1.Infant, maternal, and perinatal mortality statistics in the Republic of Korea, 2014.
Hyun Young SHIN ; Ji Youn LEE ; Juhwa SONG ; Seokmin LEE ; Junghun LEE ; Byeongsun LIM ; Heyran KIM ; Sun HUH
Journal of the Korean Medical Association 2017;60(7):588-597
This study aimed to analyze infant, maternal, perinatal, and fetal mortality statistics in the Republic of Korea (Korea), 2014. It was based on the open-access data available from the Statistics Korea website (http://kostat.go.kr/portal/eng/index.action). Recent trends in these vital statistics were also examined. The results of this study constitute a descriptive presentation and analysis of the national data. The number of infant deaths was 1,305 out of 435,435 live births in 2014, and the infant mortality rate was 3.0. The number of maternal deaths was 48. The maternal mortality ratio per 100,000 live births was 11.0. The maternal mortality ratio per 100,000 women of child-bearing age (15 to 49 years old) was 0.37. The number of perinatal deaths was 1,365, and the perinatal mortality rate was 3.1. The number of fetal deaths was 5,317. The fetal mortality rate was 12.1. The trends in those vital statistics in recent years were consistent except for a few findings, including a decrease in the maternal mortality ratio of pregnant women 40 years old and older and a change in the proportions of the causes of infant death, with a decrease in mortality due to neonatal respiratory distress and an increase in mortality due to bacterial sepsis. Although these vital statistics were generally consistent, some aspects varied by year. Pregnant women less than 20 years old should be monitored more intensively for their babies' health. Our findings can serve as basic data supporting the establishment of health policies by the Korean government.
Cause of Death
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Female
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Fetal Death
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Fetal Mortality
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Health Policy
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Humans
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Infant Death
;
Infant Mortality
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Infant*
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Korea
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Live Birth
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Maternal Death
;
Maternal Mortality
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Mortality
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Perinatal Death
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Perinatal Mortality*
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Pregnant Women
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Republic of Korea*
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Sepsis
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Vital Statistics
2.Effects of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and reversal by sugammadex in phrenic nerve-hemidiaphragm rat model
Heyran CHOI ; Sun Young PARK ; Yong Beom KIM ; Junyong IN ; Hong Seuk YANG ; Jeong Seok LEE ; Sanghyun KIM ; Suyeon PARK
Korean Journal of Anesthesiology 2019;72(4):366-374
BACKGROUND: The facilitator effects of steroids on neuromuscular transmission may cause resistance to neuromuscular blocking agents. Additionally, steroids may hinder sugammadex reversal of neuromuscular blockade, but these findings remain controversial. Therefore, we explored the effect of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and their inhibitory effect on sugammadex. METHODS: We explored the effects of steroids, dexamethasone and hydrocortisone, in vitro using a phrenic nerve-hemidiaphragm rat model. In the first phase, an effective dose of rocuronium was calculated, and in the second phase, following sugammadex administration, the recovery of the train-of-four (TOF) ratio and T1 was evaluated for 30 minutes, and the recovery index was calculated in dexamethasone 0, 0.5, 5, and 50 μg/ml, or hydrocortisone 0, 1, 10, or 100 μg/ml. RESULTS: No significant effect of steroids on the effective dose of rocuronium was observed. The TOF ratios at 30 minutes after sugammadex administration were decreased significantly only at high experimental concentrations of steroids: dexamethasone 50 μg/ml and hydrocortisone 100 μg/ml (P < 0.001 and P = 0.042, respectively). There were no statistical significances in other concentrations. No differences were observed in T1. Recovery index was significantly different only in 100 μg/ml of hydrocortisone (P = 0.03). CONCLUSIONS: Acute exposure to steroids did not resist the neuromuscular blockade caused by rocuronium. And inhibition of sugammadex reversal on rocuronium-induced neuromuscular blockade is unlikely at typical clinical doses of dexamethasone and also hydrocortisone. Conclusively, we can expect proper effects of rocuronium and sugammadex when dexamethasone or hydrocortisone is used during general anesthesia.
Anesthesia, General
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Animals
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Dexamethasone
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Hydrocortisone
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In Vitro Techniques
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Models, Animal
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Neuromuscular Blockade
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Neuromuscular Blocking Agents
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Neuromuscular Monitoring
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Rats
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Steroids
3.Cause-of-death statistics in 2016 in the Republic of Korea
Hyun young SHIN ; Ji youn LEE ; Jee eun KIM ; Seokmin LEE ; Heejo YOUN ; Heyran KIM ; Jeonghun LEE ; Min sim PARK ; Sun HUH
Journal of the Korean Medical Association 2018;61(9):573-584
This study aimed to analyze changes in the causes of death in the Korean population in 2016 and to provide some insights regarding how to cope with related issues of public health and welfare. The causes of death made available by Statistics Korea were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision as well as the KCD-7 (Korean Standard Classification of Diseases and Causes of Death), which has been modified to fit circumstances in Korea. The total number of deaths was 280,827, which was an increase of 4,932 (1.8%) from 2015. The crude death rate was 549.4 per 100,000 population, which was an increase of 7.9 (1.5%) from 2015. The 10 leading causes of death, in order, were malignant neoplasms, heart diseases, cerebrovascular diseases, pneumonia, intentional self-harm, diabetes mellitus, chronic lower respiratory diseases, liver diseases, hypertensive diseases, and transport accidents. The rank of hypertensive diseases rose from 10th in 2015 to 9th in 2016, while that of transfer accidents dropped from 9th in 2015 to 10th in 2016. The proportion of the number of deaths caused by cancer was 27.8%. The death rate due to cancer was 153.0 per 100,000 population, which was an increase of 1.4% from 2015; 16.5 deaths per 100,000 population were due to colon cancer, and 16.2 were due to stomach cancer. The above trends in causes of death reflect aspects of the population structure, disease patterns, lifestyle, and medical care in present-day Korean society.
Cause of Death
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Cerebrovascular Disorders
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Classification
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Colonic Neoplasms
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Diabetes Mellitus
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Heart Neoplasms
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Hypertension
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International Classification of Diseases
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Korea
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Life Style
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Liver Diseases
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Mortality
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Pneumonia
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Public Health
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Republic of Korea
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Stomach Neoplasms
4.Effects of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and reversal by sugammadex in phrenic nerve-hemidiaphragm rat model
Heyran CHOI ; Sun Young PARK ; Yong Beom KIM ; Junyong IN ; Hong Seuk YANG ; Jeong Seok LEE ; Sanghyun KIM ; Suyeon PARK
Korean Journal of Anesthesiology 2019;72(4):366-374
BACKGROUND:
The facilitator effects of steroids on neuromuscular transmission may cause resistance to neuromuscular blocking agents. Additionally, steroids may hinder sugammadex reversal of neuromuscular blockade, but these findings remain controversial. Therefore, we explored the effect of dexamethasone and hydrocortisone on rocuronium-induced neuromuscular blockade and their inhibitory effect on sugammadex.
METHODS:
We explored the effects of steroids, dexamethasone and hydrocortisone, in vitro using a phrenic nerve-hemidiaphragm rat model. In the first phase, an effective dose of rocuronium was calculated, and in the second phase, following sugammadex administration, the recovery of the train-of-four (TOF) ratio and T1 was evaluated for 30 minutes, and the recovery index was calculated in dexamethasone 0, 0.5, 5, and 50 μg/ml, or hydrocortisone 0, 1, 10, or 100 μg/ml.
RESULTS:
No significant effect of steroids on the effective dose of rocuronium was observed. The TOF ratios at 30 minutes after sugammadex administration were decreased significantly only at high experimental concentrations of steroids: dexamethasone 50 μg/ml and hydrocortisone 100 μg/ml (P < 0.001 and P = 0.042, respectively). There were no statistical significances in other concentrations. No differences were observed in T1. Recovery index was significantly different only in 100 μg/ml of hydrocortisone (P = 0.03).
CONCLUSIONS
Acute exposure to steroids did not resist the neuromuscular blockade caused by rocuronium. And inhibition of sugammadex reversal on rocuronium-induced neuromuscular blockade is unlikely at typical clinical doses of dexamethasone and also hydrocortisone. Conclusively, we can expect proper effects of rocuronium and sugammadex when dexamethasone or hydrocortisone is used during general anesthesia.
5.Cause-of-death statistics in the Republic of Korea, 2014.
Hyun Young SHIN ; Ji Youn LEE ; Juhwa SONG ; Seokmin LEE ; Junghun LEE ; Byeongsun LIM ; Heyran KIM ; Sun HUH
Journal of the Korean Medical Association 2016;59(3):221-232
This article presents recent trends and statistical indicators related to mortality in the Republic of Korea by analyzing the 2014 cause-of-death statistics. Specifically, we assessed the number of deaths, the crude death rate, the ranking of causes of death, and trends in the death rate from the major causes of death. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision, as recommended by the World Health Organization. In order to determine the ranking of causes of death, Statistics Korea used the selection list of 56 causes of death from the 80 causes of death list for tabulation mortality statistics recommended by World Health Organization to better fit the Korean situation. The 10 leading causes of death were, in order, cancer, heart disease, cerebrovascular disease, suicide, pneumonia, diabetes mellitus, chronic lower respiratory disease, liver disease, transport accidents, and hypertensive diseases. The top 10 causes of death accounted for 70.5% of all Korean deaths. The ranking of cancer types as causes of death was lung, liver, stomach, colon, and pancreatic cancer. Death rates for heart disease increased from the third in 2013 to the second leading cause in 2014 and the rank of pneumonia moved up from the sixth in 2013 to the fifth in 2014. The mortality rate due to stomach cancer has decreased continuously over time.. This finding may reflect changes in Korean society involving population structure, epidemiological patterns, and lifestyles, including dietary habits.
Cardiovascular Diseases
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Cause of Death
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Colon
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Diabetes Mellitus
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Food Habits
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Heart Diseases
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International Classification of Diseases
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Korea
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Life Style
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Liver
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Liver Diseases
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Lung
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Pancreatic Neoplasms
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Pneumonia
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Republic of Korea*
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Stomach
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Stomach Neoplasms
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Suicide