• Title/Summary/Keyword: Clinical morbidity

Search Result 844, Processing Time 0.028 seconds

Safety of Thyroidectomy in Thyroid Cancer Patients Older than 75 Years (고령 갑상선암 환자의 갑상선 절제술의 안정성)

  • Yang, Seung Yoon;Kim, Seok-Mo;Kim, Soo Young;Kim, Bup-Woo;Lee, Yong Sang;Park, Cheong Soo;Chang, Hang-Seok
    • Korean Journal of Head & Neck Oncology
    • /
    • v.32 no.2
    • /
    • pp.5-8
    • /
    • 2016
  • Background and Objectives: The aim of this study was to evaluate the safety and the feasibility of thyroidectomy for aged (${\geq}75$ years old) thyroid cancer by reviewing postoperative morbidity and pathologic characteristics. Materials & Methods: The clinical records of patients submitted to thyroid operation between 2014 and 2015 with histopathological diagnosis of thyroid cancer were analyzed. Clinical variables included age, gender, preoperative symptom, final pathology, length of stay, comorbidities, American Society of Anesthesiologists score, postoperative complications, and mortality. Results: There were 30 patients aged more than 75 years old, and only one patient passed over with postoperative pneumonia. There were 8 male and 22 female patients. Half of the patients presented with symptoms such as palpable mass (33.3%), voice change (6.7%) and dyspnea (6.7%). The pathologic diagnosis was thyroid cancer in all cases. The median postoperative hospitalization time was 4 days. There was one perioperative mortality case observed in this study. Conclusion: Thyroid surgery in patients 75 years or older can be performed except extensive surgical resection. Aggressive histology and extent of surgery may be an important factor of perioperative mortality and morbidity.

Astrocyte lesions in cerebral cortex and cerebellum of dogs with congenital ortosystemic shunting

  • Williams, Alun;Gow, Adam;Kilpatrick, Scott;Tivers, Mickey;Lipscomb, Vicky;Smith, Ken;Day, Michael Oliver;Jeffery, Nick;Mellanby, Richard John
    • Journal of Veterinary Science
    • /
    • v.21 no.3
    • /
    • pp.44.1-44.10
    • /
    • 2020
  • Background: Congenital portosystemic shunt (cPSS) is one of the most common congenital disorders diagnosed in dogs. Hepatic encephalopathy (HE) is a frequent complication in dogs with a cPSS and is a major cause of morbidity and mortality. Despite HE been a major cause of morbidity in dogs with a cPSS, little is known about the cellular changes that occur in the central nervous system of dogs with a cPSS. Objectives: The objective of this study was to characterise the histological changes in the cerebral cortex and cerebellum of dogs with cPSS with particular emphasis on astrocyte morphology. Methods: Eight dogs with a confirmed cPSS were included in the study. Results: Six dogs had substantial numbers of Alzheimer type II astrocytes and all cases had increased immunoreactivity for glial fibrillary acidic protein in the cerebral cortex, even if there were minimal other morphological changes. Conclusions: This study demonstrates that dogs with a cPSS have marked cellular changes in the cerebral cortex and cerebellum. The cellular changes that occur in the cerebral cortex and cerebellum of dogs with spontaneously arising HE are similar to changes which occur in humans with HE, further validating dogs with a cPSS as a good model for human HE.

A Relation between Clinical Characteristics of Cancer Patients on Radiotherapy and Psychiatric Disorders (방사선 치료중인 암환자의 임상적 특징과 정신과 장애의 관련성)

  • Kim, Ho-Chan;Moon, Chang-Woo;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.7 no.1
    • /
    • pp.134-141
    • /
    • 1999
  • Objects : Cancer patients receiving radiotherapy have many psychological problems. Those problems depend on clinical factors of cancer and the characteristics of patients. This study was designed to estimate the morbidity of psychiatric disorder and to investigate the relationship between psychiatric disorders and clinical variables. Methods : The subjects were 47 patients who had been treated by radiotherapy. Psychiatric disorder was diagnosed according to DSM-IV. The authors assessed the relation between psychiatric disorder and demographic features, clinical features of cancer such as site, duration, frequency of recurrence of cancer, and patients' awareness of disease and expectation of outcome of radiotherapy. Results : 21 patients(44.7%) had a psychiatric disorder. The most common psychiatric disorder were adjustment disorder(66.7%), and the next major depressive disorder(23.8%). There was a significant positive relationship between psychiatric disorder and recurrence of cancer, patients' expectation of poor outcome after radiotherapy. Psychiatric morbidity was significantly low in those who had no evidence of recurrence and who considered radiation treatment as curative. However, site and duration of cancer, patients' awareness about serious illness were not related with psychiatric disorder. Conclusion : Psychiatric disorders are common among cancer patients on radiotherapy. Further clinical attention and effective treatment of psychiatric complication in cancer patients are needed not only for reducing symptoms but for better adjustment.

  • PDF

Healthcare-Associated Pneumonia (의료기관관련 폐렴)

  • Lee, Heung-Bum;Han, Hyo-Jin
    • Tuberculosis and Respiratory Diseases
    • /
    • v.70 no.2
    • /
    • pp.105-112
    • /
    • 2011
  • Pneumonia is frequently encountered in the clinical fields, both as a cause for admission and as a complication of the underlying disorder or as the course of treatment. Pneumonia is the second most common hospital-acquired infection and is associated with the highest morbidity and mortality rates among hospital-acquired infections. The guidelines for the management of hospital-acquired pneumonia by the American Thoracic Society include identifying individuals who have recently received antibiotics therapy or have been in medical facilities; these individuals are at higher risk for infection with multiple drug resistant organisms. Individuals, who have acquired pneumonia according to this clinical scenario, have what is known as healthcare-associated pneumonia (HCAP). Patients with HCAP should be considered to have potentially drug-resistant pathogens and should receive broad spectrum empiric antibiotic therapy directed at the potentially resistant organisms. In this paper, the diagnosis, risk factors, and treatment of HCAP are discussed.

Lung Regeneration Therapy for Chronic Obstructive Pulmonary Disease

  • Oh, Dong Kyu;Kim, You-Sun;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
    • /
    • v.80 no.1
    • /
    • pp.1-10
    • /
    • 2017
  • Chronic obstructive pulmonary disease (COPD) is a critical condition with high morbidity and mortality. Although several medications are available, there are no definite treatments. However, recent advances in the understanding of stem and progenitor cells in the lung, and molecular changes during re-alveolization after pneumonectomy, have made it possible to envisage the regeneration of damaged lungs. With this background, numerous studies of stem cells and various stimulatory molecules have been undertaken, to try and regenerate destroyed lungs in animal models of COPD. Both the cell and drug therapies show promising results. However, in contrast to the successes in laboratories, no clinical trials have exhibited satisfactory efficacy, although they were generally safe and tolerable. In this article, we review the previous experimental and clinical trials, and summarize the recent advances in lung regeneration therapy for COPD. Furthermore, we discuss the current limitations and future perspectives of this emerging field.

Clinical Characteristics, Presentation, and Outcomes of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension

  • Kim, Do-Hyun;Kim, Han-Suk
    • Neonatal Medicine
    • /
    • v.25 no.3
    • /
    • pp.91-95
    • /
    • 2018
  • Bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) is increasingly being recognized as a cause of morbidity and mortality in preterm infants. Recently, BPD-PH has also been shown to have additional long-term negative effects on neurodevelopmental outcomes and right ventricular function. Several significant risk factors associated with the development of BPD-PH have been identified. A screening strategy for BPD-PH is needed for infants presenting more than one risk factor. In addition, an early echocardiogram within 14 days of age may be a useful tool to identify infants at high-risk for BPD-PH. We have reviewed recent progress in research concerning clinical characteristics, presentation, and outcomes of BPD-PH and have suggested direction for future studies.

Multiple extrarenal manifestations in hemolytic uremic syndrome: A case report (다발성 신외 증상이 동반된 용혈요독증후군 1례)

  • Kim, Eugene;Kim, So-Young
    • Clinical and Experimental Pediatrics
    • /
    • v.50 no.12
    • /
    • pp.1261-1265
    • /
    • 2007
  • Extrarenal manifestations of hemolytic uremic syndrome (HUS) have increasingly been recognized and may be major determinants of mortality and morbidity. Although microthrombi are often found in the pulmonary and coronary circulation, apparent lung and cardiac involvement are clinically infrequent. We describe here a 10-month-old boy with HUS who developed pulmonary hemorrhage, acute respiratory distress syndrome and dilated cardiomyopathy. Complete renal as well as clinical recovery from these very uncommon complications was achieved by optimum supportive care.

Hidden Hematologic Disease in Trauma Patients: A Report of Two Cases

  • Jang, Sung Woo;Jung, Pil Young
    • Journal of Trauma and Injury
    • /
    • v.33 no.2
    • /
    • pp.112-118
    • /
    • 2020
  • In trauma patients, coagulopathy and abnormal increases or decreases in cell counts are frequently observed, and are associated with high mortality and morbidity in the acute phase of trauma. Because major trauma is often life-threatening, and hematologic abnormalities are multi-factorial and transient, major blood loss is usually suspected to be the primary cause of these abnormalities, and much time and cost may be spent attempting to identify a focus of hemorrhage that might or might not actually exist. Persistent abnormalities in the complete blood count, however, require clinical suspicion of other hematologic diseases to minimize improper transfusions and to improve outcomes, including mortality. Physicians at trauma centers should be familiar with the clinical characteristics of hematologic diseases and should consider these diseases in trauma patients. In this report, we present cases of two hematologic disorders found in trauma patients: autoimmune hemolytic anemia induced by systemic lupus erythematosus and myelodysplastic syndrome.

Evaluation of Appropriate Management of Chronic Obstructive Pulmonary Disease in Korea: Based on Health Insurance Review and Assessment Service (HIRA) Claims

  • Chung, Sang Mi;Lee, Sung Yong
    • Tuberculosis and Respiratory Diseases
    • /
    • v.80 no.3
    • /
    • pp.241-246
    • /
    • 2017
  • Chronic obstructive pulmonary disease (COPD) is an ambulatory care-sensitive condition, and effective treatment of outpatients can prevent worsening of the illness and hospitalization. Current COPD guidelines provide appropriate guidance for the diagnosis and treatment of patients with COPD. In fact, it has been shown that when appropriate guidance and treatment are performed, the morbidity and mortality rates of COPD patients are reduced. However, there is a gap between the clinical guidelines and the actual clinical treatment. Therefore, the Health Insurance Review and Assessment Service (HIRA) conducted an evaluation of the adequacy of COPD diagnosis and treatment using the Claims Database of HIRA. This review provides a summary of the COPD adequacy assessment results reported by the HIRA and some brief comments on the results.

Clinical Application of PET in Abdominal Cancers (소화기 암에서 PET의 임상적 의의)

  • Choi, Chang-Woon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.36 no.1
    • /
    • pp.39-45
    • /
    • 2002
  • Clinical application of positron emission tomography (PET) is rapidly increasing for the defection and staging of cancer at whole-body studios performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in the liver and the other abdominal organs, it is particularly useful for identification and characterization of the entire body simultaneously. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterizing of indeterminate soft-tissue masses. Most abdominal cancer requires surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The abdominal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea, and PET is one of the most promising and useful methodologies for the management of abdominal cancers.