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A Comparative Study of Health Behaviors by Chronic Diseases of the Low-income Middle-aged People in Seoul's Apartment Residents (서울시 임대아파트에 거주하는 일부 저소득 중장년의 만성질병별 건강행태 비교연구)

  • Yang, Junmo;Park, Haemo;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.18 no.2
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    • pp.11-30
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    • 2014
  • Objective : To compare the differences in health behaviors by chronic diseases of middle-aged living in Seoul's low-income housing Method : Of the 1469 residents aged 35 to 60 living in low-income housing in Seoul's District A, 318 were equal probability of selection method selected. t-test, ANOVA, $x^2$, OR(95% CI, P-value) were selected to analyze the data, and the confidence interval was 5%. Results : There were no significant differences in all health behaviors by vascular and metabolic, But there was a statistically significant difference for gastrointestinal diseases caused by sleep hours(p=0.001), liver diseases caused by smoking, drinking and sleep hours(p=0.004, p=0.001, and p=0.033, respectively), musculoskeletal diseases caused by sleep hours and health exam(p=0.0000 and p=0.002, respectively). Also, statistically significant differences were found for tumors caused by sleep hours(p=0.004), depression by the sleep hours and health exam(p=0.001 and p=0.013, respectively), allergies by in sleep hours(p=0.004), thyroid diseases by smoking and health exam(p=0.013 and p=0.007, respectively). After adjusting for the confounding factors for diseases, OR was obtained for each health behavior. There were no statistically significant differences in all health behaviors for vascular, metabolic, and tumors. However, the OR for gastrointestinal diseases 4.10(1.63-10.36, 0.0028) and 2.96(1.05-8.41, 0.0041) at 5-7 and 7-9 sleep hours. The OR for liver diseases was 3.13(1.03-9.48, 0.0437) at 7-9 sleep hours, the OR values for musculoskeletal diseases were 2.91(1.23-6.88, 0.00149), and 4.46(1.68-11.86, 0.0027) at 5-7 and 7-9 sleep hours. OR for depression were 4.82(1.70-13.66, 0.0031) and 4.13(1.19-14.31, 0.0026) at 5-7 and 7-9 sleep hours. OR for allergy were 2.78(1.22-6.32, 0.0015) and 3.93(1.49-10.39, 0.0058) at 5-7 and 7-9 sleep hours. There were statistical significances for liver diseases for 1-2 times of health exam at 0.35(0.14-0.90, 0.00301), for liver diseases for 1-2 times of health exam at 0.35(0.14-0.90, 0.00301), for musculoskeletal diseases for 3-4 times of health exam at 0.26(0.09-0.79, 0.0175), for depression for 3-4 times of health exam at 0.17(0.04-0.66, 0.0106), for allergies for 1-2 times of health exam at 0.30(0.13-0.70, 0.0055), and for thyroid diseases for 1-2 times and annually of health exam at 0.07(0.01-0.60, 0.00154), 0.09(0.01-0.96, 0.0461). We known significant difference the health behaviors by the diseases. especially in sleep hours and health exam times Conclusion : Only sleep hours and health exam caused statistically significant differences in chronic diseases. but the sleep hours was postitively correlated with the risk of disease, while health exam were inversely related.

Clinical Characteristics of Influenza B Virus in Children and the Efficacy of Oseltamivir: Data from Two University Hospitals (소아에서 B형 인플루엔자 바이러스의 감염에서 oseltamivir 치료의 유용성: 2개 병원에서 조사된 환자들을 대상으로)

  • Youn, Song Ee;Chun, Ji Hye;Lee, Kyung Suk;Rha, Yeong Ho;Choi, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.199-206
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    • 2014
  • Purpose: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. Methods: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. Results: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was $3.6{\pm}2.8$ year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period ($4.18{\pm}2.10$ vs $4.79{\pm}1.49$ days, P=.17) and total fever duration ($5.32{\pm}2.07$ vs $6.41{\pm}3.25$ days, P =.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. Conclusion: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.

Video-Assisted Thoracoscopic Pleural Adhesiotomy and Decortication for Complicated Pleural Space Occupying Lesions (복잡한 흉막강내 공간차지병소의 흉강경적 흉막 유착박리술 및 박피술)

  • Jo, Min-Seop;Cho, Deog-Gon;Moon, Seok-Whan;Moon, Young-Kyu;Kang, Chul-Ung;Cho, Kyu-Do;Jo, Keon-Hyeon
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.350-354
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    • 2009
  • Background: Complicated pleural space occupying lesions (SOL) have been treated by thoracentesis, closed thoracotomy drainage (CTD) or surgical intervention with using a video thoracosocpe or open thoracotomy depending on the extent of the disease. With the development of video assisted thoracoscopic surgery (VATS), VATS pleural adhesiolysis and decortication have revealed good results as compared to those for open thorcotomy. To assess the effectiveness of VATS pleural adhesiolysis and decortication, we retrospectively analyzed the medical record and radiologic findings of the patients with complicated pleural SOL and who were treated by this surgery. Material and Method: From May 1996 to April 2006, 64 patients (mean age: 41.8 years) with complicated pleural SOL underwent 65 VATS. To analyze the surgical outcome, we classified the postoperative findings on the simple chest X-rays into 4 classes as Class I: no or minimal pleural lesion, Class II: blunting of the cardiophrenic angle and mild pleural thickening, Class III: an elevated diaphgram or persistent lung collapse and Class IV: complicated or recurrent effusion. Result: Before VATS, the patients underwent the diagnostic or therapeutic procedures: single or repeat diagnostic tapping for 41, thoracoscotomy drainage for 11, pigtail catheter drainage for 10 and intrapleural fibrinolytics for 10. The mean duration between the onset of symptom and surgery was 18.4 days. There was neither mortality nor severe complications. The surgical outcomes were class 1 for 28, class 2 for 13, class 3 for 19 and class 4 for 5. There were statistically significant differences between the symptom duration and the classes, and between the operation time and the classes. Conclusion: VATS pleural adhesiolysis and decortication are effective, safe treatments for managing complicated pleural SOL, and an earlier operation is needed for obtaining a better surgical outcome.

A Study on the Simplification of Questionnaire for Sasang Constitution Classification(QSCC II) (사상체질진단검사(QSCC II) 설문지 간소화 연구)

  • Park, Jee-Won;Kim, Jeong-Ah;Wang, Myung-Ja
    • Research in Community and Public Health Nursing
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    • v.14 no.2
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    • pp.334-350
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    • 2003
  • The purpose of this descriptive study was to evaluate the clinical validity of QSCCII (Questionnaire for the Sasang Constitution Classification), whose high accuracy as a constitutional diagnostic tool has been recognized by medical professionals. The subjects of this study were 568 clients from an A university hospital in Suwon. Of the subjects, 259 were health center visitors and 292 were ambulatory clinic visitors. Data were collected using self-reported questionnaire and were analyzed by $X^2$-test and one-way ANOVA. The results of this study as follows: 1. In 4 types of constitution, Soeumin type was found in 41.5% of the subjects. Taeumin type in 39.2%.,and Soyangin type in 19.2%, respectively. There was no Tayangin type found in this study. There were no significant differences on types of constitution by demographic characteristics such as age, sex, marital status, education, religion, and economic status. 2. As for 15 item-selective questionnaire, there were statistically significant differences on the response rate of the 12 items, except items such as A4, A11 and A14, by the types of constitution. When the subjects' own criteria on their constitution were compared to the given constitutional criteria on each item, 4 items such as A6, A11, A13 and A14 were advisable to be excluded from the questionnaire or to be reunited to the other criteria. In the meanwhile, 3 items such as A7, A18 and A15 were desirable to be re-categorized to the other constitutional types and reconstructed to the QSCC II questionnaire. 3. In terms of 106 true-false questionnaire, there were statistically significant differences on the response rate of 46 items by the types of constitution. The 46 items include 15 items (32.6%) of the domain of 'handling something/strength and weakness', 4 items (8.7%) of the domain of 'interpersonal relationship', 9 items (19.6%) of the domain of 'state of mind at ordinary times', 2 items (4.3%) of the domain of 'distinctive emotional characteristics' area, 11 items (23.9%) of the domain of 'specific behavioral trait' and 5 items (10.9%) of the domain of 'physical characteristics'. Therefore, the areas of 'handling something/strength and weakness' and' specific behavioral trait' mainly contributed to the classification of constitutional type. 4. When the 106 true-false items were simplified to the 46 items, statistically significant differences were found on the rate of items allocated to the 3 types of constitution. The rate of selection assigned to the 3 constitutional types of the simplified 46-item questionnaire was higher than that of the original 106-item questionnaire. Conclusions; It was concluded that the rate of selection of each lay person about his own constitutional type would be still higher even though the simplified items of QSCC II questionnaire were applied. If more replicated studies are conducted on the diverse population using the simplifying QSCC II questionnaire in the future, a more simplified standardized Sasang Constitution Questionnaire that is available to the public rather than to medical staffs in the clinical settings could be developed. Moreover, the simplified scale will help nurses deliver more efficient nursing care by providing a more rapid way of health assessment.

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Surgical Treatment of Loculated Empyema - Closed Rib Resectional Drainage (국소화 농흉의 외과적 치료 - 폐쇄식 늑골절제 배농술 -)

  • 허진필;이정철;정태은;이동협;한승세;선기남
    • Journal of Chest Surgery
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    • v.31 no.11
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    • pp.1063-1069
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    • 1998
  • Background: Multi-loculated empyema makes treatment difficult, and more so when thoracentesis or chest tube drainage fails. Materials and methods: From December 1991 to December 1997, we performed closed rib resectional drainage for 18 cases of loculated empyema on the fibrinopurulent or early chronic phase. Results: Surgery was performed on patients with loculated empyema complaining of persistent symptoms due to failure of treatment by thoracentesis(8 cases) or chest tube drainage(10 cases). Predisposing factors of empyema were pneumonia in 13 cases, clotted hemothorax in 3 cases, cholecystectomy, and tuberculous pleurisy in 1 case. Causal organisms were cultured in 8 cases(42.1%), and methicillin-resistant staphylococcus aureus was found in 3 cases, pseudomonas aeruginosa in 2 cases, and enterococcus aerogens, α-hemolytic streptococcus, and acinetobacter baumannii were found in 1 case. Size of loculations was various, and computed chest tomogram showed multiple loculations of empyema numbering 1∼4(mean 1.78±1.00). Operating time was relatively short, about 55∼140 mins(mean 102.8±30.8). All toxic symptoms including fever disappeared postopratively and general conditions improved very quickly in all patients. Length of chest tube indwelling time and hospital stay after surgery were 3∼42 days(mean 11.4±11.5) and 6∼36 days(mean 12.9±8.1), respectively. Complications of prolonged drainage occurred in 2 cases and no death occurred. There were no recurrences and chest x-rays taken 3∼6 months after surgery showed normal findings in 14 cases and slight pleural thickening in 4 cases. Conclusions: Closed rib resectional drainage requires very simple techniques and has excellent outcomes and little complications, therefore, we think that it is the choice of operation for patients with loculated empyema on the fibrinopurulent or early chronic phase.

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Two Crystal Structures of Bromine Sorption Complexes of Vacuum Dehydrsted Fully Cd(II) -Exchanged Zeolite A (카드뮴 이온으로 완전히 치환된 제올라이트 A를 진공 탈수한 후 브롬 증기로 흡착한 두개의 결정구조)

  • 고광락;장세복
    • Korean Journal of Crystallography
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    • v.3 no.1
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    • pp.9-22
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    • 1992
  • Two crystal structures of bromine sorption complexes of vacuum dehydrated Cd(ll)-exchanged zeolite A have been determined by single-crystal xray diffraction techniques in the cubic space group Pm3m at 21(1) ℃. Both crystals were ion exchanged in flowing streams of exchange solution In which mole ratio of Cd(NO3)2 and Cd(OOCCH3)B was 1:1 with a total concentration of 0.05 M. First crystal was dehydrated at 450℃ and 2 ×10-6 Torr for two days. Second crystal was dehydrated at 650℃ and 2 ×10-6 Torr for two days. Both crystals were then treated with 160 Torr for two days. Second crystal was dehydrated at 650℃ and 2 × 10-6 Torr for two days. Both crystals were then treated with 160 Torr of zeolitically dried bromine vapor at 24℃. Full-matrix least-squares refinements of toe first crystal(a: 12.250(1) A )· and the second crystal(a: 12.204(2) A ) have contecoed to final error indices, Rl:0.075 and Ra:0.079 with 212 reflections, and Rl : 0.089 and Ra = 0.078 with 128 reflections, respectively, for which I >3σ(I). Crystallographic analyses of both crystals show that six Cd2+ ions are located on two different threefold axes of unit cell associated with 6-ring oxygens. Each 4.5 Cd2+ ion is recessed ca.0. 441 A Into the large cavity to complex either with Brsor with Br3from the (111) plane of 0(3), whereas each 1.5 Cd2+ ions recessed ca. 0.678 A into we sodalite unit. Approximately 1.5 Br5-and 1.5 Br3-ions are sorbed per unit cell. Each Brsion interacts and stabilized by complexing with two Cd2+ ions and framework oxide ions, while each Br3ion interacts with one Cd2+ ion and framework oxide ions. Because of residual water molecules the following reactions may be occurred inside of zeolite cavity:

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Clinical Features of Simple Bronchial Anthracofibrosis which is not Associated with Tuberculosis (비결핵성 기관지탄분섬유화증의 임상 양상)

  • Lee, Hee-Seub;Maeng, Joo-Hee;Park, Pae-Gun;Jang, Jin-Gun;Park, Wan;Ryu, Dae-Sik;Kang, Gil-Hyun;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.5
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    • pp.510-518
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    • 2002
  • Background : Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. Methods : We reviewed the patients' charts retrospectiely and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. Results : Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). Conclusion : Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.

Osteoporosis in Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환에서의 골다공증에 관한 연구)

  • Kim, Seong-Ja;Lee, Young-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.90-96
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    • 1999
  • Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

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Early Result of Demineralized Bone Matrix (DBM, Genesis$^{(R)}$) in Bone Defect after Operative Treatment of Benign Bone Tumor (양성 골 종양의 수술적 치료 후 발생한 골 결손에서 탈무기화 골 기질(DBM, Genesis$^{(R)}$)의 단기 결과)

  • Seo, Hyun Je;Chung, So Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.56-63
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    • 2013
  • Purpose: This study was performed to evaluate the efficiency of demineralized bone matrix (DBM, Genesis$^{(R)}$) used for bone defect after operative traetment of benign bone tumors by clinical and radiological methods. Materials and Methods: DBM was used to treat bone defect after operative treatment of benign tumor from February 2012 to May 2013. Total 25 benign bone tumor cases (15 males, and 10 females) with mean age of 30.3 were studied. The diagnoses were solitary bone cyst in 9 cases, non ossifying fibroma in 5, fibrous dysplasia in 5, aneurysmal bone cyst in 3 and enchondroma in 3. In categorization by location of tumor, there were 5 cases of distal femur, 4 of proximal tibia, 3 of proximal femur, 3 of proximal humerus, 3 of phalanx, 2 of distal radius, 2 of hip bone, 2 of calcaneus, and 1 of scapula. Autogenous bone was used with DBM in 6 cases, and only DBM used in 19 cases. Mean periods of follow up were 8.7 months (range: 6 to 14 months). Amount of graft resorption and bone formation was observed with compare of post operation radiograph and the difference was shown by percentage. Resorption level was measured by DBM level which could be observed from simple x-ray, and bone formation level by bone trabecular formation level at impaired site. Results: Twenty three cases of total 25 cases showed bone union. In the 23 cases, more than 98% DBM resorption was observed after mean 4.3 months, and more than 98% bone formation was observed after mean 6.9 months. Lesser bone defect sizes showed faster bone formation and it was statistically significant (p=0.036). But other comparative studies on other factors such as, sex, age of patients and combination of autogenous bone were no statistically significant differences in graft resorption and bone formation. And there was no significant complication in periods of follow-up. Conclusion: Demineralized Bone Matrix (Genesis$^{(R)}$) is thought to be useful treatment for bone defect after operative treatment of benign bone tumor, however longer follow-up periods appears to be needed.

A study of Conjunctival Cellular Changes in Dry Eye Patients by Impression Cytology (Impression cytology를 이용한 건성안의 결막 세포변화에 관한 연구)

  • Kim, Jai-Min;Kho, Eun-Gyung;Chae, Soo-Chul;Kim, Soon-Ae
    • Journal of Korean Ophthalmic Optics Society
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    • v.9 no.2
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    • pp.333-343
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    • 2004
  • Impression cytology refers to application of cellulose acetate filter material to the ocular surface to remove the superficial layers of the conjunctival epithelium. The technique is non-invasive, is easy to perform, causes minimal discomfort to the patient, and can be used to follow changes in the conjunctival ocular surface over time. With this method, the morphology of the conjunctival ocular surface can be studied and the degree of squmaous metaplasia assessed. This study was performed to evaluate the conjunctival surface by impression cytology in dry eye patients. A total of 70 students with no contact lens wearing history were recruited. Subjects were required to fill in a McMonnies dry eye symptom questionnaire. The non-invasive tear thinning time(TIT) test of each subject was measured, followed by Schirmer tear test(STI), tear film break-up time(TBUT) tests and Rose-bengal staining were performed as a baseline. Conjunctival epithelial cells from the inferior bulbar conjunctiva were harvested by the impression cytology technique. The specimens collected were labelled and stained with PAS(Periodic Acid Schift)-haematoxylin. The goblet cells and conjunctival epithelial cells were observed under a light microscope of 400x magnification. The specimens were classified according to the Nelson Grading scale which was based on the degree of squamous metaplasia such as changes of goblet cells density, size/form, N:C(nucleus : cytoplasm) ratio. Dry eye patients were observed morphological changes of the epithelial cells, different nuclear alterations, decrease of the goblet cells density. The degree of cytological changes was related to severity of dry eye conditions. When the epithelial cell morphology was graded according to the system described by Nelson, specimens from the control group revealed 91.43% of the eyes to be grade 0 and 8.57% to be grade 1, whereas of the dry eye patients, 20% were grade 0, 42.86% grade 1, 34.29% grade 2 and 2,86% grade 3. Impression cytology represents a non- or minimally invasive biopsy of the ocular surface epithelium with no side effects or contraindications. It has demonstrated to be a useful diagnostic aid for a wide variety of processes involving the ocular surface. This technique is a safe, simple method and may help increase understanding of various ocular surface alterations in dry eye patients.

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