• Title/Summary/Keyword: 만성간질환

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당뇨병환자에게 발생하는 감염의 원인은?

  • Lee, Hyeon-Cheol
    • The Monthly Diabetes
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    • s.200
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    • pp.22-25
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    • 2006
  • 만성 간질환자는 간과 근육의 에너지 저장소로서의 역할이 장애를 받고, 에너지 대사상 지방조직의 활용도가 높아지는 변화와 함께 질환 자체의 합병증으로 인한 식사섭취 감소로 영양 불량이 흔히 동반되므로 영양공급이 매우 중요하다.

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u-DailyCare Design of a Health Management System for Chronic IlIness Patients (u-DailyCare : 만성질환자를 위한 건강 관리 시스템의 설계)

  • Yoo, Byung-Sik;Kim, Dai-Hun;Jo, Gun-Ryun;Kim, Sung-Hyun;Oh, Seoung-Jun;Cho, Jin-Sung
    • Proceedings of the Korean Information Science Society Conference
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    • 2011.06a
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    • pp.146-149
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    • 2011
  • 최근에 우리 사회는 급격히 증가하는 만성질환으로 위기에 처해있다. 진보된 의료기술도 여전히 만성 질환을 완벽히 진료해 주지 못하고 있다. 현대 사회의 많은 사람들은 긴 수명을 보장받는 대신에 만성질환 장애를 가지게 되었고 비싼 의료 비용은 심각한사회 문제로 대두되고 있다. IT가 발달함에 따라 병원 중심의 치료서비스에서 개인과 주치의가 상호 긴밀하게 협력하여 질병의 예방, 관리, 건강증진 등을 제공하는 u-Healthcare 시스템이 빠르게 발전하고 있다. u-Healthcare 시스템은 개인 건강 기기로부터 측정된 생체 정보 데이터가 병원과 주치의에게 전달되어 언제 어디서나 검사 및 피드백이 가능하도록 하는 것이 목적이다. 본 논문에서는 유헬스케어 시스템에 발 맞추어 스마트 폰 기반의 만성질환자를 위한 u-DailyCare 시스템의 설계한다. 스마트폰 사용자로부터 얻어진 행위 데이터 및 생체 정보 데이터를 수집하여 서버에 보내면, 이 정보들을 바탕으로 주치의 혹은 병원에서 실시간으로 데이터를 분석하여 피드백을 준다. 본 논문의 특징으로는 키넥트 카메라와 신체 활동을 측정하는 MET 단위를 사용하여 정확한 행위 데이터 측정과 분석에 도움을 주었다. 이로써 주치의는 환자에게 좀더 정확하고 정교한 피드백을 전달할 수 있다.

How Much should the Poor Pay for their Health Care Services under the National Health Insurance System? (계층간 진료비 본인부담의 형평성에 관한 연구)

  • Kim, Hak-Ju
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.113-133
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    • 2004
  • Although National Health Insurance(NHI) in the South Korea has guaranteed access to health insurance coverage to virtually all the people, a significant portion of out-of-pocket spending can create substantial financial burdens for some beneficiaries, particularly those with low incomes. Previous studies have estimated the magnitude of out-of-pocket spending by types of chronic illness or in- and out-patients. Prior estimates, however, have not given a complete picture of the impact of health care costs on lower-income populations. The result from this study shows that 20 percent of beneficiaries in the lowest-income quintile spent more than twelve percent of their household equivalent income out-of-pocket health services, whether they were enrolled in a Health care services or not. In comparison, the beneficiaries in the highest-income quintile level spent only 2 percent of their income out-of-pocket on health care. Also, the regression analysis suggests that age, household income, number of chronic illness, type of hospital in addition to the number of usage may affect the size of out-of-pocket spending.

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TNF-α stimulated IL-8 and IL-10 expression in monocytes from patients with chronic granulomatous disease (만성육아종질환 환자 단핵구에서 TNF-α 자극에 의한 IL-8과 IL-10의 발현 양상)

  • Shin, Kyung-Sue
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1096-1101
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    • 2008
  • Purpose : Patients with chronic granulomatous disease (CGD) have genetic mutations in a component of the NADPH oxidase enzyme that is necessary for the generation of the superoxide anion. The profound defect in innate immunity is reflected by the patients susceptibility to catalase-positive bacteria and fungi. In addition, CGD patients display signs of persistent inflammation, which is not associated only with deficient superoxide anion production. The aim of this study was to elucidate the cytokine responses in CGD patients after $TNF-{\alpha}$ stimulation. Methods : Heparinized blood samples were collected from 8 CGD patients and 10 healthy volunteers. Monocytes ($1{\times}10^6cell/well$) isolated by the magnet cell isolation system were incubated with a constant amount of $TNF-{\alpha}$ (10 ng/mL) at $37^{\circ}C$ for 6 h. Incubated cells were harvested at 60-min intervals for IL-8 and IL-10 mRNA analysis, and the supernatant was collected at the same intervals to determine IL-8 and IL-10 expression. Monocytes from healthy volunteers were also incubated with antioxidants followed by $TNF-{\alpha}$ stimulation for IL-8 and IL-10 expression. Results : In CGD patients, a high expression of IL-8 together with a significantly higher IL-10 expression than in the healthy controls was seen after $TNF-{\alpha}$ stimulation. Moreover, normal monocytes treated with antioxidants exhibited increased IL-8 responses. Conclusion : The absence of phagocyte-derived reactive oxidants in CGD might be associated with a dysregulated production of pro- and antiinflammatory cytokines. Additional research related to reactive oxidants is needed to clarify the role of cytokines in CGD patients.

The Influence of Health Literacy and Social-Support on Medication Adherence in Eldery with Chronic Disease (만성질환노인의 건강정보이해능력, 사회적지지가 약물복용이행에 미치는 영향)

  • Jeong, Hyun-Ju;Bae, Jeong-Hee
    • Journal of Digital Convergence
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    • v.16 no.7
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    • pp.419-428
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    • 2018
  • Purpose: The study was done to investigate the correlation among health literacy, social support and medication adherence in elderly with chronic diseases. Method: Participants were 100 patients with chronic diseases in two small hospitals in J do H. A structured questionnaires was used to measure the study variables from July 14, 2017 to August 14, 2017. Data was analyzed using descriptive statistics, t-test, ANOVA, Spearman correlation coefficient, and Multiple regression by SPSS/WIN 18.0 program. Result: Medication adherence and health literacy were positively correlated(r=.398, p<.001), Medication adherence and social support were positively correlated (r=.453, p<.001) and health literacy and social support were positively correlated(r=.731, p<.001). The factors influencing on medication adherance are Experience of adverse drug effect. The explanation is that medication adherence is total 25.9%(F=3.91, p<.001). Conclusion: Thus this suggests that in order to enhance medication adherence of the elderly with chronic diseases, educational programs are needed for offering customized medical information considering unique characteristics of the area and objects.

PSYCHOLOGICAL CHARACTERISTICS IN CHILDREN WITH CHRONIC PHYSICAL ILLNESS AND HANDICAPPED:SELF-CONCEPT AND STRESS COPING STRATEGY (만성적인 신체 질환 및 장애를 지닌 아동의 심리적 특성 : 자기개념 및 스트레스에 대한 대처 양상 비교)

  • Choi, Seung-Mi;Chung, Chin-Youb;Kim, Zoung-Soul;Shin, Min-Sub
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.2
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    • pp.252-261
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    • 2000
  • Objectivity:This study was conducted to examine the depression, self-concept, perception of stress & coping strategy in children with chronic physical illness. Methods:Two groups of participants were recruited for this study, 13 children with chronic illness in outpatient or inpatient treatment at Seoul National University Children's Hospital, and 13 nonpatient children. They were assessed using Korean form of the Piers-Harris Self-Concept Scale (PHSCS), Kovacs' Children's Depression Inventory(CDI) and three subscaleds('color how you feel' 'color how others make you feel' 'A children in the rain' of Children's Self-Report and Projective Inventory(CSRPI). Result:There were significant differences between the chronic ill children and the healthy children in scores of depression and self-concept. The chronicity ill children were more depressive and had very negative self-concept, and obtained significantly lower scores than the healthy children in the subscales of PHSCS, 'intellectual/school status' and 'popularity' Among three scales of CSRPI, there was no difference in 'color how you feel' and 'color how others make you feel' But there were significant differences in all items of 'A child in the rain'(quantity of raining, duration of raining, tool, and effectiveness). 'Duration of raining' correlated most negatively with PHSCS scores, and correlated positively with CDI scores. Conclusion:The children with chronic illness are more depressive and have very negative selfconcept. And they feel that the stresses are more permanent, but have no appropriate coping strategy. The results suggest that the chronic illness strongly affects the psychological and emotional adjustment of children(i.e. depression, peer relation, stress coping strategy).

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업무와 관련된 질병(Work-related disorder) 역학연구에서의 고려사항들(I)-만성폐질환

  • Lee, Won-Cheol;Park, Jeong-Il;Maeng, Gwang-Ho
    • 월간산업보건
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    • s.69
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    • pp.26-32
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    • 1994
  • 어떠한 직업성 폭로와 그리고 특정한 질병간의 원인결과 관련성이 매우 명확할 때 이러한 질병은, 의학적으로 또한 대부분의 경우에 법적으로 직업성 질환으로 규정된다. 그러나 작업과 작업조건은 이러한 명확한 원인결과관계 이외에도, 일반적인 질환의 발생에 일부분 기여할수 있는데, 이는 원인의 일부로 또는 일단 발생된 질환을 악화시키는 것으로 기여할수 있고, 근로자의 직업과 관련된 생활습관을 통하여 간접적으로 그게 되는데, 이는 반드시 원인결과의 관계이어야만 한다는 것은 아니고, 직업과 직업 또는 작업조건에 어떠한 면으로 관련되어 있으면 이러한 범주에 들게 된다. 고전적인 직업병은 이러한 관련성의 한 극단을 이루고 있으며, 직업과 관련되어서 매우 미약한 관련성을 가지는 또는 불확실한 관련을 가지는 질환들은 다른 극단을 점하고 있다. 이러한 극단들 사이에 위치한 많은 질환들은 어떠한 특정한 조건에서만 업무관련성을 지니며 그들의 원인은 항상 다원적인(multifactotial) 것이다. 이러한 관련성의 확정은 역학의 중요한 역할중의 하나이나 이 글에서는 대표적인 몇가지 질환을 대상으로 이러한 연구에서 고려하여야 할 점들을 Sven Hernberg의 "Introduction to Occupational Epidemiology"를 통하여 정리하여 보고자 하였다.

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Prevalence of Combined Bronchial Asthma with COPD in Patients with Moderate to Severe Air flow Limitation (중등증 및 중증의 만성 기류 장애 환자에서 만성폐쇄성폐질환과 기관지 천식의 합병률)

  • Rhee, Yang Keun;In, Byeong Hyun;Lee, Yang Deok;Lee, Yong Chul;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.4
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    • pp.386-394
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    • 2003
  • Background : ATS(American Thoracic Society) defined new guidelines for COPD(chronic obstructive lung disease) in April 2001, following the results of the global initiative for chronic obstructive lung disease. The most important concept of COPD is an airflow limitation which is not fully reversible compared to bronchial asthma(BA). The criteria for COPD are postbronchodilator $FEV_1$ less than 80% of the predicted value and an $FEV_1$ per FVC ratio less than 70%. The global initiative for asthma(GINA) study defined asthma, which included immune-mediated chronic airway inflammatory airway disease, and found that airflow limitation was wide spread, variable and often completely reversible. Taken together COPD and BA may be combined in airflow limitation. This study was designed to evaluate the prevalence of BA in patients with COPD of moderate to severe airflow limitation. Methods : COPD was diagnosed by symptoms and spirometry according to ATS guidelines. Enrolled subjects were examined for peak flow meters(PFM), sputum eosinophils and eosinophil cationic protein(ECP) levels, serum total IgE with allergy skin prick test, and methacholine bronchial provocation test(MBPT). Results : About 27% of COPD patients with moderate to severe airflow limitation were combined with BA. There was significantly decreased response to PFM in severe COPD. However, there was no significant relationship between BA and COPD according to the degree of severity. The BA combined with COPD group showed significantly high eosinophil counts and ECP level in induced sputum. However, neutrophil counts in induced sputum showed significant elevation in the pure COPD group. Conclusion : Twenty-seven percent of COPD patients with moderate to severe ventilation disorder were combined with BA, but there were no significant differences according to the degree of severity.

Development of Artificial Intelligence Model for Diagnosing Liver Fibrosis Based on Medical Image (의료영상기반의 간 섬유화 진단을 위한 인공지능 모델 개발)

  • Noh, SiHyeong;Lim, Dongwook;Lee, Chungsub;Kim, Tae-Hoon;Jeong, Chang-Won
    • Proceedings of the Korea Information Processing Society Conference
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    • 2022.11a
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    • pp.462-464
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    • 2022
  • 의료영상기반의 인공지능 연구는 질환의 조기진단 및 예측 분야에 눈부신 기술발전이 되어왔다. 장기 섬유증은 만성 염증성 질환의 질병 진행을 특징짓고 전 세계적으로 모든 원인으로 인한 사망률의 45%에 기여하며, 그중 간 섬유증은 주로 삶의 질과 예후를 결정한다. 해당 질환은 임상 현장에서 혈액데이터 분석 그리고 간생검을 통해 진단을 하고 있으나 최근 의료영상 분석을 통해 진단에 활용하고 있는 추세이다. 본 논문에서는 인공지능을 기반으로 하여, 간 섬유화를 진단하기 위해 MRI영상을 학습하여 질환에 대한 중증도 진단을 돕는 인공지능 모델을 제시하고자 한다. 이를 위해 인공지능 모델을 개발하는 과정과 그 결과를 보인다. 본 논문에서 제시한 모델을 통해 간 섬유화를 빠르게 진단할 수 있을 것으로 기대한다.

$^{99m}Tc-MDP$ Scan in Rhabdomyolysis (횡문근융해증의 골스캔)

  • Zeon, Seok-Kil;Lee, Hee-Jung;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.106-110
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    • 1992
  • 외상, 만성간질환, 화상 및 전신성경련등의 원인으로 발생한 횡문근융해증 9예의 $^{99m}Tc-MDP$ 골스캔을 분석하여 다음과 같은 성적을 얻었다. 동통부위보다 넓은 전신성 병변이 44%에서 확인되었으며 나머지 56%는 국소 동통부위의 근육에만 Bone-seeking agent가 침착되는 것이 확인되있고, 골스캔만으로도 44%에서 신부전증이 동반되었음을 확인할 수 있었다. 전신성 병변은 원인과는 관계없이 출현하였고, 신부전증도 원인질환에는 관계없이 발생하였다. 1예에서 실시한 CT는 국소성 병변만을 보여 주었으나골스캔은 전신성 병변을 나타내어 주었다. 따라서 횡문근융해증의 진단에는 골스캔이 중요함을 확인해주었다.

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