This study aimed to analyze trends in the 10 leading causes of death in Korea from 1983 to 2012. Death rates were derived from the Korean Statistics Information Service database and age-adjusted to the 2010 population. Joinpoint regression analysis was used to identify the points when statistically significant changes occurred in the trends. Between 1983 and 2012, the age-standardized death rate (ASR) from all causes decreased by 61.6% for men and 51.2% for women. ASRs from malignant neoplasms, diabetes mellitus, and transport accidents increased initially before decreasing. ASRs from hypertensive diseases, heart diseases, cerebrovascular diseases and diseases of the liver showed favorable trends (ASR % change: -94.4%, -53.8%, -76.0%, and -78.9% for men, and -77.1%, -36.5%, -67.8%, and -79.9% for women, respectively). ASRs from pneumonia decreased until the mid-1990s and thereafter increased. ASRs from intentional self-harm increased persistently since around 1990 (ASR % change: 122.0% for men and 217.4% for women). In conclusion, death rates from all causes in Korea decreased significantly in the last three decades except in the late 1990s. Despite the great strides made in the overall mortality, temporal trends varied widely by cause. Mortality trends for malignant neoplasms, diabetes mellitus, pneumonia and intentional self-harm were unfavorable.
Accidents, Traffic ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cardiovascular Diseases/*mortality ; Causality ; Cause of Death/*trends ; Comorbidity ; *Data Interpretation, Statistical ; Female ; Humans ; Liver Diseases/*mortality ; Male ; Middle Aged ; Neoplasms/*mortality ; Republic of Korea/epidemiology ; Respiration Disorders/*mortality ; Sex Distribution ; Young Adult

Pulmonary arterial sling, a rare developmental vascular anomaly forms a sling around the distal trachea and the proximal right main bronchus, where it sometimes makes tracheo-bronchial stenosis. Tracheobronchial stenosis from pulmonary arterial sling may produce non-specific symptoms of stridor, noisy breathing, dyspnea, recurrent upper respiratory tract infection, chronic cough, and dysphagia. The diagnosis of this anomaly begins with a high index of suspicion because of the lack of pathognomonic finding on usual evaluation. In this case, initial difficult intubation makes us evaluate further. Other cases reported the diagnosis is established by imaging studies, usually MRI and angiography. But, when our case was evaluated, we used cervico-thoracic enhanced computered tomography and tracheal fluoroscopy. Up to now, tracheobronchial stenosis from vascular anomaly is a rare and challenging disorder with a poor prognosis. However, early exact diagnosis would make us perform the accurate surgical treatment and reduce the mortality and morbidity.
Angiography ; Bronchi ; Constriction, Pathologic* ; Cough ; Deglutition Disorders ; Diagnosis ; Dyspnea ; Fluoroscopy ; Intubation* ; Magnetic Resonance Imaging ; Mortality ; Prognosis ; Respiration ; Respiratory Sounds ; Respiratory Tract Infections ; Trachea

BACKGROUND: Ambient fine particle (PM METHODS: A time-stratified case-crossover design was used to analyze YLL from respiratory diseases in the elderly related to ambient PM RESULTS: Each 10 μg/m CONCLUSIONS Birth season which reflects the early-life PM
Aged ; Aged, 80 and over ; Air Pollutants/analysis* ; Cause of Death ; China/epidemiology* ; Cross-Over Studies ; Environmental Exposure/analysis* ; Humans ; Life Expectancy ; Particulate Matter/analysis* ; Respiration Disorders/mortality* ; Seasons

OBJECTIVETo study the mortality and death cause proportion of respiratory disease in China, 2004-2005.

METHODSData of representative district (160 spots of national disease surveillance system) from 2004-2005 the 3rd national retrospective sampling survey of death cause were used for presenting mortality experience of respiratory diseases during 2004-2005 in urban and rural districts, different regions and in population of different genders and age groups. The total person years were 142 660 482 and standardized death rates were calculated from census data in 2000 and each five-year was counted as an age group.

RESULTSThe crude death rate of respiratory disease in survey districts (2004-2005) was 100.12/100 000 (144 106 cases), the standardized death rate was 87.56/100 000. The crude death rate and standardized death rate in male were 106.49/100 000 (77 709 cases) and 104.52/100 000. Those in female were 95.27/100 000 (66 397 cases) and 72.96/100 000, respectively. The crude death rate and standardized death rate in urban area were 86.00/100 000 (41 193 cases) and 68.60/100 000. Those in rural area were 108.60/100 000 (102 913 cases) and 97.74/100 000, respectively. The crude death rate and standardized death rate in eastern region were 95.69/100 000 (50 293 cases) and 69.33/100 000, central region 88.61/100 000 (44 113 cases) and 87.38/100 000, western region 123.26/100 000 (49 700 cases) and 116.37/100 000, respectively. The crude death rate and standardized death rate of respiratory infectious were 12.40/100 000(17 688 cases) and 10.91/100 000, chronic obstructive pulmonary disease (COPD) 82.32/100 000 (117 440 cases) and 71.18/100 000, asthma 2.45/100 000 (3500 cases) and 2.14/100 000, bronchiectasis 0.25/100 000 (362 cases) and 0.22/100 000, pneumoconiosis 0.62/100 000 (878 cases) and 0.56/100 000. Death from COPD accounted for 81.49% of total respiratory death cases, infectious respiratory 12.27%, asthma 2.43%.

CONCLUSIONThe mortality of respiratory disease was greater in rural area than that in urban area in China during 2004-2005; greater in western region than that in eastern and central regions; greater in male than that in female. The mortality of COPD and its contribution to the total mortality of respiratory diseases were high.

Adolescent ; Adult ; Aged ; Cause of Death ; Child ; Child, Preschool ; China ; epidemiology ; Data Collection ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; mortality ; Respiration Disorders ; mortality ; Retrospective Studies ; Young Adult

BACKGROUND: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these pa tients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. METHODS: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. RESULTS: Forty (85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis (p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis (p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis (p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. Tne obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urae nitrogen, creatinine, potassium and phoshorus was observed after hemodialysis (p<0.05), but the differences of paramenters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two night. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis (p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas anslysis (p<0.05). CONCLUSION: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failre, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.
Apnea ; Blood Gas Analysis ; Creatinine ; Electrolytes ; Gases ; Humans ; Hydrogen-Ion Concentration ; Kidney Failure, Chronic* ; Mortality ; Nitrogen ; Polysomnography ; Potassium ; Surveys and Questionnaires ; Renal Dialysis* ; Respiration ; Sleep Apnea Syndromes* ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep, REM ; Snoring ; Urea

Acute liver failure (ALF) is a rare condition in which rapid deterioration of liver function results in altered mentation and coagulopathy in individuals without previously recognized liver disease. The outcomes of patients with ALF vary greatly according to etiology, and the etiology of ALF varies markedly by geographical region. In Korea, about 90% of ALF are associated with etiologies that usually result in poor outcomes, including hepatitis B virus (HBV) infection and herbal remedies. The main causes of death in patients with ALF are increased intracranial pressure, systemic infection, and multi-organ failure. Recent advances in the intensive care of patients with ALF have contributed to a marked improvement in their overall survival. Emergency adult to adult living-donor liver transplantation (LDLT) can be performed expeditiously and safely for patients with ALF, and greatly improves survival rate as well as deceased-donor transplantation. As the window during which transplantation is possible is limited, emergency adult LDLT should be considered to be one of the first-line treatment options in patients with ALF, especially in regions in which ALFs are caused by etiologies associated with poor outcome and the supply of organs is very limited.
Drug-Induced Liver Injury/complications ; Hepatitis B/complications ; Humans ; Kidney Failure, Acute/etiology ; Liver Failure, Acute/*etiology/mortality/therapy ; Liver Transplantation ; Prognosis ; Republic of Korea ; Respiration Disorders/etiology ; Survival Rate