and abnormality of the zebrafish embryo after treatments of alachlor were increased in 24-48 hpf group, and the juvenile fishes in every group exposed to $40{\mu}M$ or more of alachlor displayed sever morphological changes such as bent tails, edema and activity failures. In case of the butachlor, the rates of hatching and the abnormality in 24-48 hpf group were higher than the other groups exposed in different time periods. The fatality before hatching was high in $40{\mu}M$ or more of butachlor treatment, and entire zebrafish embryos in 48 hpf group died before hatching. All the living juvenile fishes showed morphological changes as like as the treatment of alachlor. The rate of hatching and the survival of the zebrafish embryo by the fipronil were higher than other pesticides. However, morphological changes such as bent tails were observed from the most of living juvenile fishes. Therefore, the effects of three different pesticides with different concentrations and exposing time periods on the development of zebrafish embryos showed that all the pesticides effects were proportional to the concentration, and exposing time periods may cause the morphological abnormality.