• Title/Summary/Keyword: 경증

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2009 Pandemic Influenza A(H1N1) Infections in the Pediatric Cancer Patients and Comparative Analysis with Seasonal Influenza (소아암 환자에서 2009 대유행 인플루엔자 A(H1N1) 감염의 임상적 고찰 및 계절 인플루엔자와의 비교 분석)

  • Choi, Soo Han;Yoo, Keon Hee;Ahn, Kangmo;Sung, Ki Woong;Koo, Hong Hoe;Kim, Yae Jean
    • Pediatric Infection and Vaccine
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    • v.19 no.2
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    • pp.61-70
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    • 2012
  • Purpose: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. Methods: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. Results: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. Conclusion: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.

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The Clinical Value about Pulmonary Tuberculosis of Indirect Chest Radiography in Physical Examination for Conscription (징병 신체 검사시 집단 흉부 간접 방사선 촬영의 폐결핵 관련한 진단적 유용성)

  • Park, Sung Bin;Choi, Byeong-Kyoo;Ha, Keun Woo;Seo, Joon Beom
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.356-360
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    • 2005
  • Background : This study examined the clinical utility of using indirect chest radiography during a physical examination of new conscripts for determine the presence of pulmonary tuberculosis. Methods : Over an eight-month period, this study examined 25386 people who underwent a physical examination after conscription. The abnormal findings on mass miniature radiography were followed-up using direct chest radiography. The positive predictive value of mass miniature radiography and direct chest radiography was compared. The incidence, degree of infiltration and clinical outcome of active pulmonary tuberculosis were also evaluated during a follow-up examination. Results : The positive rate of mass miniature radiography was 1.19% (n=302). Various lesions were identified: Parenchymal lesions (n=109), mediastinal lesions (n=6), cardiovascular lesions (n=45), pleural lesions (n=49), bony lesions (n=90) and miscellaneous lesions (n=7). The incidence of active pulmonary tuberculosis by mass miniature radiography was 0.26% (n=67). The first diagnosis was made in 50 people; active pulmonary tuberculosis (n=42), pneumonia (n=1), a mediastinal mass (n=1), a rib fracture (n=2) and a pneumothorax (n=4). Most cases of active pulmonary tuberculosis were mildly infiltrated and either improved or were cured by the follow-up examination. Conclusion : Although mass miniature radiography in a physical examination after conscription has limitations, but it is a useful means for detecting the presence of early disease, particularly in active pulmonary tuberculosis.

2 Cases of Mycoplasma pneumoniae Infection with Severe Pneumonia (중증 폐렴의 임상상을 보인 마이코플라즈마 감염 2예)

  • Kim, Shin-Tae;Lee, Shun Nyung;Lee, Seok Jeong;Jung, Pil Moon;Park, Hong Jun;Shin, Myung Sang;Kim, Chong Whan;Lee, Bu Ghil;Kim, Sang-Ha;Lee, Won-Yeon;Shin, Kye Chul;Yong, Suk Joong
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.515-520
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    • 2007
  • Mycoplasma pneumoniae (M. pneumoniae) is the leading cause of pneumonia in older children and young adults. Normally, it does not progress to a condition requiring hospitalization but improves spontaneously or has a mild clinical course. We report two cases of M. pneumoniae pneumonia with different clinical manifestations from the normal course. The patients were young healthy individuals. The diagnoses were made by serology. However, it could not be determined beforehand that they had M. pneumoniae pneumonia. Based on the empirical treatment strategy of severe community acquired pneumonia, the patients were treated with broad-spectrum antibiotics including cephalosporin, quinolone and macrolide. After administering the antibiotics, they showed a gradually favorable clinical course and recovered without residual complications. A M. pneumoniae infection should be considered as a cause of severe community acquired pneumonia, and empirical treatment targeting this organism might be helpful in treating patients with the severe manifestation.

Surgical Treatment of Ebstein Anomaly (Ebstein 기형의 외과적 치험)

  • 이종호;김병렬
    • Journal of Chest Surgery
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    • v.32 no.1
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    • pp.5-9
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    • 1999
  • Background: Ebstein anomaly is a rare congenital disease distinguished by its unique deformity in tricuspid valve and right ventricle & atrium. In its surgical treatment , tricuspid valve reconstruction and valve replacement are well known method, but various surgical methods were suggested. Material and Method : From January 1984 to December 1995, 8 patients with Ebstein anomaly underwent surgical correction. Age and sex distribution, clinical symtoms, radiologic findings, preoperative studies, operative findings, operative methods and its results were analyzed. Result: The sex ratio was 5 to 3(male : female). Patients' ages were averaged 17.6(2-28) years. In all cases, it showed typical deformities of the tricuspid valve. Associated anomalies were permenant foramen ovale, atrial septum defect, pulmonary stenosis. Surgical procedures included tricuspid valve replacement(n=4) and tricuspid valve reconstuction(n=4). Two cases of sinus tachycardia and complete AV block occured postoperatively. There were two hospital death and no late death. All survivors are in NYHA class I or II with median follow up of 64.8 months. 2-D echocardiogram disclosed improvement tricuspid regurgitation during the follow up period. Conclusion: Even though operative method of Ebstein anomaly should be decided according to each anatomical characteristics, we recommended that tricuspid valvuloplasty and plication can be one of the good methods method in the selective cases.

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Cognitive Impairment in the Patients with Mildly Active Systemic Lupus Erythematosus (경증 전신성 홍반성 루프스 환자의 인지기능장애)

  • Kim, Jin-Hee;Lee, Chul;Lee, Chang-Uk;Paik, In-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.89-96
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    • 1997
  • This study was designed to determine whether cognitive impairment was evident in patients with SLE. Also, it aimed to examine the association of cognitive impairment with other clinical variables. The subjects consisted of 20 patients with mildly active SLE and 20 healthy controls. Methods : A total of 20 SLE patients and 20 normal controls completed a computerized neuropsychological test battery using Vienna Test System. These included Cognitrone test, Continuous attention test, Corsi block tapping test, Standard progressive matrices. Also, neuro-behavioral cognitive status examination was done. The symptom severity of depression was measured with Beck Depression Inventory, Hamilton Depression Rating Scale, and current medications were documented. Disease activity was rated using the SLE diasease activity index (SLEDAI). Results : SLE patients had poorer performance than normal controls on the tests of Cognitrone, attention, nonverbal IQ and memory, independent of age, education, disease activity, steroid use and depression status. Conclusion : Cognitive dysfunction was not uncommon in ambulatory SLE patients as measured by standardized neuropsychological tests. It seemed to occur independently of various clinical variables. These findings would suggest that cognitive dysfunction in SLE may be explained by reflecting subclinical central nervous system(CNS) involvement, rather than coexisting psychological distress due to chronic illness or side effect of medication.

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Living and Behavioral Differentials of the Elderly's Dementia in Daegu (대구시 노인들의 치매 실태 및 치매노인들의 생활 습관적 특성)

  • Kim, Han-Gon
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.165-182
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    • 2005
  • The main purposes of this study are to describe the elderly dementia, and to explore characteristics of the elderly dementia among the aged 65 and over in Daegu area. In this study, 1,120 subjects which were 0.6 percent of the population were selected and face-to-face interviews were conducted. The face-to-face interviews were conducted from July 1, 2004 to August 31, 2004. KMMSE was introduced to measure the status of the interviewees' dementia. The findings of this study are as follows: 8.9 percent of respondents turns out to be dementia patients. Among the dementia patients, 52.5 percent are mild dementia patients, 35.0 percent are mid-level symptoms and 12.5 percent are severe symptoms of dementia patients. Cross-tabulation analyses and logistic regression analysis were introduced to explore the demographic, living, and behavioral differentials of the elderly's dementia. According to the logistic regression analysis, it turns out that white educational attainment, participating in the leisure activities for both physical exercise and mental activities, having meals regularly, adequate amount of meals, and high economic status decrease the odds ratio of elder dementia among the elderly who are 65 and above in Daegu area and are statistically significant. On the other hand, age increases the odds ratio of the elder dementia of the elder among Koreans above 65 in Daegu area. Finally, policy implications and some suggestions for the improvement of the elder dementia are introduced and discussed.

A Study on Health Status' Factors Affecting HRQOL in the Elderly Stroke Patients With or Without Sequela (노인 뇌졸중 환자의 후유증 유무에 따른 HRQOL 요인별 중요도 분석)

  • Kim, Souk-Boum;Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.1
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    • pp.37-47
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    • 2017
  • Objective : The main purpose of this study was to analyze factors affecting a health related quality of life(HRQOL) in the elderly stroke patients with(Group 1) or without(Group 2) sequela. Methods : This survey performed secondary analysis with 'the fifth korea national health and nutrition examination survey', and investigated 91 elderly stroke patients over 65 years. Results : The results were as followed: HRQOL and self rated health had a significantly lower in Group 1(p<.05). In all groups, HRQOL was affected by self rated health(${\beta}=0.39$), mental health, and medical health significantly(p<.05). In group 1, HRQOL was affected by mental health(${\beta}=0.45$), self rated health significantly(p<.05). In group 2, HRQOL was affected by medical health(${\beta}=0.45$), functional health, mental health significantly(p<.05). Conclusion : In order to improve the HRQOL of stroke patients during rehabilitative therapy, it is important that early detection and early intervention of depression and suicide, which affect mental health status, are important in the case of severe aftereffects. If the patient continues to support his/her current status regardless of aftereffects, he/she can improve the HRQOL with functional recovery of the stroke patient, and finally have a positive effect on the independence of the stroke patients.

Treatment of Obese Women with Low Calorie Diet, Aerobic Exercise and Behavior Modificaiton (저열량균형식, 운동 및 행동수정에 의한 비만여성의 치료에 관한 연구)

  • 장경자
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.4
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    • pp.510-516
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    • 1995
  • A multidisciplinary weight control program was conducted for obese women. The major components of the program included low calorie diet therapy, exercise, behavior modification and nutritional education and counseling. Sixteen healthy volunteers in excess of body fat, above 30%, were enrolled in the group support program. But 5 person were dropped out in the 2nd week of treatment. During the 1st week of group orientation, individual cause of obesity was assessed through a computer program including survey of dietary intake, activity, eating habits and life styles. During the 5 weeks of treatment, 4.8kg of average weight loss was accomplished using a following program ; low calorie diet(1200kcal/day with all essential nutrients), low impact aerobic exercise(50~60% of $VO_{2max}$, 1 hour/day in a group, 3~5 days/week), behavior modification of individual life styles and eating habits causing obesity and nutritional education concerning nutrition, role of exercise such as brisk walking, importance of slow eating in regular meal pattern and internal motivation for weight reduction, health risk of obesity and rapid weight loss, weight recycling and yo-yo syndrome, etc. Nutritional conseling was conducted 3 times per week with checking self-records of foods, activity, emotional state and tiredness. Before and immediately after 5 weeks of treatment, blood pressure, fasting blood glucose, cholesterol and triglyceride were measured and comparied with paired t-test. After 5 weeks of treatment, body weight, body mass index, body fat and circumferences of waist, upper arm and hip were significantly decreased. Also LDL-cholesterol was significantly decreased after obesity treatment.

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Evaluation on the Extended Transseptal Approachin Mitral Valvular Operations (승모판막수술에 있어서 확장된 경중격절개술의 평가)

  • Na, Myung-Hoon;Park, Sang-Soon;Yoon, Soo-Young;Hwang, Eui-Doo;Hwang, Kyung-Hwan;Yu, Jae-Hyeon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.31 no.9
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    • pp.855-860
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    • 1998
  • Background: Adequate exposure of the mitral valve is a prerequisite for mitral procedures including the repair. An extended transseptal approach in mitral valvular operations is known to have certain technical advantages in recent years because of the anatomic posterior location of the mitral valve, especially in reoperations and in the presence of the small atrium in spite of the possibility of arrhythmia due to injury of sinus nodal artery. Material and Method: We compared the preoperative status, operative, and postoperative factors among patients in two study groups, transseptal only (Group I, n=10) and extended transseptal approach(Group II, n=25). Result: There were no differences in age, sex, NYHA functional class, left atrial size, and left ventricular function. The incidence of the redo-operation was high and early postoperative arrhythmia, which was improved later, appeared in 3 patients in Group II, but not in Group I. Conclusion: We believe that atrial septal incision could be extended up to the atrial roof whenever exposure of the mitral valve during a transseptal approach is inadequate because the late results were similar.

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The Hypoglycemic Effect of Supungsunkihwan on Impaired Glucose Tolerance & Mild NIDDM Patiens (수풍순기환(搜風順氣丸)이 내당능장애 환자와 경증 당뇨병환자의 혈당조절에 미치는 영향)

  • Kwon, Young-Gu;Choi, Ki-Lim;Lee, Jin-Sin;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung;Lee, Byung-Cheol
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.285-290
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    • 2001
  • Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

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