• Title/Summary/Keyword: Respiratory mortality

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Middle East Respiratory Syndrome-Coronavirus Infection into Established hDPP4-Transgenic Mice Accelerates Lung Damage Via Activation of the Pro-Inflammatory Response and Pulmonary Fibrosis

  • Kim, Ju;Yang, Ye Lin;Jeong, Yongsu;Jang, Yong-Suk
    • Journal of Microbiology and Biotechnology
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    • v.30 no.3
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    • pp.427-438
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    • 2020
  • Middle East respiratory syndrome coronavirus (MERS-CoV) infects the lower respiratory airway of humans, leading to severe acute respiratory failure. Unlike human dipeptidyl peptidase 4 (hDPP4), a receptor for MERS-CoV, mouse DPP4 (mDPP4) failed to support MERS-CoV infection. Consequently, diverse transgenic mouse models expressing hDPP4 have been developed using diverse methods, although some models show no mortality and/or only transient and mild-to-moderate clinical signs following MERS-CoV infection. Additionally, overexpressed hDPP4 is associated with neurological complications and breeding difficulties in some transgenic mice, resulting in impeding further studies. Here, we generated stable hDPP4-transgenic mice that were sufficiently susceptible to MERS-CoV infection. The transgenic mice showed weight loss, decreased pulmonary function, and increased mortality with minimal perturbation of overexpressed hDPP4 after MERS-CoV infection. In addition, we observed histopathological signs indicative of progressive pulmonary fibrosis, including thickened alveolar septa, infiltration of inflammatory monocytes, and macrophage polarization as well as elevated expression of profibrotic molecules and acute inflammatory response in the lung of MERS-CoV-infected hDPP4-transgenic mice. Collectively, we suggest that this hDPP4-transgenic mouse is useful in understanding the pathogenesis of MERS-CoV infection and for antiviral research and vaccine development against the virus.

Single Dose Toxicity Study of Seonpyejeongcheon-tang in Sprague-Dawley Rats (Sprague-Dawley 랫드를 이용한 선폐정천탕의 단회투여독성시험)

  • Lee, Eung-Seok;Han, Jong-Min;Yang, Su-Young;Kim, Min-Hee;Kim, Seung-Hyung;NamGung, Uk;Park, Yang-Chun
    • The Journal of Internal Korean Medicine
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    • v.33 no.1
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    • pp.62-68
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    • 2012
  • Objectives : This study aimed to evaluate the single oral dose toxicity of Seonpyejeongcheon-tang (SJT) in male and female Sprague-Dawley rats. Methods : In this single oral toxicity study, rats were orally administrated in a single dose of 0 or 5,000 mg/kg SJT. There were 7 rats in each group. After single administration, mortality, clinical signs, body weight changes and gross pathological findings were observed for 14 days. Organ weight, clinical chemistry and hematology were tested after 14 days. Results : There was no mortality or other clinical signs for 14 days. There were also no significant differences in body weight, organ weights, hematological and serum chemical parameters between the SJT and control groups. Conclusions : The results obtained in this study suggest that the 50% lethal dose of SJT is over 5,000 mg/kg, so this finding can be expected to provide scientific evidence for the safety of SJT.

The Relationship between Blood Transfusion and Mortality in Trauma Patients (외상환자에서 수혈과 사망의 연관성)

  • Choi, Se Young;Lee, Jun Ho;Choi, Young Cheol
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.108-114
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    • 2008
  • Purpose: Using a propensity analysis, a recent study reported that blood transfusion might not be an independent predictor of mortality in critically ill patients, which contradicted the results of earlier studies. This study aims to reveal whether or not blood transfusion is an independent predictor of mortality in trauma patients. Methods: A total of three hundred fifty consecutive trauma patients who were admitted to our emergency center from January 2004 to October 2005 and who underwent an arterial blood gas analysis and a venous blood analysis were included in this study. Their medical records were collected prospectively and retrospectively. Using a multivariate logistic analysis, data on the total population and on the propensity-score -matched population were retrospectively analyzed for association with mortality. Results: Of the three hundred fifty patients, one hundred twenty-nine (36.9%) received a blood transfusion. These patients were older (mean age: 48 vs. 44 years; p=0.019) and had a higher mortality rate (27.9% vs. 7.7%; p<0.001). In the total population, the multivariate analysis revealed that the Glasgow coma scale score, the systolic blood pressure, bicarbonate, the need for respiratory support, past medical history of heart disease, the amount of blood transfusion for 24 hours, and hemoglobin were associated with mortality. In thirty-seven pairs of patients matched with a propensity score, potassium, new injury severity score, amount of blood transfusion for 24 hours, and pulse rate were associated with mortality in the multivariate analysis. Therefore, blood transfusion was a significant independent predictor of mortality in trauma patients. Conclusion: Blood transfusion was revealed to be a significant independent predictor of mortality in the total population of trauma patients and in the propensity-score-matched population.

A Comparison of Community Health Status by Region and an Investigation of related Factors using Community Health Indicators (지역사회 보건사회지표를 이용한 시군구 지역 간 건강수준 비교 및 관련 요인 상관관계 분석)

  • Park, Eun-Ok
    • Research in Community and Public Health Nursing
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    • v.23 no.1
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    • pp.31-39
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    • 2012
  • Purpose: The purpose of this paper was to compare community health status by region and to investigate related factors using community health and social indicators. Methods: Data were collected from statistics of local districts that were provided by KNSO and KCDC. ANOVA and correlation were analyzed using PASW 18.0. Results: The standardized cancer mortality rate was higher in metropolitan areas than in other areas. On the contrary, the mortality of respiratory disease, traffic accident, and suicide were higher in rural areas. Small cities and county districts showed higher prevalence in obesity prevalence than metropolitan areas. Metropolitan areas presented higher prevalence in alcohol drinking during the previous month, perceived stress, and seat belt use. The age-adjusted standardized mortality rate was correlated with higher prevalence of smoking, obesity, percentage of the elderly, number of beds, number of social welfare facilities, number of registered cars, lower percentage of financial independence, number of doctors, and percentage of water supply service & sewage. Conclusion: Since significant differences in mortality rate and prevalence of health risk behaviors exist between regional areas and the mortality rate was correlated with other social indicators and health indicators, health policies and social policies considering these differences should be develop and implemented to the communities.

Spatio-temporal analysis of tuberculosis mortality estimations in Korea (시공간 분석을 이용한 결핵 사망률추정)

  • Park, Jincheol;Kim, Changhoon;Han, Junhee
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.5
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    • pp.1183-1191
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    • 2016
  • According to WHO (World Health Organization), Korea ranked 1st place for TB mortality rate among OECD countries. In order to improve the situation, several administrative policies have been suggested and their efforts start showing some improvement. Meanwhile, those policies must be supported by solid scientific evidences by conducting appropriate statistical analyses. In particular, incidence and mortality rates of respiratory infectious disease such as TB must be analyzed considering their geographical characteristics. In this paper, we analyzed TB mortality rates in Korea from 2000 to 2011 using one of bayesian spatio-temporal models, which is implemented as R package (R-INLA).

Respiratory Failure of Acute Organophosphate Insecticide Intoxication (유기인제 중독에 의한 호흡부전)

  • Shin, Kyeong-Cheol;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Chang-Jin;Lee, Choong-Ki;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.363-371
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    • 1999
  • Background: Because of the widespread use and availability of agricultural insecticides, acute organophosphate poisoning as a suicide or an accident is becoming the most common type of poisoning and serious problem in Korea. The mortality of organophosphate poisoning varied from 10 to 86 percent. The cause of death was thought to be a combination of excessive bronchial secretion, bronchospasm, respiratory muscle paralysis and depression of respiratory center, summarily respiratory failure. We evaluated the respiratory complications in patients with acute organophosphate intoxication to determine the predisposing, factors to respiratory failure and to reduce the incidence of respiratory failure or mortality. Method: We conducted a retrospective study of 111 patients with the discharge diagnosis of organophosphate poisoning who were hospitalized at Yenugnam University Hospital during the 5 years. The diagnosis of organophosphate poisoning has based on the followings (1) a history of exposure to an organophosphate compounds. (2) the characteristic clinical signs and symptoms. (3) decrease in the cholinesterase activity in the serum. Results: Respiratory failure developed in 31(28%) of 111 patients with acute organophosphate poisoning. All cases of respiratory failure developed within 96 hours after poisoning and within 24 hours in 23 patients. The 80 patients who did not develop respiratory failure survived. In 31 patients with respiratory failure, 15(44%) patients were dead. The patients with respiratory failure had more severe poisoning, that is, the lower level of serum cholinesterase activity on arrival, the higher mean dosage of atropine administered within first 24 hours. In 16 patients with pneumonia, 14 patients developed respiratory failure. In 5 patients with cardiovascular collapse, 2 patients developed respiratory failure. There was no correlation to between age, sex, the use of pralidoxime and respiratory failure. The serum cholinesterase level in survivors at time of respiratory failure and weaning was $66.05{\pm}85.48U/L$, $441{\pm}167.49U/L$, respectively. Conclusion: All the respiratory failure complications of acute organophosphate poisoning occurred during the first 96 hours after exposure. The severity of poisoning and pneumonia were the predisposing factors to respiratory failure. Aggressive treatment and prevention of the above factors will reduce the incidence of respiratory failure.

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Analysis of Characteristics and Prognostic Factors in Adult Patients Receiving Mechanical Ventilation in the Medical Intensive Care Unit of a University Hospital (한 대학병원 내과계 중환자실의 기계환기 시행 환자의 현황 및 예후인자의 분석)

  • Song, Jin Woo;Choi, Chang-Min;Hong, Sang-Bum;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.292-300
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    • 2008
  • Background: Respiratory failure is a common condition that requires intensive care, and has a high mortality rate despite the recent improvements in respiratory care. Previous reports of patients with respiratory failure focused on the specific disease or included a large proportion of surgical patients. This study evaluated the clinical characteristics, outcomes and prognostic factors of adult patients receiving mechanical ventilation in a medical intensive care unit. Methods: Retrospective chart review was performed on 479 adult patients, who received mechanical ventilation for more than 48 hours in the medical ICU of one tertiary referral hospital. Results: The mean age of the patients was $60.3{\pm}15.6$ years and 34.0% were female. The initial mean APACHE III score was $72.3{\pm}25$. The cause of MV included acute respiratory failure (71.8%), acute exacerbation of chronic pulmonary disease (20.9%), coma (5.6%), and neuromuscular disorders (1.7%). Pressure controlled ventilation was used as the initial ventilator mode in 67.8% of patients, and pressure support ventilation was used as the initial weaning mode in 83.6% of the patients. The overall mortality rate in the ICU and hospital was 49.3% and 55.4%, respectively. The main cause of death in hospital was septic shock (32.5%), respiratory failure (11.7%), and multiorgan failure (10.2%). Males, an APACHE III score >70, the cause of respiratory failure (interstitial lung disease, coma, aspiration, pneumonia, sepsis and hemoptysis), the total ventilation time, and length of stay in hospital were independently associated with mortality. Conclusion: The cause of respiratory failure, severity of the patients, and gender appears to be significantly associated with the outcome of mechanical ventilatory support in patients with respiratory failure.

The dairy calf mortality : the causes of calf death during ten years at a large dairy farm in Korea (대규모 젖소 목장의 10년간 송아지 폐사 원인 분석)

  • Hur, Tai-Young;Jung, Young-Hun;Choe, Chang-Yong;Cho, Yong-Il;Kang, Seog-Jin;Lee, Hyun-June;Ki, Kwang-Seok;Baek, Kwang-Soo;Suh, Guk-Hyun
    • Korean Journal of Veterinary Research
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    • v.53 no.2
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    • pp.103-108
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    • 2013
  • The objective of this study was to investigate the calf death and analyse the causes of the mortality by based on medical records and autopsy findings during 10 years in a large dairy farm. Total of 1,361 calf born and 146 calf dead during the invested period. Mortality rate was 10.7% and showed the big difference by year-specific mortality from 2.8% (4 calves) to 19.2% (28 calves). The highest rate of mortality was 1 week age (18.5%, 27 calves) and followed by 2 week age (11.6%, 17 calves) and mortality of more old calf tended to be reduced. The death less than 4 weeks and 8 weeks of age of the entire mortality accounted for 41.1% (60/146 calves) and 70.0% (102/146 calves), respectively. Causes of calf death were digestive diseases (53.4%), respiratory diseases (17.1%), musculoskeletal disease (8.2%), and systemic disease (8.2%) in order. Specific causes of calf death was highest in enteritis (43.2%), followed by pneumonia (14.4%), sepsis (8.2%) and fractures (3.4%). Seasonally, most of calf death happened in winter (48.6%) and then fall (21.2%). This results showed that enteritis and pneumonia are the main reason of calf death but other reasons were involved in calf death on the based on autopsy finding. On going research relating factors of calf mortality is needed.

Relationship between Incidental Abnormalities on Screening Thoracic Computed Tomography and Mortality: A Long-Term Follow-Up Analysis

  • Jong Eun Lee;Won Gi Jeong;Hyo-Jae Lee;Yun-Hyeon Kim;Kum Ju Chae;Yeon Joo Jeong
    • Korean Journal of Radiology
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    • v.23 no.10
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    • pp.998-1008
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    • 2022
  • Objective: The present study aimed to assess the relationship between incidental abnormalities on thoracic computed tomography (CT) and mortality in a general screening population using a long-term follow-up analysis. Materials and Methods: We retrospectively collected the medical records and CT images of 840 participants (mean age ± standard deviation [SD], 58.5 ± 6.7 years; 564 male) who underwent thoracic CT at a single health promotion center between 2007 and 2010. Two thoracic radiologists independently reviewed all CT images and evaluated any incidental abnormalities (interstitial lung abnormality [ILA], emphysema, coronary artery calcification [CAC], aortic valve [AV] calcification, and pulmonary nodules). Kaplan-Meier analysis with log-rank and z-tests was performed to assess the relationship between incidental CT abnormalities and all-cause mortality in the subsequent follow-up. Cox proportional hazards regression was performed to further identify risk factors of all-cause mortality among the incidental CT abnormalities and clinical factors. Results: Among the 840 participants, 55 (6%), 171 (20%), 288 (34%), 396 (47%), and 97 (11%) had findings of ILA, emphysema, CAC, pulmonary nodule, and AV calcification, respectively, on initial CT. The participants were followed up for a mean period ± SD of 10.9 ± 1.4 years. All incidental CT abnormalities were associated with all-cause mortality in univariable analysis (p < 0.05). However, multivariable analysis further revealed fibrotic ILA as an independent risk factor for all-cause mortality (hazard ratio, 2.52 [95% confidence interval, 1.02-6.22], p = 0.046). ILA were also identified as an independent risk factor for lung cancer or respiratory disease-related deaths. Conclusion: Incidental abnormalities on screening thoracic CT were associated with increased mortality during the long-term follow-up. Among incidental CT abnormalities, fibrotic ILA were independently associated with increased mortality. Appropriate management and surveillance may be required for patients with fibrotic ILA on thoracic CT obtained for general screening purposes.

Predictors of Long-term Mortality after Hospitalization for Acute Exacerbation of COPD (만성폐쇄성폐질환의 급성악화로 입원했던 환자에서 장기간 사망의 예측인자)

  • Jung, Hae-Seon;Lee, Jin Hwa;Chun, Eun Mi;Moon, Jin Wook;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.205-214
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    • 2006
  • Background : Acute exacerbations form a major component of the socioeconomic burden of COPD. As yet, little information is available about the long-term outcome of patients who have been hospitalized with acute exacerbations, although high mortality rates have been reported. The aim of this study was to determine predictors of long-term mortality after hospitalization for acute exacerbation of COPD. Methods : We performed a retrospective cohort study of consecutive patients admitted to the hospital for COPD exacerbation between 2000 through 2004. Patients who had died in hospital or within 6-months after discharge, had tuberculosis scar, pleural thickening or bronchiectasis by chest radiography or had been diagnosed with malignancy during follow-up periods were excluded. Results : Mean age of patients was 69.5 years, mean follow-up duration was 49 months, and mean $FEV_1$ was 1.00L (46% of predicted). Mortality was 35% (17/48). In the multivariate Cox regression analysis, heart rate of 100/min or more (p=0.003; relative risk [RR], 11.99; 95% confidence interval [CI], 2.34-61.44) and right ventricular systolic pressure (RVSP) of 35mmHg or more (p=0.019; RR, 6.85; 95% CI, 1.38-34.02) were independent predictors of mortality. Conclusion : Heart rate and RVSP in stable state may be useful in predicting long-term mortality for COPD patients admitted to hospital with acute exacerbation.