• Journal of Trauma and Injury
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• 제26권3호
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• pp.207-213
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• 2013

Purpose: Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population. Methods: Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes. Results: Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies(23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock. Conclusion: In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.

• Journal of Chest Surgery
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• 제32권6호
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• pp.573-578
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• 1999

배경: 식도절제술후 식도대용장기로 위장이 가장 흔히 사용되어지는데 위장은 다른 장기에 비해 다루기가 비교적 간편하며 합병증이 적게 발생된다고 한다. 위장을 이용한 식도재건술에서 발생한 합병증을 분석 조사하였다. 대상 및 방법: 연세의대 영동세브란스병원 흉부외과에서는 1990년부터 1998년까지 식도질환으로 식도절제술후 식도위 문합술을 시행 받은 환자를 대상으로 하였다. 결과: 술후 합병증이 70.5%이었고 수술 사망률이 6.8%이었다, 가장 흔히 발생되었된 합병증은 문합부협착이 13.6%, 폐렴 11.4%, 창상 감염이 9.1% 이었다. 술후 사망원인은 전부가 폐합병증과 패혈증이였다. 결론: 문합부 누출 및 협착 등의 기술적인 문제는 많은 발전을 보였으나 술후 충분한 영양공급, 폐감염 방지 , 적극적인 물리치료 등이 폐합병증 및 사망률을 감소시키는데 중요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1577-1581
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• 2016

Tobacco use is a well-established risk factor for many types of cancers. Recent data on selected cancer incidence and mortality related to smoking in the Indonesian population are provided in this study. Morbidity and mortality data were derived from GLOBOCAN 2012 and the population attributable fraction (PAF) was estimated using the standard methodology developed by the World Health Organization. Using these data, we calculated disability adjusted life year (DALY) values for smoking-related cancer. The DALY was estimated by summation of the years lived with disability (YLD) and years life lost due to premature death (YLL). The cancer cases related to smoking in Indonesia numbered 45,132, accounting for 35,580 cancer deaths. The morbidity and mortality of lung cancer can be considered as the highest priority in both men and women. Furthermore the greatest YLD due to smoking in Indonesian men and women were from pancreas and lung cancers. For YLL among men, the highest years lost were from lung and liver cancers. On the other hand, among women lung oral cavity and lip were most important. Based on the DALY indicator, burden priorities for Indonesian men were lung cancer (298,980), liver cancer (60,367), and nasopharynx (46,185), while among Indonesian women they were lung cancer (34,119), cervix uteri (9,213) and pancreas cancer (5,433). In total, Indonesian burden of cancers attributed to smoking was 638,682 DALY. This study provides evidence about the burden of cancers caused by smoking as a rational basis for initiating national tobacco control policies in Indonesia.

• 대한두경부종양학회지
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• 제32권2호
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• pp.5-8
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• 2016

Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

• Journal of Chest Surgery
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• 제33권2호
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• pp.173-178
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• 2000

Background: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer Material and method: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. Result: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) Conclsion: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.

• 한국인구학
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• 제19권1호
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• pp.123-137
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• 1996

이 논문은 건강수명의 개념을 도입하여 우리 나라 국민의 건강수준이 어느 정도인지를 규명하고 있다. 평균수명으로는 수명의 양적인 측정은 가능하지만 수명의 질적인 측면의 측정이 배제되기 때문에 일부 선진국가에서는 국민들의 사망과 상병상태를 결합한 활동장애가 없는 건강여명(Disability-Free Life Expectancy)을 산출하여 이용하고 있다. 우리 나라 국민의 활동장애가 없는 건강여명을 산출하기 위하여 사망자료로는 1989년도 간이생명표를 이용하였으며 상병자료로는 대표성을 고려하여 표본의 크기가 가장 큰 1989년 국민건강조사를 이용하였다. 주요 결과를 보면 우리 나라 남자의 경우 0세에서 활동장애가 없는 건강여명은 60.48년이었으며, 여자는 남자보다 3.2년이 더 높은 63.80년으로 나타났다. 연구자에 따라 활동장애에 대한 정의나 측정방법이 다르기 때문에 국제간 정확한 비교는 곤란하지만 우리 나라의 활동장애여명을 외국과 비교해보면 단기이환으로 인한 활동장애여명은 비교적 높지만, 장기이환으로 인한 활동장애여명은 선진국에 비해 낮은 수준이라 할 수 있다. 앞으로 우리 나라에서도 국민의 건강수준을 질적 양적 측면에서 정확히 평가하기 위하여 필요한 기초자료가 주기적으로 생산되어야 할 것이다.

• 대한지리학회지
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• 제51권3호
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• pp.367-380
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• 2016

본 연구에서는 우리나라에서 발생한 저체중아 출생 집계 자료를 공간적으로 지도화하기 위한 기법들을 검토 비교하고, 이를 기반으로 우리나라의 LBW 지도를 작성하였다. 표준화사망률이나 조사망률 등은 역학 분야에서 지속적으로 광범위하게 사용되고 있는 지표이다. 그러나 이러한 표준화사망률은 집계 단위의 샘플 수에 영향을 많이 받는다는 단점을 가지고 있다. 이에, 본 연구에서는 베이지언 기법을 활용하여 샘플 수에 따른 통계적 변동성을 감소시키고자 하였다. 이를 위해 경험적 베이지언 기법과 풀 베이지언 기법을 모두 활용하였고, 결과적으로 유사한 통계량을 산출한 것을 확인할 수 있었다. 반면, SMR 기반의 통계량은 높은 분산을 가지고 있음을 확인하였다. 연구의 결과에 따른 통계 지도는 우리나라 저체중아 출생의 높은 위험도를 가지는 지역들을 파악할 수 있도록 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2345-2348
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• 2012

Epidemiological studies of cancer incidence in Kazakhstan have revealed an uneven distribution for cervical cancer. Incidence and mortality rates were calculated for different regions of the republic, including the two major cities of Almaty and Astana, in 1999-2008. Defined levels for cartograms for incidence were low (up to 12.8/100,000), medium (12.8 to 15.9) and high (above 15.9) and for mortality were up to 7.1, 7.1 to 10.8 and more than 10.8, respectively. Basically high incidence rates were identified in the eastern, central and northern parts of the country and in Almaty. Such differences in cervical cancer data, and also variation in mortality/ incidence ratios, from a low of 0.4 in Almaty to a high of 0.71 in Zhambyl, point to variation in demographic and medical features which impact on risk and prognistic factors for cervical cancer in the country. Further research is necessary to highlight areas for emphasis in cancer control programs for this important cancer.

• Journal of Chest Surgery
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• 제28권11호
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• pp.977-982
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• 1995

Early repair of complex congenital heart malformation may lead to life-threatening respiratory and hemodynamic embarrassment on sternal closure. We performed delayed sternal closure in nine neonates to avoid a fatal outcome in these situations. Primary elective open sternum was used in 8 [66.7% and primary sternal closure in 4 [33.3% of the 12 patients studied. one patient with primary sternal closure underwent delayed sternal reopening in the intensive care unit. Of the 9 patients with open sternum, 2 patients died of low cardiac output and acute renal failure respectively before delayed sternal closure. 7 patients could undergo delayed sternal closures 3 days after initial operation. The mean age at open cardiac procedure was 14.3 days [range 3 to 30 and mean preoperative weight was 3.4kg [range 2.8 to 4.1 . The aortic cross-clamping time was longer in the group with open sternum than the group with closed sternum [p=0.042 . There was no morbidity and mortality related to delayed sternal closure. Given the low morbidity and potential benifits, this technique should be used in neonates after open heart procedures when postoperative mediastinal compression produces frank low cardiac output or respiratoy compromise during a trial of sternal closure.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권2호
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• pp.189-195
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• 2023

Subarachnoid hemorrhage secondary to rupture of an aneurysm is a severe condition, associated with a high rate of morbidity and mortality. There are few cases in the literature of rupture of an aneurysm of the persistent trigeminal artery. This is the case of a 62-year-old female who has suffered multiple ruptures of aneurysms, in different decades of her life, with the development of de novo aneurysm, been this the presented case, a rupture of aneurysm of the persistent trigeminal artery. This patient has survival to these conditions and remain without important morbidity. The case manifested with a clinical picture of third and seventh cranial nerve deficit, which this last one, there are not previous publications of cases with this deficit. This aneurysm was embolized with coils, and the postoperative condition was satisfactory, been discharged at 4 postoperative days.