1.Relationship between Heart Rate Turbulence and Heart Rate Variability in Korean Adults with Structurally Normal Heart.
Ji Ho YOON ; Jin Ho KANG ; Byung Jin KIM ; Ki Chul SUNG ; Bum Soo KIM ; Man Ho LEE ; Jung Ro PARK ; Hun Sub SHIN
Korean Circulation Journal 2006;36(2):126-132
BACKGROUND AND OBJECTIVES: Heart rate variability (HRV) illustrates the autonomic integration of the heart. Depressed HRV has been proven to be associated with an increased risk of cardiac death, whereas heart rate turbulence (HRT) is believed to reflect baroreflex sensitivity and it was recently introduced as another noninvasive tool for risk stratification. The aim of this study was to determine the relationship between the HRT and HRV parameters in Korean adults with a structurally normal heart. SUBJECTS AND METHODS: We studied 61 adults (males: 31) who showed ventricular premature complexes on 24 hour Holter recording and who were found to have normal hearts on full noninvasive investigation. We calculated the mean heart rate (RR interval), the number of VPBs, the time- and frequency-domain HRV parameters and two HRT parameters: turbulence onset (To) and turbulence slope (Ts). RESULTS: Ts showed a strong correlation with the HRV parameters (LF/HF ratio: r=0.35, p=0.006; VLF: r=0.32, p=0.013; LF: r=0.27, p=0.035; SDNN: r=0.28, p=0.029; SDANN: r=0.32, p=0.012), but To showed no significant correlation with the HRV parameters. CONCLUSION: The HRT parameters, and especially Ts, correlate strongly with the HRV parameters; therefore, Ts should be considered as a parameter that reflects the overall cardiac autonomic tone.
Adult*
;
Baroreflex
;
Death
;
Heart Rate*
;
Heart*
;
Humans
;
Ventricular Premature Complexes
2.The survival rate and causes of death in patients with chronic renal failure on hemodialysis.
Won Suk CHOO ; Ki Woun KIM ; Dong Ho YANG ; Sae Yong HONG
Korean Journal of Nephrology 1992;11(1):56-61
No abstract available.
Cause of Death*
;
Humans
;
Kidney Failure, Chronic*
;
Renal Dialysis*
;
Survival Rate*
3.Deaths from Pesticide Poisoning in Japan, 1968-2005: Data from Vital Statistics
Takeshi Ito ; Yosikazu Nakamura
Journal of Rural Medicine 2007;3(1):5-9
Objective: We analyzed the number of deaths due to poisoning by pesticides over 38 years through vital statistics published annually by the Ministry of Health, Labour and Welfare of the Japanese government, from 1968 through 2005. Materials and Methods: Data not published as vital statistics were obtained from the Ministry of Health, Labour and Welfare Statistics and Information Department. The vital statistics provide the numbers of deaths with individual causes of death classified by sex and 5-year age group. We also calculated age-adjusted death rates by this classification, using a direct method based on the 1985 Japanese model population. Results: Deaths from pesticide poisoning increased rapidly beginning in 1982, reached a peak in 1986 (death rate per 100,000 population: 2.6 in males and 1.7 in females) and declined gradually thereafter. In the most recent several years, these figures have declined to levels previously unseen (death rate per 100,000 population: 0.4 in males and 0.3 in females). A difference in death rates between the sexes was observed at every age level, with death rates of males approximately 1.1-1.5-fold those of females. In the 1985-1987 data, these figures were highest in the three prefectures of northern Kanto (Tochigi, Gunma, and Ibaraki Prefectures; crude death rates per 100,000 population: 6.8, 6.8, 6.2, respectively), followed by that in Kagoshima Prefecture (5.0). In the 2003-2005 data, the figure was highest in southern Kyushu (Miyazaki Prefecture; crude death rate per 100,000 population: 1.9), followed by Tochigi (1.6), Ibaraki (1.4), and Kagoshima (1.4). Conclusions: Deaths from pesticide poisoning were extremely well correlated to the history of paraquat. Through the 1985 Advisory Resolution on Paraquat Regulations by the Japanese Association of Rural Medicine and other public health-oriented efforts, the concentration of highly fatal paraquat formulations was reduced, leading to discontinuation of its production, customer identification was strictly enforced when purchasing pesticides, and people's safety consciousness regarding pesticides improved. We regard and these developments as having had the greatest contribution to the reduction in deaths from pesticide poisoning.
Pesticides
;
Death Rate
;
seconds
;
Vital Statistics
;
Poisoning aspects
4.Nonlinear Cardiac Dynamics and Morning Dip: An Unsound Circadian Rhythm.
Myung Kul YUM ; Nam Su KIM ; Jae Won OH ; Chang Ryul KIM ; Jae Ung LEE ; Soon Kill KIM ; Chul Bum LEE ; Chung Il NOH ; Jung Yun CHOI ; Yong Soo YUN
Korean Circulation Journal 1998;28(3):382-393
OBJECTIVES: We studied the circadian rhythm of nonlinear heart rate dynamics in healthy subjects. BACKGROUND: The frequency of sudden cardiac death increases in the morning. The relationship between decreased complexity of heart rate dynamics and sudden cardiac death has been documented. An understanding of the circadian variation in the complexity of cardiac dynamics may be important and to predict and prevent this sudden cardiac death. METHODS: Dynamic 24-hour electrocardiographic recordings were obtained from 30 healthy ambulant subjects aged 41 to 50 years and the digitized data was partitioned into sections of 30 minutes' duration. For each section, four indexes obtained from separate algorithms of nonlinear dynamics of RR interval - correlation dimension, Lyapunov exponent, approximate entropy, and fractal dimension - were calculated. Normalized low- (0.04-0.1 hertz) and high-frequency (>0.15 hertz) components were also calculated. RESULTS: All the four indexes of nonlinear dynamics showed a remarkably similar circadian rhythm: a prominent morning dip preceded by a steep decline during the late night, a recovery during the evening and a peak around midnight. In the morning, the low frequency component rose rapidly with concomitant withdrawal of the high frequency component. CONCLUSION: The complexity of cardiac dynamics decreases significantly in the morning, and this may contribute to the ominously increased rate of cardiac death in the morning hours.
Circadian Rhythm*
;
Death
;
Death, Sudden, Cardiac
;
Electrocardiography
;
Entropy
;
Fractals
;
Heart Rate
;
Nonlinear Dynamics
5.Mortality Analysis of Surgical Neonates : A 20-year Experience by A Single Surgeon.
Journal of the Korean Association of Pediatric Surgeons 2006;12(2):137-146
Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods : from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7 : 1 to 2.1 : 1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.
Birth Rate
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Cause of Death
;
Classification
;
Female
;
Humans
;
Infant, Newborn*
;
Male
;
Mortality*
;
Patient Care
;
Prenatal Diagnosis
6.Torsade de Pointes Caused by Cardiac Pacemaker Malfunction: A case report.
Jai Min LEE ; Oh Kyoung KWON ; Jong Ho CHOI ; Su Hyung CHO ; Jin Deok JOO
Korean Journal of Anesthesiology 1999;37(1):164-167
Anesthesiologists are faced with a growing number of patients in need of cardiac pacing with symptoms of increasing complexity. Because intraoperative pacemaker malfunction can lead to sudden death, it is important for the anesthesiologists to possessthe information necessary to evaluate and treat such patients. On the other hand, torsade de pointes, a particular form of life-threatening polymorphic ventricular tachycardia, is known to be elicited in patients with cardiac pacemakers in the setting of abnormally long QT intervals, decreased heart rate and severe electrolyte disturbances, notably hypokalemia. We herein report a case of intraoperative torsade de pointes that was triggered by pacemaker malfunction-induced bradycardia in a patient with a VVI-type cardiac pacemaker, whose serum potassium and magnesium level were low preoperatively. (Korean J Anesthesiol 1999; 37: 164~167)
Bradycardia
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Death, Sudden
;
Hand
;
Heart Rate
;
Humans
;
Hypokalemia
;
Magnesium
;
Potassium
;
Tachycardia, Ventricular
;
Torsades de Pointes*
7.In Utero Shunting for Fetal Hydrothorax, Ascites and Obstructive Uropathy: A Review of 7 Cases.
Kook LEE ; Jung Ihn YANG ; Suk Young KIM ; Byung Seok LEE ; Min Soo PARK ; Chul LEE ; Seung Hoon CHOI ; Seung Kang CHOI
Korean Journal of Perinatology 2004;15(4):379-387
OBJECTIVE: To evaluate the value of intrauterine shunting and to investigate the complication and outcome of these procedures for different fetal indications. METHODS: 7 fetuses who underwent 13 intrauterine catheter shunting from 1992 to 1997 were reviwed. The indications were uni-or bilateral hydrothorax in 4 cases, ascites in one case, and obstructive uropathy in 2 cases. RESULTS: Catheter migration occurred 6 times out of the 13 shunts (46%). Procedure related death rate was 23% (3/13); within 48 hours of pleuroamniotic shunting, amniorrhexis and coincidental abruptio placenta resulting in one fetal death and each one of amniorrhexis and premature labor resulting in 2 neonatal deaths. Pregnancy was terminated after shunting in one case of urethral atresia. Postnatal survival rate was 50% (3/6). CONCLUSION: A high complication rate requires the selection of cases for shunting. A large prospective controlled trial is needed to determine its value.
Ascites*
;
Catheters
;
Female
;
Fetal Death
;
Fetus
;
Hydrothorax*
;
Mortality
;
Obstetric Labor, Premature
;
Placenta
;
Pregnancy
;
Survival Rate
8.Necessity for a National Carcinogen List in Korea, Based on International Harmonization.
Jong Han LEEM ; Hwan Cheol KIM ; Myungsook PARK ; Jung Ae KIM ; Shin Bum KIM ; Mina HA ; Min Kyeong LIM ; Jeongseon KIM ; Eun Young PARK ; Domyung PAEK
Environmental Health and Toxicology 2013;28(1):e2013008-
Cancer has been the leading cause of death in Korea for the last 30 years. Cancer patients' 5-year survival rate between 2005 and 2009 was 62.0%, representing a highly advanced standard of care, as much as developed countries in the EU and the US. The Korean government formulated its first 10-year plan for cancer control in 1996 and has been carrying out a second 10-year plan for cancer control since 2006. But despite the Korean government's efforts, the cancer burden in Korea continues to increase. Many separate laws have gone into effect concerning the management of carcinogen exposure. However, there are no integrated regulatory laws or management systems against carcinogen exposure in Korea. Dead zones remain where carcinogen exposure cannot be controlled properly in Korea. In this paper, we suggest the need to establish a national carcinogen list based on international harmonization as a prerequisite for a paradigm shift in cancer control policy from treatment to primary prevention.
Cause of Death
;
Developed Countries
;
Jurisprudence
;
Korea*
;
Primary Prevention
;
Standard of Care
;
Survival Rate
9.Survivorship Analysis of Pedicle Screw Fixation.
Byung Joon SHIN ; Kyung Je KIM ; Sung Tae KIM ; Yon Il KIM
Journal of Korean Society of Spine Surgery 1999;6(3):355-361
STUDY DESIGN: This is a retrospective study analyzing survivorship of pedicle screw fixation in various spinal lesions. OBJECTIVES: To determine the survivorship of pedicle screw fixation and to assess the risk factors for the death of system. SUMMARY OF LITERATURE REVIEW: The previous reports of ten years survival rate of pedicle screw instruments was about eighty percent and the factors which influenced were bone quality, strength of instruments, design of instruments and compliance of patients. MATERIALS AND METHODS: Three hundred and thirty-eight patients(178 males and 160 females), treated by pedicle screw fixation from May 1988 to Dec. 1997, were analysed. Follow-up averaged 26.8months(3 to 116 months). The survival rates according to spinal lesions which caused spinal fixation, types of instruments, level of fusion and methods of fusion were predicted by life table method. The criteria of death were 1)breakage of screw or rod 2)gross bending of screw >5 degree 3)screw pullout and 4)dissociation of rod-screw coupling mechanism. RESULTS: Death of instrumentation was identified in twenty-six patients(7.7%). Of the 1,827 screws used, forty-three screws(2.4%) in twenty patients had broken(28) or bent(15). Thirty-nine Cotrel-Dubousset screws(3.5%) and four Diapason screws(1.6%) had involved. Four patients showed pullout of screws and two had dissociation of rod and screw. There was no rod broken. Life table calculations predicted the survivorship of instrumentation would be 88.7% at 10 years of follow-up. Single segment fixation showed higher survival rate than more than three segments fixation(93.3% vs 83.4%). Fracture had the lowest survival rate(78.3%). Screw failure was not influenced by the method of fusion. Suspected causes of death were collapse of disc space(12 patients), increased kyphosis(6), forceful reduction of fracture(3), infection(2), nonunion(2) and trauma(1). CONCLUSIONS: Ten year survival rate of pedicle screw fixaion was 88.7%. The survival rate was influenced by 1)number of fixed segments 2)cause of fixation .
Cause of Death
;
Compliance
;
Follow-Up Studies
;
Humans
;
Life Tables
;
Male
;
Retrospective Studies
;
Risk Factors
;
Survival Rate*
10.Autonomic Activity, Cardiac Chaos and Circadian Rhythm in Asymptomatic Children with Postoperative Tetralogy of Fallot.
Myung Kul YUM ; Nam Su KIM ; Jae Won OH ; Chang Ryul KIM ; Chul Burm LEE ; June HUH ; Chung Il NOH
Journal of the Korean Pediatric Society 1998;41(11):1517-1529
PURPOSE: This study aimed to characterize the autonomic and chaotic control of heart rate and circadian rhythm in asymptomatic patients with postoperative tetralogy of Fallot (pTOF). METHODS: Twenty-four-hour electrocardiogram recordings were obtained in 30 asymptomatic pTOF patients and in 30 age-and sex-matched controls, aged between 6 and 11 years. The data was digitized and partitioned into sections of 30- minute'durations. For each section, time-domain and frequency-domain measures (low- and high- frequency component) of heart rate variability and three measures based on chaotic dynamics- approximate entropy, correlation dimension and Lyapunov exponent-were calculated. RESULTS: In pTOF patients, 24-hour mean values of the time domain measures, high-frequency component, and all chaotic measures were significantly lower, while 24-hour mean value and all 6-hour mean values of the low-frequency component were significantly higher; all 6- hour mean values of high-frequency component, except from 6am to midday, were significantly lower. In pTOF patients, all 6-hour mean values of all three chaotic measures were significantly lower. In pTOF patients, the day- night circadian variation seen in controls was diminished (time- domain measures) or absent (low- and high- frequency component). CONCLUSION: Even in asymptomatic patients with pTOF, who are thought to be at minimal risk of fatal arrhythmia, a sustained increase in sympathetic activity and decrease in vagal activity, abnormal circadian rhythm of the autonomic activity, and decreased cardiac chaos were found. When other arrhythminogenic risk factors are superimposed, these abnormalities may contribute to the development of fatal arrhythmia and sudden death.
Arrhythmias, Cardiac
;
Child*
;
Circadian Rhythm*
;
Death, Sudden
;
Electrocardiography
;
Entropy
;
Heart Rate
;
Humans
;
Risk Factors
;
Tetralogy of Fallot*