• Journal of Trauma and Injury
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• 제25권4호
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• pp.247-253
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• 2012

Purpose: Hemorrhage is a main cause of death in trauma patients. The goal of this study is to describe the characteristics of trauma patients with massive bleeding and to evaluate the prognostic factors concerning their survival. Methods: This study was performed retrospectively and included trauma patients with massive bleeding who had been treated from March 2007 to August 2012. The inclusion criterion was patients who received more than 10 U of packed red blood cells within the first 24 hours after visiting the emergency department. Based on their medical records, we collected data in terms of demographic findings, mechanisms of injury, initial clinical and laboratory findings, methods for hemostasis (emergency surgery and/or angioembolization), transfusion, injury severity score (ISS), revised trauma score (RTS) and trauma and injury severity score (TRISS). We used the Mann-Whitney U test and Fisher's exact test to compare the variables between the patients that survived and those that did not. We performed a logistic regression analysis with the significant variables from the univariate test. Results: Thirty-two(32) patients were enrolled. The main mechanisms of injury were falls and motor vehicle accidents. The mean transfusion amount of packed red blood cells (PRBC) was 17.4 U. The mean elapsed time for the first hemostasis (surgery or embolization) was 3.5 hours. The initial technical success rates were 83.3%(15/18) in angioembolization and 66.7%(8/12) in surgery. The overall mortality rate was 34.4%(11/32). The causes of death were bleeding, brain swelling and multiple organ failure. The ISS(25.5 vs 46.3, p=0.000), TRISS(73.6 vs 45.1, p=0.034) and base excess(<-12 mmol/L, p=0.020) were significantly different between the patients who survived and those who did not. Conclusion: The ISS was a prognostic factor for trauma patients with massive bleeding.

• Asian Pacific Journal of Cancer Prevention
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• 제13권9호
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• pp.4281-4284
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• 2012

Background: Osteosarcoma is the most common bone cancer in children, responsible for a high rate of amputation and death. This is the first long-term, population-based, epidemiologic and survival study in Thailand. Objective: To study the incidence and survival rates of pediatric osteosarcoma in Khon Kaen. Method: Childhood osteosarcoma cases (0-19 years) diagnosed between 1985-2010 were reviewed. The data were retrieved from the population-based data set of the Khon Kaen Cancer Registry and medical records from Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. All cases were censored until the end of April 2012. The age-standardized incidence rate (ASR) was calculated using the standard method. Survival experience was analyzed using the standard survival function (STATA 9.0) and presented with a Kaplan-Meier curve. Results: 58 cases were enrolled. The overall ASR was 14.1 per million. Males and females were equally affected. The peak incidence was for 15-19 year-olds in both sexes (ASR=10.4 per million in males and 8.5 in females). The 5-year overall survival rate was 27.6% (95% CI: 15.8-40.8%). The median survival time was 1.6 years (95% CI: 1.2-2.1). In a subgroup analysis, the patients who received only chemotherapy survived longer (5-year survival 45.7%, median survival time 4.1 years, p=0.12). Conclusion: The incidence rate for childhood osteosarcoma was slightly less than those reported for Western countries. The survival rate was also lower than reports from developed countries. Further evaluation of the treatment protocol and risk factor stratification is needed.

• Earthquakes and Structures
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• 제11권2호
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• pp.195-215
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• 2016

Rehabilitation of historical unreinforced masonry (URM) buildings is a priority in many parts of the world, since those buildings are a living part of history and a testament of human achievement of the era of their construction. Many of these buildings are still operational; comprising brittle materials with no reinforcements, with spatially distributed mass and stiffness, they are not encompassed by current seismic assessment procedures that have been developed for other structural types. To facilitate the difficult task of selecting a proper rehabilitation strategy - often restricted by international treaties for non-invasiveness and reversibility of the intervention - and given the practical requirements for the buildings' intended reuse, this paper presents a practical procedure for assessment of seismic demands of URM buildings - mainly historical constructions that lack a well-defined diaphragm action. A key ingredient of the method is approximation of the spatial shape of lateral translation, ${\Phi}$, that the building assumes when subjected to a uniform field of lateral acceleration. Using ${\Phi}$ as a 3-D shape function, the dynamic response of the system is evaluated, using the concepts of SDOF approximation of continuous systems. This enables determination of the envelope of the developed deformations and the tendency for deformation and damage localization throughout the examined building for a given design earthquake scenario. Deformation demands are specified in terms of relative drift ratios referring to the in-plane and the out-of-plane seismic response of the building's structural elements. Drift ratio demands are compared with drift capacities associated with predefined performance limits. The accuracy of the introduced procedure is evaluated through (a) comparison of the response profiles with those obtained from detailed time-history dynamic analysis using a suite of ten strong ground motion records, five of which with near-field characteristics, and (b) evaluation of the performance assessment results with observations reported in reconnaissance reports of the field performance of two neoclassical torsionally-sensitive historical buildings, located in Thessaloniki, Greece, which survived a major earthquake in the past.

• Journal of Korean Neurosurgical Society
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• 제41권2호
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• pp.82-87
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• 2007

Objective : Pontine hemorrhages usually result in a much higher morbidity and mortality than any other intracranial vascular lesion. The purpose of this study was to evaluate survival and the contributing factors for patients with pontine hemorrhage. Methods : Of the 41 patients who were admitted to our hospital with their first acute pontine hemorrhage from 1997 to 2005, 35 patients were included in this study. Medical records were reviewed to confirm the accuracy of diagnosis and collect demographic, clinical and radiological data. The patients were divided into two groups, survivors and deceased patients; then the survivors were divided again into a group of patient with good results and those with poor results. The location of the hematoma, maximum anteroposterior [AP] diameter, maximum transverse diameter, hematoma volume, ventricular extension, extension into the midbrain, hydrocephalus and initial Glasgow coma scale [GCS] were evaluated. Results : The two year survival rate was 58.5%. The survival of patients with pontine hemorrhage was affected by initial GCS score and transverse hematoma dimeter. Functional outcome of patients who survived was affected by initial GCS, maximum transverse diameter, maximum AP diameter and hematoma volume. Conclusion : The rate of survival after pontine hemorrhage is associated with the transverse diameter of the hematoma and more importantly the initial GCS. Long-term outcome of survivors is influenced by the initial GCS, transverse diameter, AP diameter and volume. Through the multivariate analysis, initial GCS is the only significant factor on survival. Strictly speaking, initial GCS is not modifiable. However, surgical reduction may be considered to amend theses decisive factors. Additional study for indication, timing and method of surgical management is needed.

• Journal of Chest Surgery
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• 제44권4호
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• pp.273-278
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• 2011

Despite aggressive treatment, the mortality rate of cardiogenic shock with acute myocardial infarction (AMI) is high. We performed extracorporeal membrane oxygenation (ECMO) prior to coronary reperfusion, and evaluated the early clinical results and risk factors. Materials and Methods: From May 2006 to November 2009, we reviewed the medical records of 20 patients in cardiogenic shock with AMI (mean age $67.7{\pm}11.7$ yrs, M : F 14 : 6). After initially performing ECMO using the CAPIOX emergency bypass system ($EBS^{(R)}$Terumo, Tokyo, Japan), patients underwent coronary reperfusion (coronary artery bypass grafting, 13; percutaneous coronary intervention, 7). Results: All patients were in a cardiogenic shock state, cardiopulmonary resuscitations (CPR) were performed for fourteen patients (mean CPR time $20.8{\pm}26.0$ min). The mean time from vascular access to the initiation of ECMO was $17.2{\pm}9.4$ min and mean support time was $3.8{\pm}4.0$ days. Fourteen patients were able to be weaned from ECMO and ten patients were discharged (mean admission duration $50.1{\pm}31.6$ days). Patients survived on average $476.6{\pm}374.6$ days of follow-up. Longer CPR and support time, increased cardiac enzyme, lower ejection fraction, lower albumin, and major complications were the risk factors of mortality (p<0.05). Conclusion: The early application of ECMO prior to coronary reperfusion and control of risk factors allowed for good clinical results in cardiogenic shock with AMI.

• Clinical and Experimental Pediatrics
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• 제53권11호
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• pp.965-970
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• 2010

Purpose: The life expectancy of patients with spinal muscular atrophy (SMA) type I is generally considered to be less than 2 years. Recently, with the introduction of proactive treatments, a longer survival and an improved survival rate have been reported. In this study, we analyzed the natural courses and survival statistics of SMA type I patients and compared the clinical characteristics of the patients based on their survival periods. Methods: We reviewed the medical records of 14 pediatric patients diagnosed with SMA type I during a 9-year period. We examined the demographic and clinical characteristics of these patients, calculated their survival probabilities, and plotted survival curves as on the censoring date, January 1, 2010. We also compared the characteristics of the patients who died before the age of 24 months (early-death, ED group) and those who survived for 24 months or longer (long-survival, LS group). Results: The mean survival time was $22.8{\pm}2.0$ months. The survival probabilities at 6 months, 12 months, 18 months, 24 months, and 30 months were 92.9%, 92.9%, 76.0%, 76.0%, and 65.1%, respectively. Birth weight was the only factor that showed a statistically significant difference between the ED and LS groups ($P$=0.048). Conclusion: In this study, the survival probabilities at 2 years were far greater than expected. Because of the limited number of patients and information in this study, the contribution of improved supportive care on longer survival could not be clarified; this may be elucidated in larger cohort studies.

• Journal of Chest Surgery
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• 제53권6호
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• pp.368-374
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• 2020

Background: The extracorporeal ventricular assist device (e-VAD) system is designed for left ventricular support using a permanent life support console. This study aimed to determine the impact of temporary e-VAD implantation bridging on posttransplant outcomes. Methods: We reviewed the clinical records of 6 patients with the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1, awaiting heart transplantation, who were provided with temporary e-VAD from 2018 to 2019. The circuit comprised a single centrifugal pump without an oxygenator. The e-VAD inflow cannula was inserted into the apex of the left ventricle, and the outflow cannula was positioned in the ascending aorta. The median follow-up duration was 8.4±6.9 months. Results: After e-VAD implantation, lactate dehydrogenase levels significantly decreased, and Sequential Organ Failure Assessment scores significantly improved. Bedside rehabilitation was possible in 5 patients. After a mean e-VAD support duration of 14.5±17.3 days, all patients were successfully bridged to transplantation. After transplantation, 5 patients survived for at least 6 months. Conclusion: e-VAD may reverse end-organ dysfunction and improve outcomes in INTERMACS I heart transplant patients.

• 대한물리치료과학회지
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• 제8권1호
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• pp.841-850
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• 2001

This study was conducted to find out current status and characteristics, so that the result could provide basic data to establish prevention programs for hip fracture among the elderly. The data were coolected from 199 cases hospitalized in 4 university hospitals in Pusan during three years period from January, 1966 to December, 1998. The data were obtained from medical records and by using questionnaires through telephone contact or direct personal interview with the subjects or their family, and were analyzed with x2-test. The results were as follow: The mean age of elderly hip fractured cases was 75.7 years, and 61.8% were female. The average hospital stay of the cases was 30.8 days, and 73.9% survived. Femur neck fracture cases comprised 51.7% of the toral cases, while trochanteric fracture cases comprised 48.3%. The hip fracture occurred more frequently during the day, shown as 66.9%, and the most frequently due to trips(44.2%), followed by slips(322%), c1ash(14.6%), dizziness(7.5%), and 00 on. Femur neck fracture, however, occurred the most frequently due to trips(51.5%) and, on the other hand, trochanteric fracture due to slips(40.6%) and trips(36.5%). About two third of hip fracture(67.8%) occurred inside of the building. The most frequently mentioned location for hip fractures was rooms or floors(32.1%), followed by streets(24.1%), bathrooms(17.6%), stairways(13.1%), and so on. Trochanteric fracture, especially, more frequently occurred inside of the building(71.9%) as compared to femur neck fracture(64.1 %). The rate of independent indoor walking in femur neck fractured cases reduced from 88.3% to 74.8% after fracture incidences, while the rate reduced from 86.0% to 45.8% in trochanteric fracture cases. It indicated that trochanteric fractures affected the walking ability of the elderly more severely that femur neck fractures. In conclusion, hip fracture occurs as a combined result of aging characteristics, environmental factors, and health related characteristics. Future studies that investigaterisk factors of hip fracture in elderly are recommended.

• 복식
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• 제31권
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• pp.131-144
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• 1997

This thesis is mainly on the study of Gongbok and Sangbok in the system of official outfit of the Koryo dyn-asty which has not yet fully studied in the history of Koren dress and its ornaments. Even in this difficult circumstances the sys-tem of dress and its ornaments can be under-stood with the help of remaining Buddhi-stliterature. Thus the system of official outfit in the Koryo dynasty has been studied here with some documentary records such as Koryo-dokyung Koryosa-yeobokji (The His-tory of Dress And Its Ornaments in The Koryo Dynasty) and so on. As the Koryo dynasty de-veloped her international relationships continu-ously with her neighbouring nation which were geographically closely connected so the systems of official outfit in the Chinese dyn-asty of Sung had to be studied and compared with, In the Koryo dynasty the same four colour system of purple red, deep red and green had survived until the year of 1123 from the year of 960 not using the blue colour from the four colour system of purple Chinese red green and blue of the Sung dynasty. The four colour system of purple deep red green and black under the regin of the King Euijong was exactly the same as that of official outfit of the Sung dynasty in he year of 1078 the first year of Wonpung's regin and wearing Eodae is a sure sign of influence of the system of Sung dynasty. Even though Koryo was invaded by Yuan druing the period of the regin of the King Chungyul the four colour system was not changed of purple deep red. green and black along with the same Dae-sudanryung(long sleeve and round collar). In 1387 the thirteenth year of the King Woo of the Koryo dynasty Pumdae was used ofor different official ranks and the sys-tem of wearing Samo and Dayung was established for the official outfit of every government officers.

• 대한치과의사협회지
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• 제53권9호
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• pp.628-643
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• 2015

Purpose: The aim of this retrospective study was to compare marginal bone loss and survival rates of double short implants(multiple implant) which had been installed and restored in severely atrophic maxillary molar site without a grafting procedure. Material and Method: The subjects were patients (90 patients, 180 implants) who had been installed double short implants in severely atrophic maxillary single molar site without bone augmentation procedure from 2006 to 2014 in dental clinic in Chuncheon city. Following data were collected from dental records and radiographic panoramic views: patient's age, gender, smoking status, implant site, timing of implant installation, residual ridge height. The correlation between those factors and survival rate and marginal bone loss were analyzed. Statistical analysis was performed using Chi-square test, Student's t- test and ANOVA. Result: Eleven implants in 6 patients failed and the cumulative survival rate was 93.9%. No significant differences were found in relation to the following factors: patient's age, gender, implant site, timing of implant installation (P> .05). There were significant differences in smoking status and residual ridge height(P< .05). The average follow-up time was $45{\pm}14.7months$. The mean marginal bone loss of survived 169 implants was $0.08{\pm}0.59mm$. Conclusion: Despite the short term outcomes, the survival rate of double short implants was comparable to normal length implants. This study demonstrated that placement of double short implants without the use of bone grafting procedure for severely atrophic posterior maxilla is a simple and predictable treatment procedure.