• Title/Summary/Keyword: 일차 진료

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The Length of Postoperative Antituberculous Therapy in Patients with Pulmonary Tuberculosis (폐결핵 환자의 폐절제술 후 항결핵제 투여기간)

  • Kwon, Eun-Su;Song, Jin-Ho;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.421-431
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    • 2000
  • Background : The length of postoperative drug therapy remains controversial in pulmonary tuberculosis. We analyzed our experiences to determine the postoperative duration of chemotherapy after resection. Method : A retrospective review was performed in 66 of 95 patients that underwent pulmonary resection for pulmonary tuberculosis between January 1993 and December 1998. We compared the relapse rates according to the length of postoperative chemotherapy in each group, classified by the results of sputum AFB culture before the surgery, the number of resistant drugs, the number of prior treatment and the division of anti-TB drugs used postoperatively. Results : Fifty three of 66(80.3%) were men and 13(19.7%) were women with a median age of 33.5 years(range, 16 to 63). The mean lengths of the pre- and post-operative chemotherapies were 4.9 months, and 12.9 months respectively. Five of 66 patients (7.6%) relapsed during the mean period of follow up (39.7 months). In the group less than three times of the prior treatment, there were two relapses (20%) in Ed-the highlight above-rephrase 10 patients that were medicated for 6 months or less, and one relapse in 43 patients (2.3%) that took medicine for more than 6 months (p=0.03). In the group using second-line drugs postoperatively, there was one relapse (25%) in four patients that were medicated for 12 months or less. No patient in a total of 17 that received medicine for more than 12 months relapsed (p=0.03). Conclusion : We recommend that patients with the prior treatment less than three times should be treated for more than 6 months after resection and patients using the second-line drugs postoperatively should be medicated for more than 12 months.

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Clinical Parameters Predicting Responsiveness to Treatment in Enuresis Patients (야뇨증 치료반응 예측에 관계하는 평가지표)

  • Lee, Kang-Gyoon;Lee, Hyun-Jung;Lim, Yun-Ju;Kwon, Duck-Geun;Kim, Eun-Jin;Pai, Ki-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.272-279
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    • 2007
  • Purpose : We tried to find out the clinical parameters which predict the outcome of treatment in children with enuresis. Methods : Enuresis patients who visited our hospital during 2003-2007 were included. Parameters such as age, gender, height, weight, minimal voided volume, maximal voided volume, maximum functional bladder capacity, frequency of voiding, urine S,G. before and after sleep were measured and an enuresis diary was also recorded. The reduction in wetting frequencies were classified into three groups; none(<50%), partial(50-90%) and complete(90%) response groups. We also compared the 'initial responders' who showed improvement(${\ge}50%$) during the 2 weeks of evaluation and behavioral therapy to the 'initial non-responders'. Results : Parameters mentioned above showed no significant relation to the treatment out-come. The response rate during the 2 weeks of the evaluation period was 32%(49/151) [complete in 1.3% (2/151), partial in 29.6% (47/151)]. Two-months' treatment responses were complete in 14(40%), partial in 19(54.3%) and none in 2(5.9%) responders(n=35), while they were 10(13.5%), 46(62.2%) and 18(24.3%), respectively in the non-responders(n=73) (P<0.05). Conclusion : We suggest that initial 'responsiveness' can be used as a predictor for good treatment outcome in patients with enuresis.

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Clinical Characteristics of Headache in Orofacial Pain Patients (구강안면통증 환자에서의 두통 양상의 분류)

  • Kang, Jin-Kyu;Ryu, Ji-Won;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.355-364
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    • 2006
  • Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

Incidence of Vesicoureteral Reflux and Renal Scar in Asymptomatic Siblings of Patients with Primary Vesicoureteral Reflux (선천성 방광요관역류 환아의 형제자매에서 방광요관역류와 신반흔의 유병률)

  • Yu Je-Yun;Suck Hyo-Chung;Song Jun-Young;Park Moon-Sung;Kim Young-Soo;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.7 no.2
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    • pp.181-188
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    • 2003
  • Purpose : Vesicoureteral reflux(VUR) is known to be the main cause of childhood hypertension and renal failure. Knowing its familial occurrence, we determined the incidence of VUR and renal scar in asymptomatic siblings of Korean patients with primary VUR Methods : A total of 50 siblings from 37 index patients were included. Voiding cystourethro-graphy(VCUG) and renal scintigraphy using $^{99m}Tc-DMSA$ were peformed in these siblings from June, 1994 to May, 2001, Index patients were classified into two groups according to the presence of VUR in their siblings, and the clinical factors of the index patients such as age, sex, grade of reflux and renal cortical defect were compared between the groups. Results : Among the 50 siblings, VUR were found in 8(16%) and renal cortical defects were detected in 8(16%) siblings respectively. The incidence of renal cortical defects was 87.5%(7 out of 8) in the VUR(+) siblings. There was a case of VUR(-) cortical defect in one sibling, presumed as a scar from an old VUR. There was no relationship among age, sex, grade of reflux and renal cortical defect of the index patient to the presence of VUR in siblings. Conclusion : This study confirmed a significant incidence of VUR(16%) and renal cortical defects(16%) in the asymptomatic siblings of patients with primary VUR in Korea. It Is resonable to recommend screening studies to the siblings of patients with VUR for the early detection and prevention of probable reflux nephropathy. (J K orean Soc Pediatr Nephrol 2003;7:181-188)

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Prevalence of Drug-resistances in Patients with Pulmonary Tuberculosis and Its Association with Clinical Characteristics at One Tertiary Referral Hospital in Pusan, Korea (부산지역 한 3차 병원으로 내원한 폐결핵 환자에서 약제 내성률과 예측인자간의 연관성)

  • Son, Choon-Hee;Yang, Doo-Kyung;Rho, Mee-Sook;Jeong, Jin-Sook;Lee, Hyuck;Lee, Ki-Nam;Choi, Pil-Jo;Lee, Soo-Keol;Chang, Kwang-Yul;Choi, Ik-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.416-425
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    • 2001
  • Background : The incidence of drug-resistant tuberculosis has recently decreased in Korea. However, it is still one of the major obstacles in treating pulmonary tuberculosis. This study was performed to determine the prevalence and clinical characteristics associated with drug-resistance in pulmonary tuberculosis at the tertiary referral hospital in Pusan, Korea. Methods : The medical records of 138 patients, who had been diagnosed as active pulmonary tuberculosis were retrospectively reviewed, and results of drug susceptibility from May 1997 to June 2000. The relationships among those with a history of previous tuberculosis treatment, the extent of lung involvement, the presence of cavities on the initial chest X-ray films and patterns of drug resistance were analyzed. Results : The total number of patients who had drug resistance to at least one drug was 55(39.9%). Among them 34(24.6%) had resistance to isoniazid(INH) and rifampin(RFP). There was drug resistance in 20(22%) of 91 patients without previous tuberculosis therapy, and among them 9(9.9%) were multi-drug resistant. Thirty-two(74.5%) out of 47 patients with previous therapy were drug-resistant and 25(53.2%) were multidrug resistant. For all 138 patients, resistance to INH was the most common(34.1%), followed by RFP(26.1%) and ethambutol(EMB)(14.5%). Drug resistance to INH, RFP, PZA and streptomycin(SM) were independently associated with a history of previous treatment(odds ratio; 9.43, 9.09, 8.93 and 21.6 respectively, p<0.01). The extent of lung involvement on the chest films was significantly associated with the drug resistance to INH and RFP(odds ratio; 2.12 and 2.40 respectively, p<0.01). The prevalence of drug resistance to RFP, INH and RFP was significantly more common in patients with a cavitary lesion on the chest films by multivariate analysis(odds ratio; 4.17 and 4.81 respectively, p<0.05). Conclusion : This study revealed that patients with a prior treatment history for pulmonary tuberculosis, and the presence of a cavitary lesion on chest films had a higher prevalence of anti-tuberculosis drug resistance. A very careful clinical and microbiological examination is needed for patients with such characteristics.

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