• 제목/요약/키워드: Underlying cause

검색결과 489건 처리시간 0.031초

일부 농촌지역 사망신고자료에 기재된 사인에 관한 연구 -사망신고사인과 조사사인의 비교- (A Study of the Cause-of-Death reported on Official Death Registry in a Rural Area)

  • 남해성;박경수;선병환;신준호;손석준;최진수;김병우
    • Journal of Preventive Medicine and Public Health
    • /
    • 제29권2호
    • /
    • pp.227-238
    • /
    • 1996
  • This study was conducted to evaluate the accuracy of the official death registry in rural area. The base data used for the study was 379 deaths registered during the period of 1993 and 1994 in 4 rural townships of Chonnam province. The interview survey for cause-of-death was performed on the next of kin and/or neighbor. Additional medical informations were collected from hospitals and medical insurance associations for the purpose of verification. The underlying cause-of-death of 278 cases presumed by the survey was compared to the cause on official death registry. There was a prominent disagreement of cause-of-death between the survey data and the registry data(agreement rate: $38.9\sim44.6%$, according to disease classification method). These results may be caused by extremely low rates of physicians' certification, which were mostly confined to the poisoning and injury. Symptoms, signs, and ill defined conditions on death registry could be classified into circulatory disease(32.3%), neoplasm(21.2%), digestive disease(7.1%), injury and poisoning(7.1%) and so on. These results suggest that careful attention and verification be required on utilization of death registry data in rural area.

  • PDF

용혈성 요독 증후군 (Hemolytic uremic syndrome)

  • 박혜원
    • Clinical and Experimental Pediatrics
    • /
    • 제50권10호
    • /
    • pp.931-937
    • /
    • 2007
  • The hemolytic uremic syndrome (HUS) is a rare disease of microangiopathic hemolytic anemia, low platelet count and renal impairment. HUS usually occurs in young children after hemorrhagic colitis by shigatoxin-producing enterohemorrhagic E. coli (D+HUS). HUS is the most common cause of acute renal failure in infants and young children, and is a substantial cause of acute mortality and morbidity; however, renal function recovers in most of them. About 10% of children with HUS do not reveal preceding diarrheal illness, and is referred to as D- HUS or atypical HUS. Atypical HUS comprises a heterogeneous group of thrombomicroangiopathy (TMA) triggered by non-enteric infection, virus, drug, malignancies, transplantation, and other underlying medical condition. Emerging data indicate dysregulation of alternative complement pathway in atypical HUS, and genetic analyses have identified mutations of several regulatory genes; i.e. the fluid phase complement regulator Factor H (CFH), the integral membrane regulator membrane cofactor protein (MCP; CD46) and the serine protease Factor I (IF). The uncontrolled activation of the complement alternative pathway results in the excessive consumption of C3. Plasma exchange or plasma infusion is recommended for treatment of, and has dropped the mortality rate. However, overall prognosis is poor, and many patients succumb to end-stage renal disease. Clinical presentations, response to plasma therapy, and outcome after renal transplantation are influenced by the genotype of the complement regulators. Thrombotic thrombocytopenic purpura (TTP), another type of TMA, occurs mainly in adults as an acquired disease accompanied by fever, neurologic deficits and renal abnormalities. However, less frequent cases of congenital or hereditary TTP associated with ADAMTS-13 (a disintegrin and metalloprotease, with thrombospondin 1-like domains 13) gene mutations have been reported, also. Recent advances in molecular genetics better allow various HUS to be distinguished on the basis of their pathogenesis. The genetic analysis of HUS is important in defining the underlying etiology, predicting the genotype-related outcome and optimizing the management of the patients.

A Review of Recent Trend of COVID-19 Infection and Correlation with Pulmonary Function

  • Kim, Min Woo
    • 대한의생명과학회지
    • /
    • 제26권3호
    • /
    • pp.127-135
    • /
    • 2020
  • Coronavirus is generally known to cause minor respiratory diseases in animals and humans. However, some coronavirus genus is reported to cause animal-to-human interspecies infection. Since the end of 2019, a new type of coronavirus (COVID-19) infection is spreading rapidly throughout the world, leading to the declaration of the pandemic by the World Health Organization (WHO). Despite various clinical studies to counter COVID-19 infection, the total confirmed cases and death rates are still accumulating. To break down this new threat, we should pay attention to newly revealed information based on scientific facts. In this review, we introduced the clinical characteristics, diagnostic methods, and treatment of patients infected with COVID-19. Moreover, we highlighted the correlation between COVID-19 severity and patients with underlying diseases. Potential risks associated with COVID-19 can be differed depending on the condition of patients and can cause pulmonary complications. Therefore, lung capacity exams are expected to help predict the progression of the disease along with previously established detection methods such as molecular diagnostics and immunoassay. Although physiological research hasn't yet been emphasized to evaluate COVID-19 infection, this review is expected to be valuable to give new inspiration to deal with COVID-19 which might strike again in the future.

슬래브교 상판의 전문가 시스템 개발 (Development of the Expert System for Management on Slab Bridge Decks)

  • 안영기;이증빈;임정순;이진완
    • 한국구조물진단유지관리공학회 논문집
    • /
    • 제7권1호
    • /
    • pp.267-277
    • /
    • 2003
  • The purpose of this study makes a retrofit and rehabilitation practice trough the analysis and the improvement for the underlying problem of current retrofit and rehabilitation methods. Therefore, the deterioration process, the damage cause, the condition classification, the fatigue mechanism and the applied quantity of strengthening methods for slab bridge decks were analysed. Artificial neural networks are efficient computing techniqures that are widely used to solve complex problems in many fields. In this study, a back-propagation neural network model for estimating a management on existing slab bridge decks from damage cause, damage type, and integrity assessment at the initial stsge is need. The training and testing of the network were based on a database of 36. Four different network models werw used to study the ability of the neural network to predict the desirable output of increasing degree of accuracy. The neural networks is trained by modifying the weights of the neurons in response to the errors between the actual output values and the target output value. Training was done iteratively until the average sum squared errors over all the training patterms were minimized. This generally occurred after about 5,000 cycles of training.

치주질환으로 인해 유발된 하악의 만성 화농성 골수염의 치험 일례 (Chronic suppuraive osteomyelitis of the mandible caused by periodontal disease;a case report)

  • 임요한;표성운;한은영
    • Journal of Periodontal and Implant Science
    • /
    • 제32권4호
    • /
    • pp.745-752
    • /
    • 2002
  • Osteomyelitis is an exhaustive disease whose main feature is an inflammation of inner part of bone, bone marrow. In oral and maxillofacial area, we have maxillary and mandibular osteomyelitis and the latter is dominant because of its impaired blood supply. The main cause of osteomyelitis is a bacterial infection and the ways of infections are by periapical odontogenic infection, fracture, post-operative complication, and periodontal disease. The predominant etiologic factor is periapical odontogenic infection mostly caused by advanced dental caries. It is generally believed that periodontal disease could be a cause of osteomyelitis. But periodontal disease is usually confined to the alveolar bone area and not extends to the underlying bone marrow. Accordingly periodontal infection per se rarely cause produce oseomyelitis. Even though osteomyeltis could be occurred by periodontal disease, its virulence of infection is milder than periapical odontogenic infection. So it usually provokes sclerosing or hyperplastic osteomyelitis rather than suppurative type. We had a case of suppurative osteomyelitis caused by periodontal disease and treated it with periodontal and oral and maxillofacial surgical method.

티로신 키나아제 저해제의 간독성에 대한 고찰 (Reviews on the Hepatotoxicity of Tyrosine Kinase Inhibitors)

  • 한지민;곽혜선
    • 한국임상약학회지
    • /
    • 제29권4호
    • /
    • pp.223-230
    • /
    • 2019
  • Background: Small-molecule tyrosine kinase inhibitors (TKIs) have had major impacts on anticancer therapy by targeting the catalytic activities of dysregulated tyrosine kinases. TKIs have not presented traditional toxicities; however, some serious adverse effects, including hepatotoxicity, have been documented in clinical trials and post-marketing surveillance. Although TKI-induced hepatotoxicity can cause severe clinical complications in patients, the underlying mechanism is still unclear. Methods: Studies on TKI-induced hepatotoxicity were identified by Pubmed search, and relevant articles were reviewed. Results: Immunoallergic reaction, cytochrome P (CYP) 450 polymorphisms, and formation of reactive metabolites are under consideration as mechanisms of TKI-induced hepatotoxicity. Host protein-drug metabolite conjugates are recognized as antigens by class II major histocompatibility complexes and are believed to cause liver injuries. Polymorphisms in CYP, which influences TKI metabolism, can slow TKI metabolism and may induce development of hepatotoxicity. The formation of reactive metabolites during drug metabolism can induce hepatotoxicity by directly causing cytotoxicity, leading to cell dysfunction, and indirect toxicity by mediating secondary immune reactions. Concurrent use of various medications with TKI can also cause hepatotoxicity by affecting drug transporter or enzyme activities. Conclusion: Periodic monitoring of patients taking TKIs and risk/benefit reassessments though post marketing surveillance are necessary to prevent hepatotoxicity.

임상가를 위한 특집 2 - 턱관절장애와 관련된 교합변화의 치료 (Treatment of occlusal changes associated with temporomandibular joint disorder)

  • 정재광
    • 대한치과의사협회지
    • /
    • 제51권2호
    • /
    • pp.84-91
    • /
    • 2013
  • Temporomandibular joint disorder(TMJD) was mainly characterized with joint pain, motion limitation, joint sound, resulted from pathologic conditions in temporomandibular joint and around tissue. As temporomandibular joint is one of decisive factors determining the occlusion, disorders in temporomandibular joint may cause the occlusal changes. The causes of occlusal changes related with TMJD can be classified into 2 categories; (1) those related to progression of disorder, 2) those related to treatment of the disorder. The clinical manifestation of occlusal changes depend on their causes and affected site. Therefore, whenever possible, treatment should be directed to the relief of the underlying causes, However, it is not always possible to relieve the underlying conditions. Moreover, some occlusal changes may remain irreversible even after the considerable improvement in clinical symptoms. Regarding the treatment of the permanent occlusal changes, it has been reported that the extensive occlusal treatment including occlusal adjustment, prosthodontic treatment, orthodontic treatment should be applied. Here, we present with a case report of occlusal change caused by the progressive temporomandibular joint disorder, together with introducing the intermaxillary traction appliance as the possible treatment option.

A Study on Abdominal Temperature of Dysmenorrhea Patients

  • Lee, Kyung-Sub;Cho, Jung-Hoon
    • 대한한방체열의학회지
    • /
    • 제2권1호
    • /
    • pp.1-5
    • /
    • 2003
  • Dysmenorrhea is one of the common gynecologic disorders of menstruation women. Primary dysmenorrhea is menstrual pain without pelvic pathology. whereas secondary one is painful mestruation with underlying pathology. The cause of primary dysmenorrhea is increased endometrial prostaglandin. The mechanisims underlying secondary dysmenorrhea are not eluciated. There are many blood vessels under the skin and they play a very important role in the thermal control of peripheral part. The control of blood circulation is mainly controlled by autonomic nervous system and it is known that D.I.T.I. (digital infra-red thermographic imaging) is an objective method showing the body temperature. I observed the abdominal themerature of 49 patients complaning of dysmenorrhea who visited the gynecologic department of Pundang Oriental Medical Hospital during 1997. In order to rule out thermal abnormality due to obesity. the causes whose obesity index were above I. were excluded in this study. The mean temperature of lower abdomen of the dysmenorrhea group was $35.22{\pm}1.33^{\circ}C$ and control group was $36.01{\pm}0.74^{\circ}C$.

  • PDF

자연기흉의 원인 및 치료에 관한 연구 (A Study of Etiology and Treatment of Spontaneous Pneumothorax)

  • 김종원;김진식
    • Journal of Chest Surgery
    • /
    • 제8권2호
    • /
    • pp.125-134
    • /
    • 1975
  • The record of 137 patients with spontaneous pneumothorax seen at Busan National University Hospital during past 3years were reviewed to study the possible pathogenesis and its effective management. and the results obtained as follows; 1] The incidence of the "spontaneous" pneumothorax which developed without underlying pathology was 13-1%. The majority of those cases was considered as the result of rupture of subpleural blebs. 2] The incidence of secondary pneumothorax which developed with underlying pathology was 50.0%, in which 42.3% was combined with pulmonary tuberculosis and 8, 0% was combined with pulmonary infection. The traumatic pneumothorax was developed in 36-5% of total series. 3] In age distribution, there was pronounced difference between spontaneous and secondary pneumothorax. The majority of spontaneous pneumothorax cases was 20-30 decade and tall and tall and thin in body structure. In secondary pneumothorax, however, the incidence was relatively high in age group more than 50 years old. 4] The incidence of pneumothorax combined with pulmonary tuberculosis was particularly high in our country, and the cause of pneumothorax was seemed due to the rupture of subpleural caseous foci in some cases, but the majority was seen due to the rupture of emphysematous blebs which were formed with a pathological process of chronic tuberculosis. 5]Closed [tube] thoracotomy was the main therapeutic approach of choice in the great majority ,of pneumothorax in our series with the relapse rate of 19.6%. However, open thoracotomy and adequate surgical procedures should be undertaken in patients with continuous air leakage over 7 days and recurrent attack of pneumothorax.

  • PDF

Practical stepwise approach to rhythm disturbances in congenital heart diseases

  • Huh, June
    • Clinical and Experimental Pediatrics
    • /
    • 제53권6호
    • /
    • pp.680-687
    • /
    • 2010
  • Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.