• Title/Summary/Keyword: 류마티스질환

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Assessment of the Severity of Degenerative Aortic Stenosis: Three Case Reports (퇴행성 대동맥판 협착증의 중증도 평가: 증례보고 3례)

  • Kim, Sung-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.270-275
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    • 2019
  • The incidence of degenerative valve disease also increasing with the increasing life expectancy of the elderly population. Rheumatic valve disease is decreasing gradually and the incidence of calcified degenerative aortic stenosis (AS) is growing. Echocardiography is a very important tool for evaluating the prognosis and treatment method as well as the time of operation and diagnosis of heart valve disease. When evaluating valvular heart disease, 2-dimensional echocardiography, which observes all heart valves in detail, should take precedence. Understanding the clinical findings of degenerative valve disease and performing precise echocardiography are extremely important. In addition, an assessment of the severity of aortic stenosis is necessary to determine the surgical indications. An assessment of the severity by echocardiography was explained with three cases of degenerative aortic stenosis. To perform echocardiography accurately, it is necessary to understand degenerative valve disease and its clinical findings accurately.

Risk factors for hypertension in elderly people aged 65 and over, and adults under age 65 (65세 이상 노인과 65세 미만 성인의 고혈압 위험요인)

  • Kim, Ka Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.162-169
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    • 2019
  • This study investigated the risk factors of hypertension among individuals under and over 65 years of age. A total of 6,152 participants were analyzed using the 6th Korean Longitudinal Study of Aging. The collected data were analyzed by Chi-square tests and logistic regression using SPSS 23. The results showed that the subjective health status, diabetes, heart disease, and degree of obesity according to BMI were risk factors affecting hypertension in individuals both under and over age 65. In adults under age 65, chronic lung disease, digestive disease, and drinking were risk factors affecting hypertension. In elderly over age 65, region, arthritis and rheumatic disease, smoking, and cognitive function were risk factors affecting hypertension. There is a need for chronic disease management in Korea due to rapid aging. In particular, it is important to analyze for effective management age-related risk factors affecting steadily increasing hypertension with age. Therefore, it is necessary to manage chronic disease management through social welfare improvement and welfare plans for the elderly, as well as personal management.

Mid-term Result of Operations for Atrial Fibrillation (심방세동 수술의 중기적 결과)

  • 최종범;고광표;한재오
    • Journal of Chest Surgery
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    • v.33 no.11
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    • pp.876-880
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    • 2000
  • 배경: Maze수술은 승모판 질환에 동반되는 심방세동의 효과적인 치료방법으로 알려져있다. 이 연구는 승모판 수술과 심방세동 수술을 동시에 시행한 환자에서 심방세동 수술 후 중기적인 결과와 그 재발 여부를 조사하였다. 대상 및 방법: 심방세동 수술과 승모판 수술을 받은 11예의 환자(10예는 류마티스성 승모판 질환)를 대상으로 하였다. Maze II 수술 및 그 변형수술을 6예에서 시행했고, Maze III 수술 및 그 변형수술을 5예에서 시행하였다. 심방세동 수술 후 좌심방의 수축정도를 심방세동 수술 없이 승모판 수술만으로 동율동을 얻은 경우와 비교하였다. 결과: Maze II 수술을 받은 환자 6예 중 5예(83.3%)에서, maze III 수술을 받은 환자 5예 모두에서 동율동을 회복하였다(전체적으로 90.9%). 전자의 1예(20%)와 후자의 2예(40%)에서 수술 후 각각 23, 2, 13개월만에 심방세동이 재발하였다. 그 후 다시 2예는 동율동으로 전환되었으나, 1예는 재발된 심방세동을 그대로 유지하고 있다. 변형술을 받은 3예에서는 심방세동의 재발이 없었다. Maze 수술 후 4예(40%)에서만 좌심방의 수축기능을 보였으며, maze 수술 후 좌심방 수축 정도(승모판의 A파의 속도)도 maze 수술 없이 승모판 수술과 항부정맥제 투여로 동율동을 회복한 경우보다 낮았다. 결론: 심방세동을 동반한 승모판 수술 환자에서 maze 수술로써 심방세동으로부터 동율동을 회복할 수 있으나 중기적으로 재발할 수 있으며, maze 수술 후 좌심방 수축정도는 상당히 떨어질 수 있다고 생각된다.

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Heart Failure by a Calcific Pericardial Ring -A case report - (식회화된 심낭 고리에 의한 심부전즙 - 1예 보고)

  • Hong Seong-Beom;Ahn Byung-Hee;Ryu Sang-Wan;Jung In-Suk;Kim Sang-Hyung
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.648-651
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    • 2005
  • Calcific constrictive pericarditis is considered to be a nonspecific response to chronic inflammation. This disease has become rare, because the cause of it is usually tuberculosis, which has the tendency to decrease. Other possible causes of it include radiation, rheumatoid disorders, sarcoidosis, and trauma. Whatever the etiology, it can lead to cardiac tamponade by reducing cardiac diastolic filling. We report, herein, the case of a patient with heart failure by a calcific pericardial ring.

Differences in T Serotypes and emm Genotypes of Group A Streptococci Obtained from Invasive and Non-invasive Streptococcal Infections (침습적 및 비침습적 감염 환자에서 분리된 A군 연구균의 T 혈청형과 emm 유전자형의 비교 연구)

  • Hahn, Wonho;Kim, Sejin;Ko, Hansoek;Jung, Sajun;Cha, Sungho;Lee, Heejoo;Lee, Kyungwon
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.106-114
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    • 2006
  • Purpose : Studying the serotypes and emm genotype of group A streptococci(GAS) hold a key role in the investigation of epidemiology, pathogenesis, and resistance to antibiotics. We planed to find out the possible differences in serotypes and genotypes between the invasive and the non-invasive GAS infection. Methods : We obtained 39 isolates from the patients hospitalized in 2004 with the diagnosis of invasive GAS infectious diseases in the Severance Hospital, Yonsei University. We sent the isolates to the WHO Collaboratory Center in University of Minnesota and analyzed T serotypes and emm genotypes. These results were compared with non-invasive GAS infections in our hospital. Results : Compared this data with the results of 2003 to 2004, T2/28, T3, T5/27/44, T9 and NT were more prevalent. The NT showed statistically significant difference(P=0.019). The emm 3, emm 9, emm 18, emm 44 and emm provision type STG485 were more frequent genotypes compared with the study in 2003~2004, relatively. The emm provision type STG485 had statistically significant difference(P=0.000). The incidence of T12 plus T4, known as erythromycin(EM) resistant serotypes, was as low as 17.9% in this study, compared with those of non-invasive strains. Conclusion : The incidence of EM-resistant strains is supposed not to be higher in invasive GAS infection. We could find out possible higher incidence of rheumatogenic strains in the invasive GAS infections. It seems to be important to have an effort on studying of serotyping and genotyping for the monitoring of strains and to know the epidemiologic characteristics.

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Occlusion of the Right Coronary Artery Ostium due to Rheumatic Aortic Valve Stenosis (류마티스성 대동맥 판막협착증에 의한 우관상동맥 개구부 폐쇄)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Kim, Soo-Cheol;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.445-447
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    • 2007
  • Occlusion of a coronary artery ostium and especially occlusion of the right by an aortic cusp is a rare condition. We experienced an adult patient with occlusion of the right coronary ostium that was due to fusion of the right coronary cusp to the aortic wall along with underlying rheumatic aortic valve stenosis. During the operation, the adherent right coronary cusp was excised. After confirming that the right coronary ostium was patent, the other cusps were removed, and this followed by replacement of the aortic valve with a mechanical valve. The postoperative course was uneventful.

Pain, perceived exercise barriers, and related factors in arthritis patients (관절염 환자의 통증 및 운동 장애성 지각과 관련 요인)

  • An, Eun-Jeong;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4588-4597
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    • 2012
  • This study aimed to investigate pain, perceived exercise barriers, and related factors in arthritis patients. The study was conducted on 140 arthritis patients (89 rheumatoid arthritis patients and 51 osteoarthritis patients) who visited C University Hospital in Daejeon due to arthritis and agreed to participate in a survey. The self-administered survey was conducted from February 2011 to September 2011. The results are as follow. The perceived exercise barriers increased in both groups as the education level and monthly household income decreased. In the rheumatoid arthritis group, the pain became more intense as the self-rated health status became poorer while the perceived exercise barriers became more significant as the self-rated health status became poorer and the patients had other diseases besides arthritis. In the osteoarthritis group, the pain was greater as the duration of arthritis was longer and the self-rated health status became poorer. In both groups, the perceived exercise barriers became more significant as the exercise stage approached the pre-planning stage. The results of the multiple linear regression analysis showed that the most influential factor on pain in both groups was the 'very bad' self-rated health status. In the rheumatoid arthritis group, influential factors on the perceived exercise barriers were the exercise stage and the education level while for the osteoarthritis group, they were the exercise stage and the monthly household income. In conclusion, the results of this study showed that the pain and perceived exercise barriers of arthritis patients were associated with various factors such as the education level, monthly household income, self-rated health status, and exercise stage, which suggests that these factors should be considered in the planning of exercise programs.

Synovial Lesions with Low Signal Intensities on T2-Weighted MR Image (T2 강조 MR 영상에서 저신호강도를 보이는 윤활막 질환)

  • Choo, Hye-Jung;Lee, Sun-Joo;Cho, Kil-Ho;Suh, Kyung-Jin;Lee, Sung-Moon;Lee, Young-Hwan;Lee, In-Sook;Lee, Gyung-Kyu;Kim, Bo-Mi
    • Investigative Magnetic Resonance Imaging
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    • v.15 no.1
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    • pp.1-10
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    • 2011
  • Pigmented villonodular synovitis, synovial chondromatosis, long-standing rheumatoid arthritis, hemophilic arthropathy, chronic tophaceous gout, amyloid arthropathy, tuberculous arthritis, and hemangioma are the synovial diseases showing low signal intensity on T2-weighted image. Synovial deposition of hemosiderin, urate, and amyloid and fibrosis or caseous necrosis of hypertrophied synovium are known as the pathologic causes of T2 signal intensity. Because of the low incidence of the synovial lesions showing T2 low signal intensity, recognition of these diseases would be helpful for the exact diagnosis.

Effect of Left Atrial Volume Reduction with Maze Operation on Sinus Conversion and Recovery of Left Atrial Transport Function (Maze 수술 후 동율동 및 좌심방 수축능 회복에 대한 좌심방 부피 감소 성형술의 영향)

  • Hong Seong-Beom;Ryu Sang-Wan;Jung Eun-Kyung;Jung In-Suk;Bum Min-Sun;Park Jung-Min;Lee Kyo-Sun;Kim Sang-Hyung;Ahn Byung-Hee
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.739-745
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    • 2005
  • Background: The Maze procedure considered the most effective method of treatment for atrial fibrillation. However, the sinus conversion rates decreased due to several factors, especially enlarged left atrium. The purpose of this study was to investigate the effects of Maze procedure with aen atrial volume reduction plasty on rheumatic mitral valve disease, Material and Method: From December of 200f to July of 2004, 45 patients received mitral valve and Maze operation. The patients were placed in either group f or group 2, based on the left atrial volume reduction plasty. The presence and onset of sinus rhythm and the incidence of trans mitral A waves were monitored during the postoperative 7 days and throughout the follow up period of 3 and 6 months. Mean follow up periods were 15.8 10.1 months in group 1 and $6.1\pm2.7$ months in group 2. Result: The sinus onset were $9.88\pm12.2$ days in group 1, and $1\pm3.6$ days in group 2 (p<0.01). The sinus conversion rates in the group 1 and 2 were $65\%,\;75\%$ (p=0.07) in the postoperative 7 days, $70.5\%,\;100\%$ (p<0.01) at postoperative 3 months, and $93\%,\;100\%$ (p<0.01) at postoperative 6 months, respectively. The wave detection rates in the postoperative 7days were $31.2\%\;and\;63.6\%$, and continued to improve over time to $83.3\%\;and\;100\%$ by 6months, respectively. Conclusion: The results suggest that Maze procedure with left atrial volume reduction plasty is effective for inducing sinus rhythm and for restoring left atrial contractile function after concomitant rheumatic mitral valve surgery. However further follow up of this patients for long time is necessary.

Interaction between Pain Aspect and Sleep Quality in Patients with Temporomandibular Disorder (측두하악장애 환자에서의 통증양상과 수면과의 관계)

  • Tae, Il-Ho;Kim, Seong-Taek;Ahn, Hyung-Joon;Kwon, Jeong-Seung;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.205-218
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    • 2008
  • Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.