• Title/Summary/Keyword: Morbidity and Mortality

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Thallium-201 Perfusion Scan in Peripheral Arterial Disease (말초성 동맥 질환에 있어서 $^{201}T1$을 이용한 말초혈관 관류스캔의 유용성)

  • Nah, Jung-Il;Woo, In-Sook;Kim, Deog-Yoon;Koh, Eun-Mi;Kim, Jin-Woo;Kim, Young-Seol;Kim, Kwang-Won;Choi, Young-Kil
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.2
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    • pp.192-199
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    • 1991
  • Peripheral arterial disease, because of it's significant and prolonged morbidity and related mortality is a major medical and surgical problem. Contrast angiogram remains the essential standard for the anatomic demonstration of disease. It does not, however, provide data suitable for quantification or any evaluation of the microcirculation. For these reasons, radionuclide studies are playing an increasingly important role by not only confirming the diagnosis and offering objective data on the physiologic significance of anatomic lesions, but by offering prognosis of healing and prediction of therapeutic results. In addition, radionuclide procedures offer means to safely and repeatedly monitor response to therapy and long term follow up. The object of this study was to evaluate the clinical availability of $^{201}T1$ perfusion scan in patients with peripheral arterial diseases. We performed $^{201}T1$ perfusion scans in patients with five Buerger' s disease (10 legs), six DM gangrenes (12 legs) and classified three perfusion pattern groups. Finally we compared treatment modalities among each groups and compaired T1-201 perfusion scan findings with angiographic findings in six patients with Buerger's disease. The results were as follows: 1) Seven legs showed increased perfusion in stress image and normal or increased perfusion in resting image (type 1). Six legs showed decreased perfusion in stress image and improved in resting image (type II). Of total 13 legs, only 1 leg needed to amputation. 2) Three legs showed decreased perfusion in stress and resting image (type III), and subsequently all cases were received surgical amputation. 3) In six Buerger's disease patients, there were disagreements in two patients (2 legs) between $^{201}T1$ scan and angiography, in which angiograms were normal but $^{201}T1$ scans showed 'type II' perfusion patterns.

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A Case-Control Study on Blood Lipids as a Risk Factor of Stroke (뇌졸중 위험지표로서의 혈중 지질에 대한 환자;대조군 연구)

  • Kim, Jung-Hyun;Kang, Kyung-Won;Yu, Byeong-Chan;Choi, Sun-Mi;Baek, Hye-Ki;Lim, Seung-Min;An, Jung-Jo;Seol, In-Chan;Kim, Yoon-Sik
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.830-837
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    • 2007
  • Background and purpose : Stroke is one of the most deadly diseases and a leading cause of disability. Lipids confer an increased risk for cardiovascular morbidity and mortality. In spite of many studies on the relationship between stroke and lipids, their relationship is not clear. This study was undertaken to determine whether lipids were associated with stroke. Method : We compared the components of blood lipids between stroke patients group (n=217,Cases), non-stroke control group (n=160, Controls) and healthy control group without hypertension, diabetes mellitus, ischemic heart disease, or hyperlipidemia (n=140, Normals). These data were statically analyzed by general linear models and binary logistic regression analysis to get each adjusted odds ratio. Result : The results were as follows. The blood levels of total cholesterol (T-Chol), triglyceride (TG) and low density lipoprotein cholesterol (LDL-Chol) were significantly higher in patients of ischemic stroke, while the blood levels of T-Chol and LDL-Chol were significantly lower, and the blood levels of TG significantly higher in patients of hemorrhagic stroke. The blood level of high density lipoprotein cholesterol (HDL-Chol) was significantly lower in all cases. Conclusion : These results suggest that high TG and low HDL-Chol may be risk factors of hemorrhagic stroke and ischemic stroke, high T-Chol and LDL-Chol may be risk factors of ischemic stroke, and low T-Chol and LDL-Chol may be risk factors of hemorrhagic stroke in Koreans.

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Radiologic Analysis of Congenital Origin Intestinal Obstruction in Neonate and Childhood (선천성 장관폐쇄의 방사선학적 분석)

  • Hwang, Mi-Soo;Byun, Woo-Mok;Kim, Sun-Yong;Chang, Jae-Chun
    • Journal of Yeungnam Medical Science
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    • v.4 no.1
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    • pp.33-42
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    • 1987
  • Congenital origin intestinal obstruction are important disease due to required emergency operation. So accurate and rapid diagnosis is needed for decreased mortality and morbidity. Radiologist must detect to accurate obstruction site and also associated other congenital anomalies. And also embriological bases are very important role to the diagnosis of theses diseases. We were analysed radiologically and clinically 25 cases with congenital origin intestinal obstruction with review of literature. 1. Hypertrophic pyloric stenosis 6 cases, midgut malrotation 4 cases, congenital megacolon 8 case, imperforated anus 5 cases, ileal atresia 1 case and duodenal atresia 1 case. 2. Male and female radio were 16:9. Especially on hypertrophic pyloric stenosis, 5 cases were male infants. 3. All cases of hypertrophic pyloric stenosis represented string sign and also pyloric beak sign shoulder sign on UGI. 4. I case duodenal atresia showed double bubble sign on simple abdomen x-ray and ileal atresia showed mechanical small bowel obstruction sign with microcolon. 5. On midgut malrotation, cecum was located in right upper abdomen on 4 cases. And 2 cases were associated with Ladd's band. I case with volvulus and 1 case with mesenteric defect. 6. Involved site of all congenital megacolon were localized to rectosigmoid colon. 7. On 5 cases imperforated anus, 3 cases were low type and 2 case high type. Rectoperineal and rectourogenital fistula were demonstrated on 4 cases.

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Assessment of Basal Energy Expenditure in Normal Healthy Volunteers and Patients Receiving TPN by Bioelectrical Impedance Analysis (Bioelectrical Impedance Analysis를 통한 건강한 성인과 TPN환자의 기초대사량 산출)

  • Son, Eun Sun;Kim, Choong Bai;Suh, Okkyung;Shin, Hyun Taek;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.19-26
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    • 1999
  • Adequate nutrition is important in maintaining optimal health. Malnutrition can expose individual to increased risks of morbidity and mortality. The purposes of this study were to determine the basal energy expenditure (BEE) of Korean healthy subjects and TPN patients using Bioelectrical Impedance Analysis (BIA) method and to compare these values with those predicted by Harris-Benedict equation (H-B). BEE values measured by BIA were compared with predicted BEE values by the H-B formula in 59 clinically stable TPN patients and 65 healthy volunteers. In healthy volunteers and TPN patients, statistically significant differences were not shown between the BEE values measured by BIA (1392.5 Kcal and 1325.9 Kcal) and those predicted by H-B formula (1384.1 Kcal and 1270.1 Kcal). In male volunteers, statistically significant differences were not shown between BEE values measured by BIA (1670.7 Kcal) and the H-B formula (1550.9 Kcal), but in female volunteers, statistically significant differences were shown between BEE values measured by BIA (1194.8 Kcal) and the H-B formula (1265.6 Kcal). In male TPN patients, statistically significant differences were shown between BEE values measured by BIA (1453.5 Kcal) and the H-B formula (1335.9 Kcal), but in female TPN patients, statistically significant differences were not shown between BEE values measured by BIA (1126.4 Kcal) and the H-B formula (1167.2 Kcal). In normal healthy volunteers, $90.8\%$ of BEE values measured by BIA and in TPN patients $89.8\%$ of BEE values measured by BIA were within $15\%$ of BEE values predicted by the H-B formula in non-obese subjects. In conclusion, BEE values predicted by H-B formula or measured by BIA can be applied to non-obese Koreans. However, these values should be confirmed with Indirect calorimetry for Koreans.

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Relationship between Corrected QT Interval and Cardiovascular Risk Factors in Young Healthy Adults: The Kangwha Study (젊은 성인에서 교정 QT간격과 심혈관질환 위험요인의 관련성: 강화연구)

  • Ahn, Song-Vogue;Kim, Hyeon-Chang;Hur, Nam-Wook;Ha, Kyoung-Soo;Jang, Hoo-Sun;Kim, Jin-Bae;Suh, Il
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.6
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    • pp.455-461
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    • 2006
  • Objectives : Prolongation of the heart rate-corrected QT (QTc) interval has been reported to be associated with cardiovascular morbidity and mortality. However, few studies have examined the relationship between the QTc interval and cardiovascular risk factors in young healthy people, The aim of this study was to examine the associations between the QTc interval and cardiovascular risk factors in young healthy adults. Methods : This study was performed as part of the Kangwha study, which started in 1986, and is an on-going follow-up study on blood pressure and related cardiovascular risk factors. In follow-up examinations during 2005, cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry and carotid ultrasonography, were measured, and questionnaires on health behaviors completed by 127 men and 149 women aged 25 years. The QTc interval was measured on the resting 12-lead electrocardiogram using an automatic analysis program. Results : The mean QTc interval was significantly longer in women $(419{\pm}17ms)$ than in men $(405{\pm}17ms)$ (p<0.001). A significant positive correlation was found between the QTc interval and waist-hip ratio (p=0.030) in men. Women showed a positive correlation between the QTc interval and systolic blood pressure (p=0.017). On a multiple regression analysis, the QTc interval was positively associated with the waist-hip ratio in men (p=0.012) and with the systolic blood pressure (p=0.020) in women. Conclusions : In young healthy Korean adults, the QTc interval was independently associated with the waist-hip ratio in men and with the systolic blood pressure in women.

Epidemiology of Pesticide Poisoning in Kyungpook (경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査))

  • Chung, Jong-Hak;Cho, Jae-Yeun
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.28-34
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    • 1983
  • In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.

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Experience of Reoperation after Valve Replacement Using Mechanical Heart Valve -8 cases - (기계판막을 이용한 판막치환술 후 재수술에 대한 경험 -8예 보고-)

  • Kim Hyuck;Lee Hyung Chang;Wee Jang Seop;Kang Jung Ho;Chung Won Sang;Chon Sun Ho;Lee Chul Bum;Kim Young Hak
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.783-787
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    • 2005
  • Eight patients underwvnt reoperation after valve replacement surgery with a mechanical valve from January, 1992 to December, 2003. Among the various indications for reoperation, there were 4 patients with paravalvular leakage; 3 patients underwent resuturing of the area of leakage and one patient underwent redo valve replacement. Among the three patients with stenosis due to thrombosis of the valve, 2 patients underwent redo valve replacement and one patient underwent thrombectomy. In one patient, the valve functioned normally, but stenosis was caused by overgrowth of the patient and redo valve replacement was done 123 months later. There was no postoperative mortality or morbidity. After an average of 51 months ($2\~134$ months) of postoperative follow up, the patients were in good condition and were able to maintain a NYHA functional class of I or II. The operative method used, whether it be a redo valve replacement or valve sparing method, depends upon the type of lesion and the anatomic structure.

The Local Effect after Surgery in Non-small Cell Lung Cancer (비소세포성 폐암에서 수술 후의 국소 제어효과)

  • Sa, Young-Jo;Jeon, Hyun-Woo;Lee, Sun-Hee;Wang, Young-Pil;Park, Jae-Kil
    • Journal of Chest Surgery
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    • v.40 no.5 s.274
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    • pp.356-361
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    • 2007
  • Background: Recent progress in the surgical therapy for lung cancer is one of the best examples of the successful evolution of clinical medicine. We reviewed our experience to evaluate the surgical outcomes in patients with non-small cell lung cancer. Material and Method: We reviewed clinical records of 432 consecutive patients with proven non-small cell lung cancer who underwent complete removal of the primary tumor together with hilar and mediastinal lymph nodes from 1995 to 2005. The clinical characteristics, surgical methods, and recurrence patterns were analyzed. Result: Lobectomy was the most common procedure (66.7%) performed and sleeve lobectomy was the least (5.6%). In 179 patients (42.6%) the recurrence was noted and the regional recurrence (67 cases, 16.0%) was less than systemic recurrence (112 cases, 26.7%). The main sites of regional recurrence were hilum (25 cases, 37.3%) and ipsilateral mediastinum (54/432 cases, 25.4%). The hospital mortality rate was 2.8% (12/432 cases) and resection-morbidity rate was 12.5% (54/432 cases). Conclusion: The low recurrence rate, especially regional recurrence rate indicated that our surgical procedures with preoperative measures were considered useful and effective.

Study of Relationship Between Illness Perception and Delay in Seeking Help for Breast Cancer Patients Based on Leventhal's Self-Regulation Model

  • Attari, Seyedeh Maryam;Ozgoli, Giti;Solhi, Mahnaz;Majd, Hamid Alavi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.167-174
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    • 2016
  • One of the major causes of morbidity and mortality in breast cancer patients is delay in seeking help. Leventhal's self-regulation model provides an appropriate framework to assess delay in seeking help. The aim of this study was to investigate the relationship between "illness perception" and "help seeking delay" in breast cancer patients based on Leventhal's self-regulation model. In this correlational descriptive study with convenience sampling conducted in 2013, participants were 120 women with breast cancer who were diagnosed in the last year and referred to chemotherapy and radiotherapy centers in Rasht, Iran. Data collection scales included demographic data, Revised Illness Perception Questionnaire (IPQ-R)and a researcher made questionnaire to measure the delay in seeking help. Pre-hospital delay (help seeking delay) was evaluated in 3 phases (assessment, disease, behavior). The data were analyzed using SPSS-19. The mean (SD) age calculated for the patients was $47.3{\pm}10.2$. Some 43% of the patients had a high school or higher education level and 82% were married. The "pre-hospital delay" was reported ${\geq}3months$. Logistic regression analysis showed that none of the illness perception components were correlated with appraisal and behavioral delay phases. In the illness delay phase, "time line" (p-value =0.04) and "risk factors"(p-value=0.03) had significant effects on reducing and "psychological attributions" had significant effects on increasing the delay (p-value =0.01). "Illness coherence" was correlated with decreased pre-hospital patient delay (p-value<0.01). Women's perceptions of breast cancer influences delay in seeking help. In addition to verifying the validity of Leventhal's self-regulation model in explaining delay in seeking help, the results signify the importance of the "illness delay phase" (decision to seek help) and educational interventions-counseling for women in the community.

Effective Biomarkers for Miniature Pig in Acute Kidney Injury Using Renal Ischemia-Reperfusion Model (미니돼지의 신허혈-재관류에 의한 급성신손상 모델에서의 유용한 바이오마커)

  • Kim, Se-Eun;Shim, Kyung-Mi;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.372-376
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    • 2012
  • Acute kidney injury (AKI) is a serious problem associated with high morbidity and mortality. Ischemia-reperfusion is an important cause of acute kidney injury. This study was performed to ascertain clinically useful biomarkers for the diagnosis of AKI. In three miniature pigs, AKI were induced by 60 minutes of bilateral renal ischemia by the clamping renal artery. Blood and urine samples were collected from the pigs prior to clamping (baseline) and 0, 1, 3 and 5 days post-clamping. Serum blood urea nitrogen (BUN), creatinine, sodium and uric acid were measured in serum and urine samples. Fractional excretion of sodium ($FE_{Na}$) and fractional excretion of uric acid ($FE_{UA}$) were calculated. Also, interleukin (IL)-6, IL-18, liver type fatty acid binding protein (L-FABP) and glutathione-S-transferase (GST) were detected by Western immunoblotting. Serum BUN and creatinine levels were increased significantly at day 1 post-clamping in all three miniature pigs. However, $FE_{Na}$ and $FE_{UA}$ showed marked individual differences. Western immunoblotting revealed significantly increased levels of IL-6, IL-18, L-FABP and GST in post-ischemic urine, compared to pre-clamping. While more research concerning the variance of $FE_{Na}$ and $FE_{UA}$ is needed, serum BUN, creatinine, IL-6, IL-18, L-FABP and GST may be sensitive urine biomarkers for diagnosis of AKI together with other biomarkers in the porcine ischemia-reperfusion model.