• Title/Summary/Keyword: Chronic Patients

Search Result 5,247, Processing Time 0.034 seconds

Study of the Factors affecting Unmet Medical Needs in Patients with Cerebrovascular Diseases (뇌혈관질환자의 미 충족 의료에 미치는 영향요인 연구)

  • Lee, Jeong Wook
    • Journal of Digital Convergence
    • /
    • v.16 no.9
    • /
    • pp.279-291
    • /
    • 2018
  • This study is designed to demonstrate risk factors of unmet medical care for people with cerebrovascular disease. To do this, statistical analysis was performed by using hierarchical logistic regression analysis with SPSS/WIN24.0 program using Korean Medical Panel data in 2014. In the final model of the hierarchical logistic regression analysis, which is based on Anderson's Model, adjusted for the factors of the predisposing and enabling factors, the explanatory variables affecting the unmet medical development are gender, economic activity, income level, the experience of lying in a sickbed, restriction on activity, subjective health condition, and the number of chronic diseases. Based on the results of this study, the practical and policy implications for the effective management and treatment of cerebrovascular disease should be included in the countermeasures for cerebrovascular disease, a strategy to reduce the unmet medical incidence of cerebrovascular disease, in order to meet the medical needs, the necessity of comprehensive measures considering various dimensions of variables and the influential variables of unmet medical emergence have been suggested for the necessity of making a detailed service manual that can improve accessibility to medical services.

Sex-related Differences in DNA Copy Number Alterations in Hepatitis B Virus-Associated Hepatocellular Carcinoma

  • Zhu, Zhong-Zheng;Wang, Dong;Cong, Wen-Ming;Jiang, Hongmei;Yu, Yue;Wen, Bing-Ji;Dong, Hui;Zhang, Xiao;Liu, Shu-Fang;Wang, Ai-Zhong;Zhu, Guanshan;Hou, Lifang
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.13 no.1
    • /
    • pp.225-229
    • /
    • 2012
  • Background: Males have a higher prevalence of hepatocellular carcinoma (HCC) than females in general, but the reasons for the sex disparity are still obscure. DNA copy number alteration (CNA) is a major feature of solid tumors including HCC, but whether CNA plays a role in sex-related differences in HCC development has never been evaluated. Methods: High-resolution array comparative genomic hybridization (CGH) was used to examine 17 female and 46 male HCC patients with chronic hepatitis B virus (HBV) infection in Shanghai, China. Two-tailed Fisher's exact or ${\chi}^2$ tests was used to compare CNAs between females and males. Results: The overall frequencies and patterns of CNAs in female and male cases were similar. However, female HCC tumors presented more copy number gains compared to those in males on 1q21.3-q22 (76.5% vs. 37.0%, P = 0.009), 11q11 (35.3% vs. 0.0%, P = 0.0002) and 19q13.31-q13.32 (23.5% vs. 0.0%, P = 0.004), and loss on 16p11.2 (35.3% vs. 6.5%, P = 0.009). Relative to females, male cases had greater copy number loss on 11q11 (63.0% vs. 17.6%, P = 0.002). Further analyses showed that 11q11 gain correlated with 19q13.31-q13.32 gain (P = 0.042), 11q11 loss (P = 0.011) and 16p11.2 loss (P = 0.033), while 1q21.3-q22 gain correlated with 19q13.31-q13.32 gain (P = 0.046). Conclusions: These findings suggest that CNAs may play a role in sex-related differences in HBVassociated HCC development.

A Consensus Plan for Action to Improve Access to Cancer Care in the Association of Southeast Asian Nations (ASEAN) Region

  • Woodward, Mark
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.19
    • /
    • pp.8521-8526
    • /
    • 2014
  • In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.

An 1 year prospective comparative study evaluating the effect of microthread on the maintenance of marginal bone level (임프란트 미세나사선이 주위골 수준변화에 미치는 영향에 대한 1년간의 전향적 비교 연구)

  • Shin, Dong-Hwan;Cho, Kyoo-Sung;Park, Kwang-Ho;Moon, Ik-Sang
    • Journal of Periodontal and Implant Science
    • /
    • v.33 no.3
    • /
    • pp.349-358
    • /
    • 2003
  • The success of dental implant therapy relies mainly upon the presence and maintenance of bone adjacent to implant. An 1-year prospective study was performed, upon the patients who were diagnosed as having chronic adult periodontitis, and had been treated with dental implant. The purpose of this study was to measure the radiographic bone level changes proximal to Astra Tech Single Tooth Implants (ATST, Astra Tech AB, $M{\"{o}}lndal$, Sweden) with microthread and Astra Tech TiOblast Implant (ATTB) without microthread supporting fixed partial prosthesis. Measurements were used to determine mean marginal bone loss during the first year of loading, 17 subjects with its partial prosthesis supported by 37 implants were followed up for an 1-year period. The marginal bone loss of implants was positively correlated with the retention factor, microthread($Microthread^{TM}$) in crestal area of ATST. The results were as follows. 1. The mean marginal bone loss of ATST was 0.226${\pm}$0.395mm, while ATTB was 0.440${\pm}$0.360mm. There was a statistically significant difference between ATST and ATTB (p<0.05). 2. The mean bone loss of the upper jaw fixtures was 0.269${\pm}$0.265mm for ATST and 0.529${\pm}$0.417mm for ATTB . There was a statistically significant difference between ATST and ATTB (p<0.05). In the lower jaw the corresponding figures were 0.167${\pm}$0.231mm and 0.313${\pm}$0.214mm, respectively. There was no significant difference between ATST and ATTB (p>0.05). 3. The mean bone loss of ATST was lower than that of ATTB at all sites according to bone quality. There was a statistically significant difference between ATST and ATTB at bone quality type III(p <0.05). In conclusion, the mean bone loss of ATST was smaller than that of ATTB . Therefore, the retention factor of crestal area, microthread ($Microthread^{TM}$) was effective to maintenance of marginal bone level around fixture.

A Study on the Angle between the Abdominal Aorta and the Superior Mesenteric Artery by 3D Image Reconstruction (3D 영상 재구성을 통한 복부대동맥과 상장간막동맥과의 각도에 관한 연구)

  • Kim, Young-Keun;Choi, Sung-Kwan
    • Journal of radiological science and technology
    • /
    • v.26 no.1
    • /
    • pp.63-70
    • /
    • 2003
  • SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was $50.05{\pm}15.87^{\circ}$ on average, and that the angle in men($53.64{\pm}16.57^{\circ}$) is higher than in women($46.46{\pm}14.98^{\circ}$). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.

  • PDF

Gas Transfer and Hemolysis Characteristics of a New Type Intravenous Lung Assist Device (혈관 내 신형 폐보조장치의 기체전달 및 용혈 특성)

  • 김기범;권대규;정경락;이삼철
    • Journal of Biomedical Engineering Research
    • /
    • v.24 no.2
    • /
    • pp.121-126
    • /
    • 2003
  • The purpose of this work was to assess and quantify whether the beneficial effects in long-term gas exchange at exciting frequency were obtained at different frequencies as well and then to develop a vibrating intravascular lung assist device(VIVLAD), for Patients suffering from acute respiratory distress syndrome(ARDS) or chronic respiratory problems. We investigate the optimal condition of the frequency band excited with new vibrator at state of limit hemolysis when blood hemolysis came to through a membrane vibration action. The experimental design and procedures were given for a device used to assess the effectiveness of membrane vibrations. Quantitative experimental measurements were performed to evaluate the performance of the device . and to identify membrane vibration dependence on blood hemolysis. We developed an analytical solution for the hydrodynamics of flow through a bundle of sinusoidally vibrated hollow fibers that is used to provide some insight into how wall vibrations might enhance the performance of the VIVLAD. In the result, it was measured that the effect of various excited frequencies in gas transfer rate and hemolysis from the maximum gas transfer rate at no vibration when the maximum gas transfer rates showed at module type 6, module type 6 consisted of 675 hollow fiber membranes The maximum oxygen transfer rate was caused by the occurrence of maximum amplitude and transfer of vibration to hollow fiber membranes when it was excited by the frequency band of 7Hz at each blood flow rate. because this frequency became the End mode resonance frequency of the flexible in blood flow. Also, when module type 6 was excited at an excited frequency of 7Hz. blood hemolysis was low. Therefore, we decided that the limit of hemolysis frequency is 7Hz . because maximum amplitude occurred at this frequency.

Narcolepsy Variant Presented with Difficult Waking (각성장애로 발현한 기면증의 변종)

  • Lee, Hyang-Woon;Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
    • /
    • v.7 no.2
    • /
    • pp.115-119
    • /
    • 2000
  • Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.

  • PDF

Effect of the Changes in Forward Head Posture and Neutral Head Posture on Respiratory (전방머리자세와 중립자세에 대한 인위적 자세변화가 호흡에 미치는 영향)

  • Bae, Wonsik;Lee, Keoncheol;Park, Seungwook;Baek, Yonghyeon
    • Journal of The Korean Society of Integrative Medicine
    • /
    • v.5 no.1
    • /
    • pp.67-74
    • /
    • 2017
  • Purpose : Forward head posture is typical neck disorders occur in all people. And this attitude causes a shortening and weakening of the muscles in the body. It also causes excessive extension acts as a reward. This attitude has to change if the pain occurs around the neck and shoulders, and are subjected to unusual stress. Patients with chronic neck pain associated with forward head posture was found to be the more severe the fall of the respiratory, forward head posture poor quality of much breath. The purpose of this study was to compare the effect of changes in forward head posture and neutral head posture on respiratory. Method : Forty volunteers were participated in study and divided into two groups [forward head posture group (n=20) and neutral head posture group (n=20)]. We measured cervical alignment with global postural system to find out a forward head posture. Respiratory function was measured with a SPIROVIT SP-1 equipment and we found out a forced vital capacity (FVC), forced expiratory volume at one second (FEV1) and FEV1/FVC. A pared t-test was used to determine a statistical significance for the pulmonary function variation and a independent t-test was used to determine a statistical significance in the two groups. Results : In the experimental group, FVC and FEV1 were significantly higher in the artificial neutral head posture than in the forward head posture. In the control group, FVC and FEV1 were significantly higher in the neutral head posture than in the forward head posture. FVC, FEV1, and FEV1/ FVC were significantly higher in the neutral head posture of control group than the artificial neutral head posture of experimental group and higher in the artificial forward head posture of control group than the forward head posture of experimental group. Conclusion : In conclusion, neutral head posture is considered to be an important factor in correct posture and improvement of lung function and continuous study of posture correction program for posture imbalance will be needed.

A Case of End-Stage Renal Disease with Joubert Syndrome due to CEP290 Mutation (CEP290 돌연변이로 인해 발생한 Joubert 증후군 말기 신부전 1례)

  • Kim, Sung Hoon;Lee, Sang Taek;Seong, Moon-Woo;Kim, Man Jin;Lee, Jun Hwa
    • Journal of The Korean Society of Inherited Metabolic disease
    • /
    • v.20 no.1
    • /
    • pp.29-35
    • /
    • 2020
  • Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.

Detection of Antibody to Hepatitis C Virus in Psychiatric Inpatients (정신과(精神科) 입원(入院) 환자(患者)의 C형(型) 간염(肝炎) 항체(抗體) 양성솔(陽性率))

  • Cheon, Jin-Sook;Han, Ho-Sung
    • Korean Journal of Biological Psychiatry
    • /
    • v.2 no.1
    • /
    • pp.100-106
    • /
    • 1995
  • Antibodies to hepatitis C drew attention because of high morbidity to chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. HCV was known to be transmitted by transfusion, sexual behavior and parenteral drug use. However, some kind of autoimmune mechanism was suggested to be involved in the genesis of HCV-induced liver diseases. We hypothesized the prevalence of having anti-HCV might be higher in psychiatric patients rather than general population because of the characteristic route of transmission. Using Abbott HCV BA kit, anti-HCV was detected in the sera of 113 psychiatric inpatients from early December in 1992 to late May in 1994. The Positivity of anti-HCY was significantly(P<0.05) higher among psychiatric inpatients(10.6%) than in healthy controls(3.0%). There were no disease specificity among psychiatric inpatients who had anti-HCV, though alcoholics tended to have more anti-HCV. We couldn't find any significant correlation of anti-HCV with age, seasons of birth, lymphocytes (%) and liver function.

  • PDF