• 제목/요약/키워드: One-year mortality

검색결과 343건 처리시간 0.033초

총폐정맥환류이상증에 대한 외과적 요법 및 장기 성적 (Surgical correction of Total Anomalous Pulmonary Venous Connection - Review of 37 Cases treated surgically during 10 years)

  • 나명훈
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.695-705
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    • 1987
  • This report provides follow - up data on 37 patients, aged 7 days to 25 years [median: 6.5 months], who underwent repair of total anomalous pulmonary venous connection at Seoul national University Hospital between May, 1978 and June, 1987. The patients were 22 males and 17 females and the sex ratio was 1.6 to 1, showing a male predominance. Sixteen patients had supracardiac, 13 cardiac, 3 infracardiac and 5 had a mixed type. The duration of follow up was from 1 month to 60 months [median: 14 months] There were eight early and one late deaths, and the overall mortality was 24%. The deaths during 1 year of life were eight [89%] and only one death [11%] occurred above 1 year of age. The mortality of cardiac type was unusually high, accounting for 56 percent of the total death, which was probably due to the preoperative poor clinical condition such as pulmonary edema and congestive heart failure. The major cause of death was the perioperative myocardial failure, and the survival was closely related to the preoperative clinical status, age and moderately elevated pulmonary arterial pressure, the sign of the elevated pulmonary vascular resistance and pulmonary venous obstruction. Early diagnosis and early application of surgical intervention is essential to the improved postoperative survival

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St. Jude medical valve의 임상적 연구;조기 사망의 술전 위험인자와 술후 합병증에 대한 고찰 (Clinical Analysis of St. Jude Medical Valve Replacement - Clinical Analysis of Risk Factors for Early Death and Valve-related Complication -)

  • 이언재
    • Journal of Chest Surgery
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    • 제24권1호
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    • pp.26-35
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    • 1991
  • From January 1984 to June 1990, 188 patients have undergone cardiac valve replacement [114 MVR, 27 AVR, 47 Multiple valve replacement] with the St. Jude Medical prosthesis. The early mortality rate was 6.9%. The most common cause of early death was low output syndrome. There were no cases of valve-related early death. The risk factors for early death were advanced preoperative NYHA functional class [> IV], and prolonged ECC and ACC time. The 175 early survivors were followed-up for a total 372.7 patient-year over a period of 2 to 74 months [Mean $\pm$SD: 25.6$\pm$18.6 months]. During follow up, 12 patient died and late mortality rate was 6.9%. There were three valve-related late deaths: two were due to valve thrombosis and one was due to hemorrhage. Most late deaths [58%, 7/12] were from cardiac non-valvular causes. Valve-related complications occurred at a linearlized rate of 3.5% /pt-yr. Embolism occurred at a rate of 0.8% /pt-yr. There were three cases of valve thrombosis [0.8% /pt-yr: two fatal]. Hemorrhage due to anticoagulant occurred in 5 patients and a rate of 1.3% pt-yr [one fatal]. Five-year actuarial survival rate was 86.5 $\pm$5.1% and 97% of patient were in NYHA functional class I or II at three months postoperatively.

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Changes in the neonatal and infant mortality rate and the causes of death in Korea

  • Chung, Sung-Hoon;Choi, Yong-Sung;Bae, Chong-Woo
    • Clinical and Experimental Pediatrics
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    • 제54권11호
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    • pp.443-455
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    • 2011
  • Neonatal mortality rate (NMR) or infant mortality rate (IMR) are the rate of deaths per 1,000 live births at which babies of either less than four weeks or of one year of age die, respectively. The NMR and IMR are commonly accepted as a measure of the general health and well-being of a population. Korea's NMR and IMR fell significantly between 1993 and 2009 from 6.6 and 9.9 to 1.7 and 3.2, respectively. Common causes of infantile death in 2008 had decreased compared with those in 1996 such as other disorders originating in the perinatal period, congenital malformation of the heart, bacterial sepsis of newborns, disorders related to length of gestation and fetal growth, intra-uterine hypoxia, birth asphyxia. However, some other causes are on the increase, such as respiratory distress of newborn, other respiratory conditions originating in the perinatal period, other congenital malformation, diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism. In this study, we provide basic data about changes of NMR and IMR and the causes of neonatal and infantile death from 1983 to 2009 in Korea.

Variation in Susceptibility of Pine Species Seedlings with the Pine Wood Nematode, Bursaphelenchus xylophilus, in Greenhouse

  • Woo, Kwan-Soo;Kim, Yeong-Sik;Koo, Yeong-Bon;Yeo, Jin-Kie;Moon, Yil-Soong
    • The Plant Pathology Journal
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    • 제23권2호
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    • pp.70-75
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    • 2007
  • We conducted an inoculation test using nine open-pollinated families of pine trees to evaluate their susceptibility and mortality in different densities of pine wood nematode. Three-year-old nine open-pollinated pine families were inoculated with Bursaphelenchus xylophilus at levels of 3,000, 5,000, and 7,000 nematodes/seedling in greenhouse. There were no distinct patterns in latent period among three densities of B. xylophilus in all families. Most families showed the first disease symptoms of needle discoloration within 12-15 days after inoculation. However, open-pollinated progenies of Pinus densiflora showed the longest latent period because none of one-year-old needles were wilted until 14 days after inoculation with 5,000 and 7,000 nematodes. One-year-old needles were wilted earlier than current needles in all tested families with all densities of B. xylophilus. Current needles were not wilted until 14 days after inoculation in all seedlings. The mortality of all seedlings rapidly increased from 35 days to 49 days after inoculation, and all died within 80 days except two seedlings. A 3,000 nematodes/100 ${\mu}L$ with sterilized distilled water are enough to screen 3-year-old pine seedlings for resistance to B. xylophilus.

소아환자에서의 심장판막치환수술 (Cardiac valve replacement in children)

  • 김종환;이영균
    • Journal of Chest Surgery
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    • 제16권1호
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    • pp.10-17
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    • 1983
  • Valve replacement in children, aging up to 15 years [Mean 11.g years], has been done at Seoul National University Hospital over the past 14 years since 1968. Fifty-one patients have received 59 artificial valves: 55 bioprosthetic and 4 prosthetic valves. Thirty-one patients [60.8%] had rheumatic heart disease and the remainder [39.2%] had congenital heart disease. Forty-two patients [82.4%] survived operation: 9 patients [17.7%] died within one monfi3 postoperatively and 4 patients [7.8%]during the follow-up period with the overall mortality rate of Thromboembolic complication occurred in 3 patients with 2 deaths: 5.9% embolic rate or 4.68% emboli per patient-year. One patient who had been on coumadin anticoagulation died from cerebral hemorrhage. One mitral Ionescu-Shiley valve failed 19 months after first replacement and this was successfully re-replaced with the same kind of valve. Actuarial survival rate was 59.9% at 4 years after surgery. Thromboembolism-free and valve failure-free survivals were 80.0% and 93.1% respectively. These clinical results in the pediatric age group suggested that valve replacement in children was a serious undertaking with a higher mortality rate than in adults. However, the main superiority on the low thrombogenecity of the xenograft valve over the mechanical one warrants its continuing use until the question of its durability would otherwise be answered by a further study of clinical follow-up.

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Risk Assessment for Toluene Diisocyanate and Respiratory Disease Human Studies

  • PARK, Robert M.
    • Safety and Health at Work
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    • 제12권2호
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    • pp.174-183
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    • 2021
  • Background: Toluene diisocyanate (TDI) is a highly reactive chemical that causes sensitization and has also been associated with increased lung cancer. A risk assessment was conducted based on occupational epidemiologic estimates for several health outcomes. Methods: Exposure and outcome details were extracted from published studies and a NIOSH Health Hazard Evaluation for new onset asthma, pulmonary function measurements, symptom prevalence, and mortality from lung cancer and respiratory disease. Summary exposure-response estimates were calculated taking into account relative precision and possible survivor selection effects. Attributable incidence of sensitization was estimated as were annual proportional losses of pulmonary function. Excess lifetime risks and benchmark doses were calculated. Results: Respiratory outcomes exhibited strong survivor bias. Asthma/sensitization exposure response decreased with increasing facility-average TDI air concentration as did TDI-associated pulmonary impairment. In a mortality cohort where mean employment duration was less than 1 year, survivor bias pre-empted estimation of lung cancer and respiratory disease exposure response. Conclusion: Controlling for survivor bias and assuming a linear dose-response with facility-average TDI concentrations, excess lifetime risks exceeding one per thousand occurred at about 2 ppt TDI for sensitization and respiratory impairment. Under alternate assumptions regarding stationary and cumulative effects, one per thousand excess risks were estimated at TDI concentrations of 10 - 30 ppt. The unexplained reported excess mortality from lung cancer and other lung diseases, if attributable to TDI or associated emissions, could represent a lifetime risk comparable to that of sensitization.

Severe acute alcoholic hepatitis and liver transplant: A never-ending mournful story

  • Obed, Aiman;Bashir, Abdalla;Stern, Steffen;Jarrad, Anwar
    • 대한간학회지
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    • 제24권4호
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    • pp.358-366
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    • 2018
  • Severe acute alcoholic liver disease (SAAH) unresponsive to medical therapy shows one-year-mortality rates of up to 90%. Most transplant centers request six months of alcohol abstinence prior to transplantation, the so-called "6-month rule." This regulation is not based on strong evidence, repeatedly making it a topic of controversial debates. The majority of patients with SAAH will die before fulfilling the 6-month rule. Therefore, liver transplantation (LT) protocols are becoming more flexible towards the rigid abstinence regulation, especially concerning SAAH patients. We conducted a literature review regarding LT in SAAH and its outcomes, including post-transplant mortality and recidivism. We studied available data on PubMed from 2011 and onwards whilst including articles dealing with genetic components, medical therapy and historic snapshots of alcoholism. Emerging studies recommend LT in SAAH not responding to medical therapies even without realizing the required abstinence period, since the majority of these patients would die within 6 months. SAAH without response to medical therapy has one-year-mortality rates of up to 90%. The 6-month rule is not based on strong evidence and is repeatedly a topic of controversial debates. There is genetic linkage to alcoholism and medical therapy is not as effective as estimated, yet. The 6-months-regulation has not shown to evidently decrease the risk of recidivism post-LT, which is a lifesaving treatment in SAAH patients. Insisting on rigid sobriety rules results in excluding patients with a low risk of recidivism from being transplanted. Moreover, the genetic linkage of alcoholism must be recognized.

한국 남해안 보구치(Pennahia argentata)의 자원생태학적 특성치 및 자원량 추정 (Ecological Characteristics and Biomass of White Croaker Pennahia argentata Population in the South Sea of Korean Peninsula)

  • 전복순;이해원;강수경;이승종;오철웅
    • 한국수산과학회지
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    • 제55권5호
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    • pp.721-729
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    • 2022
  • We investigated the ecological characteristics and biomass of white croaker Pennahia argentata population in the South Sea of Korea using catch data from Danish seins fishery and biological data from 2018 to 2020. Survival rate (S), which was estimated using Pauly method (1984) was 0.361 per year, and the instantaneous coefficient of total mortality (Z) was 1.019 per year. The instantaneous coefficient of natural mortality (M) and that of fishing mortality (F) were estimated as 0.351 and 0.668 per year, respectively. At first capture, age was estimated to be 1.19 years and length at this age was 18.7cm. The annual biomass was estimated with a biomass-based cohort analysis using annual catch data between 1997-2020 in Korean water. The biomass of the white croaker declined sharply from 4,000 tons in 1999 to the lowest level of approximately 1,000 tons in 2004. Post 2004, the biomass started to increase gradually and reached approximately 7,000 tons. The amount of resources was 35.7%, 34.8%, and 16.5% at age one, two, and three years, respectively, and 86.9% of all captured white croaker individuals belonged to the age group of 1-3 years.

Surgical Repair of Ventricular Septal Defect after Myocardial Infarction: A Single Center Experience during 22 Years

  • Park, Sung Jun;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제46권6호
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    • pp.433-438
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    • 2013
  • Background: Surgical repair of post-infarct ventricular septal defect (VSD) is considered one of the most challenging procedures having high surgical mortality. This study aimed to evaluate the outcomes of the surgical repair of post-infarct VSD. Methods: From May 1991 to July 2012, 34 patients (mean age, $67.1{\pm}7.9$ years) underwent surgical repair of post-infarct VSD. A retrospective review of clinical and surgical data was performed. Results: VSD repair involved the infarct exclusion technique using a patch in all patients. For coronary revascularization, 12 patients (35.3%) underwent concomitant coronary artery bypass graft, 3 patients (8.8%) underwent preoperative percutaneous coronary intervention, and 9 patients (26.5%) underwent both of these procedures. The early mortality rate was 20.6%. Six patients (17.6%) required reoperation due to residual shunt or newly developed VSD. During follow-up (median, 4.8 years; range, 0 to 18.4 years), late death occurred in nine patients. Overall, the 5-year and 10-year survival rates were $54.4%{\pm}8.8%$ and $44.3%{\pm}8.9%$, respectively. According to a Cox regression analysis, preoperative cardiogenic shock (p=0.069) and prolonged cardiopulmonary bypass time (p=0.008) were independent predictors of mortality. Conclusion: The early surgical outcome of post-infarct VSD was acceptable considering the high-risk nature of the disease. The long-term outcome, however, was still dismal, necessitating comprehensive optimal management through close follow-up.

70세이상 환자에서의 개심술 (Open Heart Surgeries in Septuagenarians.)

  • 김형수;이원용;지현근;김응중;홍기우
    • Journal of Chest Surgery
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    • 제32권11호
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    • pp.1017-1022
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    • 1999
  • Background: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. Material and Method: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. Result: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. Conclusion: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.

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