• Title/Summary/Keyword: 중증질환

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An overview of the regulatory effect of vitamin D supplementation on atopic dermatitis (비타민 D의 기능성: 아토피피부염의 조절에 미치는 영향 연구)

  • Sung, Dong Eun
    • Korean Journal of Food Science and Technology
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    • v.53 no.2
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    • pp.139-148
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    • 2021
  • Atopic dermatitis is a chronic, recurrent, inflammatory skin disease that is a well-known allergic disease with severe itching, making daily life difficult. Since the immunomodulatory action of vitamin D has been reported, several researchers have attempted to determine the correlation between vitamin D and atopic dermatitis. In this review, 41 articles meeting the inclusion criteria were selected and reviewed from the articles published to date. Several studies have reported that low vitamin D levels are associated with the onset of atopic dermatitis and severe atopic dermatitis, but the opinions remain conflicting. Similarly, there are conflicting opinions on the improvement effect of oral vitamin D supplementation on atopic dermatitis, but some possibilities have been suggested. To apply vitamin D as a therapeutic agent for atopic dermatitis, a more systematically designed experiment should be conducted, and an appropriate intake dose for an immunomodulatory function should be obtained.

Impacts of Health Insurance Coverage Expansion on Health Care Utilization and Health Status (건강보험 보장성 확대가 의료이용 및 건강수준에 미치는 영향)

  • Bae, Ji-Young
    • Korean Journal of Social Welfare Studies
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    • v.41 no.2
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    • pp.35-65
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    • 2010
  • The purpose of this study is to identify the relationship between health insurance and health by evaluating the impacts of health insurance coverage expansion on health care utilization and health status. To analyze the causal relationship between health insurance and health, this study employed a "difference-in-difference method" that could compare changes in health care utilization and health status across groups in health insurance coverage expansion in 2005. The researcher predicted that the expansion of health insurance coverage would be an exogenous source of variation in the prices of health service use. First, the difference-in-differences estimator between 'illness group' and 'non-illness group' revealed that the increase in coverage of inpatient care services would result from the increases in the stay of length of 'non-illness group' rather than that of 'illness group'. However, the difference-in-differences estimator between 'serious illness group' and 'chronic illness group' identified that the policy change that focuses on expansion of the coverage for 'serious illness' effects on the increases in health care utilization and promotion of health status. In summary, the changes of health insurance coverage focusing on serious illness and inpatient care have positive effects on health care utilization and health status of serious illness group. But, 'non-illness groups' with acute illness receive more benefits from the policy change than 'illness group' with chronic illness.

Effects of Combined Breathing Exercise and Neuromuscular Electrical Stimulation on Patients with Severe COPD (중증 만성폐쇄성폐질환 환자를 위한 복합호흡운동과 신경근전기자극의 효과)

  • Kang, Jeong-Il;Park, Jun-Su;Jeong, Dae-Keun
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.539-548
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    • 2019
  • This study was designed to examine the effects of complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle on pulmonary function and cerebral cortex activity in patients with severe chronic obstructive pulmonary disease. After collecting samples from 20 patients with severe chronic obstructive pulmonary disease aged 60 to 80, 10 patients each were randomly placed in an experimental group and a control group. The experimental group conducted complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle, and the control group only conducted complex breathing exercise. As a pretest, pulmonary function and cerebral cortex activity were measured. The intervention program was applied to each group for 30 minutes, once a day, for 4 days a week, for 6 weeks, and the posttest was carried out the same way as the pretest. As a result, both groups showed significant differences in FEV1.0(Forced Expiratory Volume in One Second)(p<.001)(p<.05), and there were significant differences between the groups as well(p<.05). When comparing alpha waves in each domain of cerebral cortex, both of the experimental and control groups showed significant differences in Fp1, Fp2, F3 and F4 domains (p<.01)(p<.05). During the 6-week experiment, complex breathing exercise and neuromuscular electrical stimulation of Quadriceps Femoris muscle improved pulmonary function of patients with severe chronic obstructive pulmonary disease, and in relation to cerebral cortex activity, a positive breathing change was found due to the increase of alpha waves in the forehead domain. Therefore, it is considered that applying neuromuscular electrical stimulation of Quadriceps Femoris muscle to patients with severe chronic obstructive pulmonary disease additionally along with complex breathing exercise will bring a better therapeutic effect.

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

A New Healthcare Policy in Korea Part 3: Ultrasound and MRI in Urogenital Disorders (새로운 건강보험 보장성 강화 대책 3부: 비뇨생식기 초음파 및 MRI 급여 확대)

  • Young Sup Shim;Kye Jin Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1083-1095
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    • 2020
  • Since 2019, ultrasound and magnetic resonance imaging for evaluation of urogenital disorders have been covered by the National Health Insurance (NHI) in Korea. Patients with urogenital malignancies were already insured by NHI for ultrasound and MRI. With the expansion of NHI coverage, patients with suspected prostate or gynecologic cancer, uterine fibroids before myomectomy and some other benign disease such as congenital anomaly can receive benefits of NHI. In consideration of these changes, radiologists and other clinicians should be aware of the indications and standard images of each examination and the required reporting forms. Clinical application based upon thorough understanding of the NHI guidelines will aid in improving the standard care of patients.

A Review of Prevention and Treatment of the Crimes on the Characteristics of Mental Illness (정신질환의 특성에 따른 범죄 예방과 치료에 관한 소고)

  • Kim, Myung Shig;Lee, Man Seok
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.549-555
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    • 2021
  • This study reviewed the important preceding studies of prevention and treatment of the crimes and therapies on the characteristics of mental illness, trying to investigate and identify more effective ways to prevent, decrease the crimes of the mentally ill and treat them. The main results were as follows. First, relationships between mental illness and crimes have been inconsistently reported, to investigate environmental stresses and triggers of the mentally ill additionally. Second, the term 'mentally illness' was to be defined more specifically, such as severe psychiatric disabled, antisocial personality disorder, intellectual disability, anger·impulse control disorder, and drug abuse. If medication and psychosocial treatments were properly treated to the severe psychiatric disabled, their crime incidence and recidivism will be decrease enough to live with their neighbors in community. But the ways and processes of treating antisocial personality disorder, intellectual disability, anger·impulse control disorder, and drug abuse were very different from it, requiring more intense psychological, medical and biological interventions and social seclusion. The national campaigns and projects for their human rights and community care will be needed to promote the therapeutic effects for them. The limitation and future tasks were discussed.

Current Strategy in Endovascular Management for Below-the-Knee Arterial Lesions (무릎 밑 동맥의 혈관 내 치료의 최신 지견)

  • Kyosoo Hwang;Sang Woo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.541-550
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    • 2021
  • The below-the-knee arterial tree is the thinnest of all the leg vessels and is an important path for blood flow to the foot. Hence, lesions including stenosis, especially obstruction, may lead to critical limb ischemia which represents the most severe clinical manifestation of peripheral arterial disease. It is characterized by the presence of ischemic rest pain, ischemic lesions, or gangrene attributable to the objectively proven arterial occlusive disease. Typically, the atherosclerotic disease process involving the below-the-knee arterial tree is diffuse in the majority of patients. The cornerstone of therapy is vascular reconstruction and limb salvage. Revascularization should be attempted whenever technically possible, without delay, in patients presenting critical limb ischemia and when the clinical status is not hopelessly non-ambulatory. Therefore, endovascular treatment can become the gold standard for the full range of patients including below-the-knee, limiting the clinical role of the classically trained surgeons.

The Clinical Value of Intima-media Thickness in Patients with Stable Coronary Artery Disease and C-reactive Protein within Normal Limits (경동맥 내중막 두께가 정상 C-반응성 단백질 농도를 가진 안정형 협심증 환자에서 가지는 임상적 의의)

  • Kwon, Jong-Bum;Park, Kuhn;Choi, Si-Young;Park, Chan-Beom;Kim, Yong-Hwan;Her, Sung-Ho;Park, Mahn-Won;Lee, Jong-Ho
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.482-489
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    • 2010
  • Background: The purpose of this study was to determine whether hand-measured carotid intima-media thickness (IMT) was a reliable and simple tool that could be used to evaluate the severity of stable coronary artery disease (CAD) with normal high-sensitivity C-reactive protein (CRP). Material and Method: We examined left carotid IMTs in 688 patients with stable CAD and excluded 121 patients with abnormally elevated hs-CRP ($\geq$0.5 mg/dL). We sought to determine the association between risk factors and the severity of stable CAD and carotid IMT in 567 patients who were divided into lower and higher groups based on the median value. Patients underwent a coronary artery angiogram and had at least significant stenosis (>50% of the original luminal diameter involving one or more major coronary artery). Result: Of the 567 patients, 300 (52.9%) were in the lower IMT group and 267 (47.1%) were in the higher IMT group; the median value was 0.76 mm. By multivariable logistic regression analysis, the following groups were different: older age (~49 vs. 70~ years, respectively; OR=6.552), high FBS (~99 vs. 120~ mg/dL; OR=1.713) and severity of CAD (1 vessel vs. 2 vessel disease; OR=1.711, 1 vessel vs. 3 vessel disease; OR=1.714). Conclusion: We conclude that there are correlations between increased carotid IMT and severity of CAD in stable angina patients with normal CRP levels.

Right Ventricle Ejection Fraction Contributes Severity of Dyspnea in Chronic Obstructive Pulmonary Disease (COPD) (만성폐쇄성폐질환 환자의 호흡곤란 평가에서 우심실 박출계수의 의의)

  • Lee, Jung Eun;Min, Bo Ram;Park, Jae Seok;Park, Hun Pyo;Jun, Mi Jung;Won, Kyung Sook;Choi, Won Il
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.631-637
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    • 2006
  • Background: Patients with COPD generally complain of very different degrees of dyspnea regardless of their pulmonary function. The study, we assessed the right ventricular ejection fraction in relation to dyspnea in COPD patient. Methods: The pulmonary function including the diffusion capacity was measured. The right ventricle ejection fraction (RVEF) was measured using a first-pass radionuclide scan by multigated acquisition (MUGA). Forty patients with chronic obstructive pulmonary disease (COPD) were stratified for dyspnea according to the Medical Research Council (MRC) scale. Moderate dyspnea and severe dyspnea is defined as MRC 2/3 (n = 16) and MRC 4/5 (n = 24) respectively. Results: The baseline pulmonary function tests including DLCO and the resting arterial blood gas were similar in the moderate and severe dyspnea group, with the exception of the residual volume (% predicted) (moderate $160{\pm}27$, severe $210{\pm}87$, p < 0.03). The right ventricle ejection fraction was significantly (p < 0.001) lower in the severe dyspnea group ($25{\pm}8$) than in the moderate group ($35{\pm}6$). The independent factor assessed by multiple logistic regression revealed only the severity of dyspnea to be significantly associated with RVEF (p < 0.02). Conclusion: This study showed that the right ventricle ejection fraction would contributes to severity of dyspnea in patients with a similar pulmonary function.

Diagnosis of Coronary Artery Disease using Myocardial Perfusion SPECT in Patients with Diabetes Mellitus: Analysis of Risk Factors (당뇨병 환자에서 심근관류 SPECT을 이용한 관동맥질환의 진단: 위험인자 분석)

  • Seo, Ji-Hyoung;Kang, Seong-Min;Bae, Jin-Ho;Jeong, Shin-Young;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.155-162
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    • 2006
  • Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is glowing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 diabetic patients (64 male, mean age $64.1{\pm}9.0$ years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was $36{\pm}18$ months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no cardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses. Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events.