• 제목/요약/키워드: death count

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A retrospective analysis of etiology and outcomes of hemophagocytic lymphohistiocytosis in children and adults

  • Kwak, Abraham;Jung, Nani;Shim, Ye Jee;Kim, Heung Sik;Lim, Hyun Ji;Lee, Jae Min;Heo, Mi Hwa;Do, Young Rok
    • Journal of Yeungnam Medical Science
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    • 제38권3호
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    • pp.208-218
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    • 2021
  • Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare but severe, life-threatening inflammatory condition if untreated. We aimed to investigate the etiologies, outcomes, and risk factors for death in children and adults with HLH. Methods: The medical records of patients who met the HLH criteria of two regional university hospitals in Korea between January 2001 and December 2019 were retrospectively investigated. Results: Sixty patients with HLH (35 children and 25 adults) were included. The median age at diagnosis was 7.0 years (range, 0.1-83 years), and the median follow-up duration was 8.5 months (range, 0-204 months). Four patients had primary HLH, 48 patients had secondary HLH (20 infection-associated, 18 neoplasm-associated, and 10 autoimmune-associated HLH), and eight patients had HLH of unknown cause. Infection was the most common cause in children (14/35, 40.0%), whereas neoplasia was the most common cause in adults (13/25, 52.0%). Twenty-eight patients were treated with HLH-2004/94 immunochemotherapy. The 5-year overall survival (OS) rate for all HLH patients was 59.9%. The 5-year OS rates for patients with primary, infection-associated, neoplasm-associated, autoimmune-associated, and unknown cause HLH were 25.0%, 85.0%, 26.7%, 87.5%, and 62.5%, respectively. Using multivariate analysis, neoplasm-induced HLH (p=0.001) and a platelet count <50×109/L (p=0.008) were identified as independent risk factors for poor prognosis in patients with HLH. Conclusion: Infection was the most common cause of HLH in children, while it was neoplasia in adults. The 5-year OS rate for all HLH patients was 59.9%. HLH caused by an underlying neoplasm or a low platelet count at the time of diagnosis were risk factors for poor prognosis.

Development and Validation of a Prognostic Nomogram Based on Clinical and CT Features for Adverse Outcome Prediction in Patients with COVID-19

  • Yingyan Zheng;Anling Xiao;Xiangrong Yu;Yajing Zhao;Yiping Lu;Xuanxuan Li;Nan Mei;Dejun She;Dongdong Wang;Daoying Geng;Bo Yin
    • Korean Journal of Radiology
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    • 제21권8호
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    • pp.1007-1017
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    • 2020
  • Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitals were retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in the training cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in the validation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, or death. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. A nomogram was constructed based on the combination of clinical and CT features, and its prognostic performance was externally tested in the validation group. The predictive value of the combined model was compared with models built on the clinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohort experienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67-6.71; p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04-0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03-4.48; p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76-0.88), and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82-0.96). The combined model provided the best performance over the clinical or radiological model (p < 0.050). Conclusion: Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverse outcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19.

Association between Initial Chest CT or Clinical Features and Clinical Course in Patients with Coronavirus Disease 2019 Pneumonia

  • Zhe Liu;Chao Jin;Carol C. Wu;Ting Liang;Huifang Zhao;Yan Wang;Zekun Wang;Fen Li;Jie Zhou;Shubo Cai;Lingxia Zeng;Jian Yang
    • Korean Journal of Radiology
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    • 제21권6호
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    • pp.736-745
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    • 2020
  • Objective: To identify the initial chest computed tomography (CT) findings and clinical characteristics associated with the course of coronavirus disease 2019 (COVID-19) pneumonia. Materials and Methods: Baseline CT scans and clinical and laboratory data of 72 patients admitted with COVID-19 pneumonia (39 men, 46.2 ± 15.9 years) were retrospectively analyzed. Baseline CT findings including lobar distribution, presence of ground glass opacities, consolidation, linear opacities, and lung severity score were evaluated. The outcome event was recovery with hospital discharge. The time from symptom onset to discharge or the end of follow-up (for those remained hospitalized) was recorded. Data were censored in events such as death or discharge without recovery. Multivariable Cox proportional hazard regression was used to explore the association between initial CT, clinical or laboratory findings, and discharge with recovery, whereby hazard ratio (HR) values < 1 indicated a lower rate of discharge at four weeks and longer time until discharge. Results: Thirty-two patients recovered and were discharged during the study period with a median length of admission of 16 days (range, 9 to 25 days), while the rest remained hospitalized at the end of this study (median, 17.5 days; range, 4 to 27 days). None died during the study period. After controlling for age, onset time, lesion characteristics, number of lung lobes affected, and bilateral involvement, the lung severity score on baseline CT (> 4 vs. ≤ 4 [reference]: adjusted HR = 0.41 [95% confidence interval, CI = 0.18-0.92], p = 0.031) and initial lymphocyte count (reduced vs. normal or elevated [reference]: adjusted HR = 0.14 [95% CI = 0.03-0.60], p = 0.008) were two significant independent factors that influenced recovery and discharge. Conclusion: Lung severity score > 4 and reduced lymphocyte count at initial evaluation were independently associated with a significantly lower rate of recovery and discharge and extended hospitalization in patients admitted for COVID-19 pneumonia.

생쥐에서 방사선방호제로서의 인삼효과에 관한 연구 (Radioprotective Effect of Panax Ginseng in Mouse Bone-marrow)

  • 채기문;최근희;김영호;김광윤;범희승;김지열;이종빈
    • Journal of Radiation Protection and Research
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    • 제22권1호
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    • pp.1-7
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    • 1997
  • 방사선이 원자력산업과 의료용 등에 광범위하게 사용됨에 따라 인류에 대한 방사선의 직접, 간접적인 피폭이 증가되고 있는 지금 보혈, 강장제, 피로회복 등의 효과로 잘 알려진 인삼의 방사선에 대한 효과를 살펴보고자 본 실험을 실시하였다. 인삼추출물(실험군)과 생리식염수(대조군)를 각각 ICR계의 웅성마우스(7주령, 20-23g)에 10일동안 경구투여 (100mg/kg)한 후 골수사(bone marrow death)를 유도할 수 있는 선량범위인 5.08Gy(Cs-137${\gamma}$-ray, central dose rate=654Gy/h)를 체외조사하여 생존율, 혈구계수, 골수에서의 미소핵검사 및 중기염색체 검사를 실시하였다. 30일 생존율은 인삼처리군에서 65%를, 대조군에서는 5%를 나타내었고, 혈액중 혈소판은 인삼처리군에서 대조군에 비해 조사 8일 후부터 유의한 회복을 나타내었으나, 적혈구세포는 방사선 조사 전, 후로 뚜렷한 숫적 변화를 보이지 않았고, 백혈구세포는 인삼처리군에서 대조군에 비해 유의한 회복을 나타내지 않았다. 한편 골수세포의 미소핵 수는 인삼처리 군에서 79.5${\pm}$1.5, 대조군에서 185.9${\pm}$35.8로 인삼처리군에서 유의하게 감소함을 볼 수 있었고, 중기염색체상의 이상염색체 빈도 또한 112, 143개로 인삼처리군에게 적게 나타남을 관찰하였다. 이상의 결과로 보아 인삼추출물이 골수세포 내의 생리활성에 관여하여 혈소판을 유의하게 회복시키고, 방사선에 의한 염색체 손상을 감소시킴으로써 생쥐를 골수사로부터 보호한 것으로 사료된다.

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Cochlodinium polykrikoides 적조에 노출하여 치사시킨 어류의 해수저장 중 선도변화 (Effect of Cochlodinium polykrikoides Bloom on the Quality Changes of Fish during Storage in Seawater)

  • 김지회;이희정;김태진;유현덕;김풍호;박정흠
    • 한국식품위생안전성학회지
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    • 제17권4호
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    • pp.193-200
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    • 2002
  • Cochlodinium polykrikoides 적조로 폐사한 어류를 식품원료나 사료로 이용하기 위한 기초연구의 일환으로 방어(Seriola quinqueradiata), 넙치(Paralichthys olivaceus) 및 조피볼락(Sebastes schlegeli) 등 양식어류 3종을 이 적조에 노출하여 치사시켰다. 이 치사어류를 동 적조수에 저장하면서 저장시간에 따른 생균수, 휘발성염기질소 및 관능적 변화 등을 공기 중에서 질식시킨 후 신선한 해수에 저장한 어류와 비교하였다. 시험어 근육중 생균수는 저장 6시간 이후부터 증가하는 경향을 보였고, 휘발성염기질소는 지속적으로 증가하는 경향이었다. 치사 후 해수에 저장된 각 시험어 근육중 휘발성염기질소 및 생균수 함량의 변화는 적조해수에서 치사.저장한 시험구가 공기 중에서 질식시킨 대조구보다 약간 빠른 증가 경향을 보였으나, 시험구와 대조구간의 관능적 변화의 차이는 뚜렷하지 않았다. 적조로 폐사한 어류 3종을 해수에 저장하였을 때 12시간이 경과하여도 근육에서 초기 부패단계의 기준인 VBN 30 mg/100g 및 생균수 $10^{5}$ CFU/g을 초과하지는 않았으나 관능적 변화는 6시간 이후에는 변화가 나타나 적조 폐사어는 6시간 이내에 처리하여야 할 것으로 판단되었다.

서울시 미세입자(PM2.5)의 호흡기질환 사망과의 연관성 연구 (Respiratory Health Effects of Fine Particles(PM2.5) in Seoul)

  • 강충민;박성균;선우영;강병욱;이학성
    • 한국대기환경학회지
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    • 제22권5호
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    • pp.554-563
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    • 2006
  • Numerous epidemiological studies have shown stronger associations between $PM_{2.5}$ and both mortality and morbidity than $PM_{10}$. The association of $PM_{2.5}$ with respiratory mortality was examined in Seoul, during the period of $1996{\sim}2002$. Because $PM_{2.5}$ data were available for only 10% of this time period, a prediction regression model was developed to estimate $PM_{2.5}$ concentration. Death count due to respiratory-related diseases(total respiratory mortality; ICD-10, J00-J98) and death counts(cause-specific mortality) due to pneumonia(ICD-10, J12-J18), COPD(ICD-10, J40-J44) and asthma(ICD-10, J45-J46) were considered in this study. Averaged daily mortality was 5.6 for total respiratory mortality and 1.1 to 1.6 for cause-specific mortality. Generalized additive Poisson models controlling for confounders were used to evaluate the acute effects of particle exposures on total respiratory mortality and cause-specific mortality. An IQR increase in 5-day moving average of $PM_{2.5}(22.6{\mu}g/m^3)$ was associated with an 8.2%(95% CI: 4.5 to 12.1%) increase in total respiratory mortality The association of $PM_{2.5}$ was stronger for the elderly ($\geq$65 years old, 10.1%, 95% CI: 5.8 to 14.5%) and for males(8.9%, 95% CI: 2.1 to 11.3%). A $10{\mu}g/m^3$ increase in 5-day moving average of $PM_{2.5}$ was strongly associated with total respiratory mortality in winter(9.5%, 95% CI: 6.6 to 12.4%), followed by spring(3.1%, 95% CI: -1.2 to 7.5%), which was a different pattern with the finding in North American cities. However, our results are generally consistent with those observed in recent epidemiological studies, and suggest that $PM_{2.5}$ has a stronger effect on respiratory mortality in Seoul.

김치에서 분리한 젖산균의 미생물 생육 저해 (Microbial Inhibition of Lactic Strains isolated from Kimchi)

  • 박연희;권정주;조도현;김수일
    • Applied Biological Chemistry
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    • 제26권1호
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    • pp.35-40
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    • 1983
  • 김치에 분리한 젖산균 20주(株)의 Escherichia coli, Staphylococcus aureus 등 5종의 Test organism에 대한 생육저해실험 결과 가장 생육저해능력이 큰 A7 (Pediococcus cerevisiae)와 C4 (Leuconostoc spp.)를 선발하였다. 이 두 균주를 각각 Escherichia coli와 동시에 접종하여 배양한 결과 초기부터 Escherichia coli의 생육을 억제하였으며 약 24시간 후부터는 Escherichia coli의 균수가 급격히 감소하였다. Staphylococcus aureus와 Bacillus cereus에 대하여도 .대체로 비슷한 생육억제작용을 나타내었다. 세가지 Test organism 모두 A7과 배양할 경우 C4의 경우보다 더 큰 death rate constant를 나타내었다 이 혼합 배양액에 catalase를 첨가한 경우 생육저해현상에 영향이 없었으므로 이 두 균주의 생육억계작용은 $H_2O_2$ 생성과 관련이 없는 것으로 나타났다. A7의 배양 여액만을 Escherichia coli 배양액에 첨가한 경우에도 A7균주의 혼합 배양과 동일한 생육저해 현상을 보였으나 여액을 $80^{\circ}C$에서 30분간 열처리후 가하였을 때는 생육저해작용이 거의 나타나지 않을 뿐 아니라 여액에 trypsin 처리한 경우에도 생육저해작용은 크게 억제되었다. 이상의 결과로 A7 균주의 생육저해작용은 단백질류 생육저해물질의 생산에 의한 것이라고 추정할 수 있다.

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인면역결핍바이러스 감염자에서 ICD-p24 항원 탐지가 CD4+T 세포수 및 예후에 미치는 영향 (The Detection of ICD p24 Antigen Predicts Bad Prognosis in HIV-1 Infected Patients)

  • 조영걸;이희정
    • 대한바이러스학회지
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    • 제26권2호
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    • pp.259-267
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    • 1996
  • In order to evaluate the effect of viral load on the prognosis of human immunodeficiency virus-1 (HIV-1)-infected individuals, immune complex dissociated (ICD) serum p24 antigen (p24) by acid treatment was retrospectively measured for 50 HIV-infected patients for 60 months. Among them, 27 patients were p24 positive (p24+) above 25pg/ml for $40.4{\pm}12$ months and 23 patients were negative (p24-). Follow-up periods from HIV diagnosis were $63.0{\pm}19$ months (range; 40-112) for the p24+ and $68.4{\pm}19$ months (range; 38-106) for the p24-, respectively (P>0.05)Mean CD4+T cell counts in the p24+ group decreased from $473{\pm}$277/ul (median;373) to $157{\pm}150/ul$ (median; 111) for $60{\pm}16$ months (5.3/month P280/ul (median; 476) to $432{\pm}285/ul$ (median;382) for $63{\pm}19$ months (2.5/month, P<0.01). From CD4+T cell count >200/ul, the patient who progressed to AIDS of <200/ul were 13 of 23 (56%) in the p24+ and 4 of 22 (18%) in p24-, respectively (p<0.01). And the number of death in two groups were 6 (22%) and 1 (4%), respectively (p<0.01). Presumed survival in two groups were about 12 and 24.5 years. These data suggest that viral load itself be very important for the prognosis of HIV-infected patients.

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Essential Oil of Tridax procumbens L Induces Apoptosis and Suppresses Angiogenesis and Lung Metastasis of the B16F-10 Cell Line in C57BL/6 Mice

  • Manjamalai, A.;Kumar, M.J. Mahesh;Grace, V.M. Berlin
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5887-5895
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    • 2012
  • Background: To determine the effect of essential oil obtained from a traditionally used medicinal plant Tridax procumbens L, on lung metastasis developed by B16F-10 melanoma cells in C57BL/6 mice. Materials and Methods: Parameters studied were toxicity, lung tumor nodule count, histopathological features, tumor directed capillary vessel formation, apoptosis and expression levels of $P^{53}$ and caspase-3 proteins. Results: In vitro the MTT assay showed cytotoxicity was found to be high as 70.2% of cancer cell death within 24hrs for $50{\mu}g$. In vivo oil treatment significantly inhibited tumor nodule formation by 71.7% when compared with untreated mice. Formation of tumor directed new blood vessels was also found to be inhibited to about 39.5%. TUNEL assays also demonstrated a significant increase in the number of apoptotic positive cells after the treatment. $P^{53}$ and caspase-3 expression was also found to be greater in the essential oil treated group than the normal and cancer group. Conclusions: The present investigation showed significant effects of the essential oil of Tridax procumbens L in preventing lung metastasis by B16F-10 cell line in C57BL/6 mice. Its specific preventive effect on tumor directed angiogenesis and inducing effect on apoptosis warrant further studies at the molecular level to validate the significance of Tridax procumbens L for anticancer therapy.

Subchronic Oral Dose Toxicity Study of Enterococcus Faecalis 2001 (EF 2001) in Mice

  • Gu, Yeun-Hwa;Yamasita, Takenori;Kang, Ki-Mun
    • Toxicological Research
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    • 제34권1호
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    • pp.55-63
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    • 2018
  • As a part of general toxicity studies of Enterococcus Faecalis 2001 (EF 2001) prepared using heat-treatment bacillus mort body EF 2001 in mice, this study examined the toxicity of EF 2001 in single and repeated administrations following the previous report in order to apply this product to preventive medicine. The safety of oral ingestion of EF 2001 was examined in 6-week-old male and female ICR mice with 1,000 mg/kg, 3,000 mg/kg and 5,000 mg/kg body weight/day administrated by gavage of the maximum acceptable dose of EF 2001. The study was conducted using distilled water as a control following the methods for general toxicity studies described in the "Guidelines for Non-clinical Studies of Pharmaceutical Products 2002". As a control, 1) observation of general conditions, 2) measurement of body weight, 3) determination of food consumption, 4) determination of water consumption, 5) blood test and urinalysis and 6) pathological examination were performed for the administration of EF 2001. Mice received EF 2001 for 13 weeks and results were compared with those of the control group that received distilled water. The results of the above examinations revealed no significant differences between control and EF 2001 groups for both males and females. Thus, no notable toxicity was confirmed with single and repeated oral administrations of EF 2001. Oral administration in the above doses did not result in abnormal symptoms or death during the observation period. No abnormalities in blood cell count or organ weights were seen. Without any evidence of toxicity to cells and organs, EF 2001 is speculated to not adversely affect living organisms. The 50% lethal dose of EF 2001 with oral administration in mice is estimated to be greater than 5,000 mg/kg body weight/day for both male and female mice. Therefore, $LD_{50}$ value for animals was 5,000 mg/kg or more.