• Title/Summary/Keyword: 고령 환자군

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성인병 뉴스 제314호

  • The Korea Association of Chronic Disease
    • The Korean Chronic Disease News
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    • no.314
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    • pp.1-26
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    • 2007
  • 강원도 횡성군 보건소 염경숙 소장/대대적 국가암관리사업 추진/노인장기요양보험 3차 시범 내달 시행/만성질환 예방의식 고취 총력/65세 이상 노인 30%가 당뇨 환자/성인 3명 중 1명 중증 안구건조증 환자/“감 잘못 먹으면‘위석’생긴다”/방문보건.재가복지통합사업 성과 커/자율방역봉사단 구성 맞춤형 모기방제 실시/보건의료투자 전략, 어떻게 추진되나/고령친화 모델지역 기본 구상/생명표 작성, 국민건강실태 분석/

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Study on Life Changes of Recurred TMD Patients Through SRRS (SRRS를 이용한 측두하악장애 재발환자의 생활 변화에 관한 연구)

  • Noh, Kon-Hyun;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.81-90
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    • 2007
  • The life changes of TMJ patients were evaluated through the Social Readjustment Rating Scale (SRRS) questionnaire. 33 recurred TMD patients and 32 new TMD patients were studied at the TMJ clinics, Department of Oral Medicine, PNUH from September 2005 to August 2006. The obtained results were as follows: 1. The life change unit(LCU) totals in the recurred TMD patients were significantly higher than those in the control subjects, during the $7{\sim}12$ months before presentation for the hospital. 2. The life change unit(LCU) totals in the recurred TMD patients were higher a little than those in the control subjects during a year before presentation for the hospital. 3. There was no significant difference in LCU totals and life events between the recurred TMD patients and the control subjects by age. 4. There was no significant difference in LCU totals and life events between the married group and unmarried group in the subjects.

Esophagectomy for Esophageal Cancer in Elderly Patients Over 70 Years of Age (70세 이상의 식도암 환자에시 식도절제술 및 재건술)

  • Song Suk-Won;Lee Hyun-Sung;Kim Moon Soo;Lee Jong Mog;Zo Zae Ill
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.428-433
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    • 2005
  • Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. Material and Method: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. Result: The mean age was 63_4. There were 159 men. On histopathological examination, $93.1\%$ had squamous cell carcinoma. On the locations, $78.7\%$ were in mid and lower esophagus. Curative resections for esophageal cancer were possible in $162(93.1\%)$ patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients $(35.1\%)$. The most frequent morbidity was pulmonary complication in $30(17.2\%)$. Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. Conclusion: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.

Clinical Characteristics of Reintubated Patients After Planned Endotracheal Extubation (계획된 기관 내관 발관(extubation) 후 재 삽관(reintubation)한 환자의 임상적 특징)

  • Sohn, Jang Won;Shin, Sung Joon;Kim, Tae Hyung;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.439-442
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    • 2004
  • Background : Extubation failure and reintubation increase the morbidity and the mortality rate. Several extubation criteria and risk factors for extubation failure have been recommended. However, some patients present with extubation failure even after a planned extubation. The aim of this study was to evaluate the clinical characteristics of patients with extubation failure after a planned extubation. Methods : Thirty one patients who presented with planned extubation were included. Extubation failure was defined as reintubation within 48 hours after extubation. The clinical, respiratory and hemodynamic parameters between extubation success and failure group were compared. Results : Six patients were included in the failure group. The extubation failure rate was 19.4%. The age, periods of intubation and heart rates were significantly different between the extubation success and failure group. In the success and failure group, the mean age were $60.4{\pm}15.65$ vs. $80.3{\pm}7.17$ year, the intubation periods were $7.12{\pm}2.47$ vs. $13.83{\pm}2.4$ day and the heart rates were $94.32{\pm}5.77$ vs. $110.67{\pm}3.78/min$, respectively. Conclusion : Old age and patients intubated for periods will require a will careful assessment before extubation. Extensive cardiac evaluations before extubation will also be needed.

Carcinoma of the Uterine Cervix Treated with External Beam Irradiation Alone (자궁경부암의 외부방사선 치료 성적)

  • Kim, Mi-Sook;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.363-367
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    • 1993
  • A retrospective analysis was peformed on 42 patients with carcinoma of the uterine cervix who were treated with external beam (EB) radiation therapy alone at the Department of Therapeutic Radiology, Seoul National University Hospital from March 1979 to December 1988. After whole pelvic field irradiation of 50Gy, all the patients received additional booster dose of 12-22Gy to the primary tumor Thirty one received EB radiotherapy alone because of poor geometry for intracavitary application,5 because of medical problems and 6 because of other reasons. Five year locoregional control rate and five year survival rate were $34.5\%\;and\;35.4\%,$ respectively. Five year survivals were $66.7\%,\;36.4%,\;32.8\%\;and\;25.0\%$ for stage IIA, IIB, IIIB and IVA, respectively. The response one month after treatment well correlated with prognosis. The incidence of grade 2 and 3 complication was $12\%\;and\;10\%,$ respectively. There was tendency of increased complication with advanced stage.

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Differences in Associated Shoulder lesions Regarding Ages and Gender Among Patients with Complete Rotator Cuff Tear (회전근 개 완전파열 환자에서의 나이 및 성별에 따른 견관절 동반 병소의 차이)

  • Kim, Jae-Hwa;Dan, Jin-Myoung;Yoon, Byung-Ho;Kim, Young-Woong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.180-184
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    • 2008
  • Purpose: This study evaluated the differences in associated shoulder lesions on complete rotator cuff tear patients regarding ages and gender. Materials and Methods: Between June 2003 and March 2006, 109 patients (59 males, 50 females) who received arthroscopic shoulder surgery for their complete rotator cuff tear were selected and their associated shoulder lesions were analyzed. Ages were between 24 years, the youngest, and 75 years, the oldest. Groups by age were under 59 years group and over 60 years group, and associated lesions of patients to be analyzed were Acromioclavicular arthritis, SLAP(shoulder labrum anterior and posterior) lesion, and biceps tendinitis, and statistic analysis were performed by Khai-square method. Results: For acromioclavicular joint arthritis, over 60 years old group showed higher association rate compared to under 59 years young group, and for SLAP lesions, under 59 years young group showed higher association rate compared to over 60 years old group only in men. Conclusion: For diagnosis and treatment of complete rotator cuff tear patient, associated shoulder lesions in different ages should be considered, especially associations of SLAP lesions in young male patients, and acromioclavicular joint arthritis in old age patients should be verified.

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Minimal Stimulation using rhFSH and GnRH Antagonist for IVF Treated Patients of Advanced Age (고령 불임여성의 체외수정술시 최소자극법의 효용성)

  • Kim, So-Ra;Kim, Chung-Hoon;Lee, Jin-Kyoung;Jeon, Gyun-Ho;Kim, Sung-Hoon;Chae, Hee-Dong;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.36 no.1
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    • pp.63-70
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    • 2009
  • Objective: This study was performed to investigate the effectiveness of minimal stimulation using rhFSH and GnRH antagonist compared with GnRH antagonist multidose protocol (MDP) in IVF treated patients with aged 40 and above. Methods: Seventy-five patients with aged 40 and above were equally randomized to minimal stimulation group (n=37) or GnRH antagonist MDP group (n=38). For minimal stimulation group, ultrasound monitoring was started on cycle day 7 or 8. Daily injections of 0.25 mg cetrorelix together with 150 IU rhFSH were started from the day at 13${\sim}$14 mm of a leading follicle diameter. For GnRH antagonist MDP group, daily injections of 225 IU rhFSH were initiated from cycle day 2 and GnRH antagonist was started at a dose of 0.25 mg/day on rhFSH stimulation day 6 or the day at 13${\sim}$14 mm of leading follicle diameter. In both groups, transvaginal ultrasound-guided oocyte retrieval was performed. According to cleavage and morphologic characteristics of embryos, embryos were transferred 3 to 5 days after oocyte retrieval. Results: There were no differences in patients' characteristics and cycle cancellation rate between the two groups. Total dose and duration of rhFSH used were significantly fewer and shorter in minimal stimulation group than those in GnRH antagonist MDP group. The numbers of oocytes retrieved, mature oocytes and transferred embryos were also lower in minimal stimulation group. However, there were no significant differences in the clinical pregnancy rate and miscarriage rate between the two groups. Conclusions: This study demonstrates that minimal stimulation protocol provides comparable pregnancy rates to GnRH antagonist MDP with fewer dose and days of rhFSH used, and thus can be a cost-effective alternative in women aged 40 and above.

Risk Factors, Symptoms, and Intervention Analysis of Delirium Subtypes in Hospitalized Patients (입원환자에게 나타나는 섬망 아형별 위험요인과 증상 및 중재 분석)

  • Ryu, Ahyun;Kang, Young-Ok;Song, Rhayun
    • Journal of the Korea Convergence Society
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    • v.12 no.10
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    • pp.353-363
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    • 2021
  • This study aimed to investigate subtypes, risk factors, symptoms and the interventions to inpatients with delirium. The data of 108 inpatients who had the diagnosis of delirium during their hospital stay were collected from Electronic Medical Record at a university hospital and were analyzed by SPSS for Windows V. 26.0 program. As a results, Patients had a high proportion of elderly, male, orthopedic, and with fractures or amputations. The subtypes of delirium were hyperactive (51.9%), hypoactive (6.5%), and mixed (41.7%). Among the risk factors, depression and use of psychotropic agent were more common in those with hypoactive delirium. Among delirium interventions, behavioral symptom management and aggressive behavioral intervention were mainly implemented for those with hyperactive or mixed types, and emotional support was mainly implemented for those with hypoactive or mixed types. The delirium related intervention was more likely given immediately when the patients showed aggressive behaviors. Therefore, intervention strategies and protocol development are required for early detection of delirium in inpatients.

The Effect of Distal Hooks in Thoracolumbar Fusion Using a Pedicle Screw in Elderly Patients (척추경 나사못을 이용한 고령 환자의 흉요추부 유합에서 원위부 갈고리의 효과)

  • Lee, Dong-Hyun;Kim, Sung-Soo;Kim, Jung-Hoon;Lim, Dong-Ju;Choi, Byung-Wan;Kim, Jin-Hwan;Kim, Jin-Hyok;Park, Byung-Ook
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.83-91
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    • 2017
  • Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

Case Control Study of Recognition level for Dermatomycosis of Dermatomycosis Patient to be Treated in Ulleung Hospital of Ulleung island (울릉도의 일개 병원을 내원한 피부 진균증 환자들의 피부 진균증에 대한 인식도에 관한 사례 연구)

  • Bae, Jung-Min;Jung, Man-Jin;Ha, Dong-Yeup;Jung, Ho-Keun;Jung, Ki-Hun;Jung, Byung-Wook;Oh, Min-Koo;Bae, Sung-Han;An, Woo-Sup
    • Journal of agricultural medicine and community health
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    • v.30 no.2
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    • pp.205-211
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    • 2005
  • Objectives: In Ulleung island, many people was suffered from dermatomycosis. But many patients was not recognized to dermatomycosis due to little symptom. So, public health education was needed. We will plan education direction based on evidence. So, in one way, the recognition level was needed to determine education direction. Methods: From June to July in 2005, 45 patients was made a question. The questionnaire was composed of chief complaint, site, duration, similar disease in family, 5 questiones and so on. If patients was recognized to 1 question, 1 score was added. Remain 4 question was done in same manner. Results: The low score group were that total socre was beyond 2. And The high score group were that total score was above 3. The low score group was 24 persons, average age was 59. The high score group was 21 persons and average age was 42. Male and female ratio was 7 : 17 in low score group and 10 : 11 in high score group. Coinfection was 17 patients in low score group and 2 patients in high score group. There was only 17 patients that wete recognized that dermatomycosis and "Moozom" were same disease. And, many patients was not recognized to possibility of reinfection after treatment of dermatomycosis. Conclusions: In Ulleung island, coinfection rate was higher than other area bacause of low recognition level. And infection rate in family was higher too. So, there was essential to educate of dermatomycosis prevention. Dermatomycosis patient became older and was more female than other area, so there was need to centralize people to be needed of public health education. Finally, many statistical study for dermatomycosis should be needed for many patients and general populations in Ulleung island.

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