• Journal of Trauma and Injury
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• 제28권3호
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• pp.115-122
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• 2015

Purpose: To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator. Methods: The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25. Results: The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%. Conclusion: PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.

• Journal of Preventive Medicine and Public Health
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• 제2권1호
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• pp.61-76
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• 1969

A review has been made of mortality trends in Korea from 1958 to 1967 analyzing the data by sex, age and cause of death. The crude death rates and age specific death rates were estimated by the model of N. Keyfitz life table which had been developed by the data of the 1960's national census. The cause specific death rates shown in this article are based on the following: all deaths occurring in the death-registration are expressed as a numberator, while the denominator was estimated from the regular national census data by interpolation method. It is estimated that only an average of about 40% of deaths which occurred during a year were registered during 1958 to 1967. The validity and the reliability of the diagnosis of causes of death seem to be extremely poor in this country. Therefore the cause specific death rates in this article are aimed to reveal trends of causes of registered death ana not for the actual level of death rates. For 10 years very interesing mortality trends were observed : 1. The trend in the crude death rates was downward slowly. 2. The estimated death rate for the infant in 1960 was still high up to 100 per 1,000. 3. The rates for mortality attributed to such infectious diseases as pneumonia, bronchitis, gastroenteritis and measles decreased an average 40-60%. 4. The death rates for over-all tuberculosis decreased only 9.8%. 90% of the decrease was contributed by those in the less-than-15 year age group. 5. The death rates for chronic diseases, such as vascular diseases affecting the central nervous system, malignant neoplasm, major heart diseases and all accidents rose about 40-60%. 6. The rank order of the 10 leading causes of death showed large changes over the years, except for pneumonia and tuberculosis which occupyed 1st and 2nd places respectively. Vascular diseases affecting the central nervous system moved from 5th to 3rd place and malignant neoplasm from 6th to 4th place, The major heart diseases moved from 10th to 6th place and all accidents from 10th to 7th place. On tile other hand, gastroenteritis moved from 3rd to 5th place and influenja from 4th to 8th place.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.300-310
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• 2018

본 연구는 대학생들이 죽음학 강좌 수강 이전과 이후 웰다잉 인식과 결정이 어떻게 변화되었는가를 비교 연구하고자 한다. 대전광역시 소재 일개 대학교에서 죽음학 관련 교양강좌를 2016년 8월부터 12월까지 15주 동안 수강한 대학생 교육 전 93명, 교육 후 117명 대상으로 연구 참여 희망자에 한해 설문조사를 실시하였다. 설문구성은 일반적인 특성은 성별, 연령, 학년, 전공, 결혼상태, 종교, 가족 동거여부, 건강상태 8항목이었다. 죽음의 인식 측면에 관한 4항목, 죽음의 수용 측면 5항목, 죽음의 결정 측면 7항목, 죽음 교육의 관심도와 중요도 12항목을 리커트 척도로 구성하였다. 통계 검정법으로는 카이제곱검정, 독립표본 t-검정, 의사결정나무 분석을 실시하였다. 연구결과를 의사결정나무 토대로 종합해보면, 죽음 준비 시기가 죽음에 직면한 시기(암환자, 말기환자 등)와 노인(65세 이상)에서 교육 전이 66.7%로 나타났으나, 교육 후에는 성인과 중 고등학교, 초등학교 이하, 대학교, 대학원에서 교육 후가 65.3%로 나타났으며 이는 유의한 차이를 보였다. 따라서 죽음교육의 효과성과 죽음교육의 시기와 내용 등을 어떻게 구체화 시킬 것인가에 대한 방향 제시를 할 수 있을 것으로 기대되며, 초 중 고등학교, 대학교에서의 죽음교육 실시에 대한 부정적인 시각과 우려를 해소하고 죽음 교육이 학생들의 삶에 태도 변화에 긍정적인 영향을 미칠 것으로 사료된다.

• 한국동물생명공학회지
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• 제37권3호
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• pp.169-175
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• 2022

Bovine mammary epithelial (MAC-T) cells are commonly used to study mammary gland development and mastitis. Lipopolysaccharide is a major bacterial cell membrane component that can induce inflammation. Autophagy is an important regulatory mechanism participating in the elimination of invading pathogens. In this study, we evaluated the mechanism underlying bacterial mastitis and mammary cell death following lipopolysaccharide treatment. After 24 h of 50 ㎍/mL lipopolysaccharide treatment, a significant decrease in the proliferation rate of MAC-T cells was observed. However, no changes were observed upon treatment of MAC-T cells with 10 ㎍/mL of lipopolysaccharide for up to 48 h. Thus, upon lipopolysaccharide treatment, MAC-T cells exhibit dose-dependent effects of growth inhibition at 10 ㎍/mL and death at 50 ㎍/mL. Treatment of MAC-T cells with 50 ㎍/mL lipopolysaccharide also induced the expression of autophagy-related genes ATG3, ATG5, ATG10, ATG12, MAP1LC3B, GABARAP-L2, and BECN1. The autophagy-related LC3A/B protein was also expressed in a dose-dependent manner upon lipopolysaccharide treatment. Based on these results, we suggest that a high dose of bacterial infection induces mammary epithelial cell death related to autophagy signals.

• 한국학교ㆍ지역보건교육학회지
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• 제24권1호
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• pp.1-15
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• 2023

Objectives: The purpose of this study was to identify the major influencing factors of breast cancer death and to suggest policy measures to promote the health of breast cancer patients. Methods: The method of this study performed statistical analysis by applying weights to 2,300 cases of breast cancer registration statistics in Korea collected in 2018 due to the relatively small number of mortality data compared to survival. Statistical processing of the collected data was analyzed using SPSS 26.0. Results: The epidemiologic characteristics of death in breast cancer patients were 31.8% in those aged 70 years or older, and the mortality rate was 5.25 times higher in patients aged 70 years or older than those aged 39 years or younger. The anatomical site code was 36.4% in C50.4~C50.6, and the mortality rate was 1.82 times higher in C50.4~C50.6 than in C50.0~C50.1. The tumor size was 40.4% and larger than 4cm, and the mortality rate was 4.53 times higher in tumors larger than 4cm than those smaller than 1cm. The degree of differentiation was 13.9% in the poorly differentiated group, and the mortality rate was 4.38 times higher in the poorly differentiated group than in the highly differentiated group. In the hormone receptor test, non-triple negative cases were 59.6%, and the mortality rate was 0.57 times lower in non-triple negative cases than in triple negative cases. As for lymph node involvement, the presence or absence of lymph node involvement was 78.8%, and the mortality rate with lymph node involvement was 1.36 times higher than that without lymph node involvement. The survival period of 13 to 24 months was the highest at 26.5%, and the average survival period was 25.68 months (±14.830). Conclusion: A policy to advance the timing of national health examinations for early detection of breast cancer is necessary. In addition, a bill for the mandatory placement of health educators in medical institutions for patients with special diseases such as breast cancer should be prepared.

• 생약학회지
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• 제24권2호
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• pp.166-176
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• 1993

This study was attempted to investigate the acute toxicity in mice, the subacute toxicity in rats of Cynanchi wilfordii Radix extract, the effect on transaminase activities, hematological parameters, leukocyte parameters in serum of subacute-toxicated rats. In acute toxicity test, the death rate was not observed in 50, 100, 200, 300 mg/kg(i.p.), one tenths to two tenths in 300, 500, 1000, 1500 mg/kg(p.o.) for two weeks. In subacute test, rats were all died in 300 mg/kg(p.o.) during 4 weeks, in 500, 1000 mg/kg(p.o.) during three weeks. The cause of death believed to be stomach ulcer. The activities of S-GOT and S-GPT were significantly increased in all sample-treated groups, when compared with the normal groups. A number of WBC and neutrophil belong to hematological parameter were significantly increased, lymphocyte was decreased in all sample-treated group, when compared with normal group. The hemolytic action on water extract, saponin and alcohol extract showed very low activities.

• Journal of Digestive Cancer Research
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• 제10권1호
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• pp.22-30
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• 2022

Immune checkpoint inhibition has been established as a new treatment option for various types of carcinoma, and many clinical trials are being actively conducted as a treatment for advanced or metastatic gastric cancer, either as a monotherapy with an immune checkpoint inhibitor or as a combination therapy with standard chemotherapy. In the CheckMate-649 clinical trial to confirm the efficacy of the combination of nivolumab and chemotherapy (FP) in advanced gastric cancer and gastroesophageal junction cancer, nivolumab group showed improvement in overall survival in programmed death ligand 1-positive cancer patients compared with placebo group. Also, the combination therapy of pembrolizumab, trastuzumab and chemotherapy (FP) in first-line treatment was tested through the KEYNOTE-811 trial. The pembrolizumab group showed 22.7% of improvement in objective response rate compared with placebo group. Accordingly, the combination of nivolumab/pembrolizumab with standard chemotherapy was approved for the first-line treatment. In KEYNOTE-059 trials for patients with progressive disease after at least two lines of chemotherapy, pembrolizumab monotherapy showed improvement in objective response rate and overall survival, and the use of pembrolizumab was approved for the third-line or more treatment. In this article, we review the result of clinical trials related to immune checkpoint inhibitors that have been recently introduced in the treatment of gastric cancer.

• Advances in Traditional Medicine
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• 제6권3호
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• pp.245-251
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• 2006

We examined the radioprotection effects of acupoint (acupuncture point) stimulation during organogenesis stages of ICR mice. Pregnant mice received 1.5 Gy whole body X-irradiation on day 8 of gestation, which is the early stage of organogenesis. The embryonic death rate and teratogenesis rate by radiation were examined. Electroacupuncture to the leg acupoints and/ or transcutaneous stimulation to the back acupoints on the pregnant mice showed no protective effect against irradiation on embryonic or fetal death rate. On the contrary, the strong stimulation resulted in increase in the mortality after irradiation rather than protection. However acupoint stimulation to the pregnant mice never showed harmful effects by itself on embryos. It tended to reduce the skeletal malformations induced by X-ray irradiation. We suspect that acupoint stimulation removed the cells injured by irradiation during embryonic development, resulting in an increase in embryonic death rate and reduction in skeletal anomalies.

• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.884-892
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• 1997

Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

• 생물정신의학
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• 제16권3호
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• pp.198-204
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• 2009

Objectives : Schizophrenia and other psychiatric disorder are associated with an increased risk of premature death. For decades, there have been reports of shorter life expectancy among those with severe mental illness. The purpose of this study was to compare the risk of mortality among institutionalized population, treated for severe mental illness to control group who did not have severe mental illness. Methods : The medical records and the death certificates of 2,029 institutionalized population who had died from 1985 to 2003 in Kkottongnae were investigated. Results : The mean age of the death of severe mental illness(SMI) group(51.4${\pm}$15.3 years old) was lower than that of non-severe mental illness(non-SMI) group(65.0${\pm}$19.3 years old) and it was statistically significant(p<0.0001). The most causes of death among the SMI group were respiratory diseases(23.3%), infectious disease (13.0%) and digestive disease(12.3%). Also, we found that the death due to injuries of the SMI group(8.9%) were three times higher than that of non-SMI group(2.5%). The most causes of death among the non-SMI group were respiratory disease(26.3%), circulatory disease(26.2%) and neoplasm(10.8%). Conclusion : The SMI group demonstrated higher mortality rates compared with the rate in the non-SMI group. The finding suggests that careful intervention is needed not only for menal health but also physical health in long-term facilities.