• Title/Summary/Keyword: Complex Chronic Disease

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Chewing difficulty and multiple chronic conditions in Korean elders: KNHANES IV (임상가를 위한 특집 3 - 한국 노인에서 저작불편감과 복합만성질 환의 연관성: 제4기 국민건강영양조사)

  • Han, Dong-Hun
    • The Journal of the Korean dental association
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    • v.51 no.9
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    • pp.511-517
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    • 2013
  • To assess the association between oral health and general health, this study examined the relationship between chewing difficulty and twelve chronic health conditions such as hypertension, hyperlipidemia, diabetes, cerebro- and cardiovascular disease, musculoskeletal disease, respiratory disease, eye/nose/throat disease, stomach/intestinal ulcer, renal dysfunction, thyroid disease, depression, and cancer in Korea. The study population was 3,066 elders aged 65 years old and more from the fourth Korean National Health and Nutrition Examination Survey. Chewing difficulty was measured on a 5-point Likert scale. Chronic conditions were assessed by self-reported questionnaire. Confounders were age, gender, education, income, smoking, drinking, and obesity. Chi-square test, general linear model, and multiple logistic regression model were done with complex sampling design. Musculoskeletal disease (adjusted odds ratio=1.33), respiratory disease (adjusted odds ratio=1.52), and cancer (adjusted odds ratio=1.58) were independently associated with chewing difficulty. Multiple chronic conditions with more than 4 chronic disease showed significant association with chewing difficulty (adjusted odds ratio=1.37).

Protective Effects of SAPP, a Novel Herbal Complex, in Acute Hepatotoxic Mouse Model

  • Lee, Geum Seon;Lee, Ki Man;Kim, Seung Hyun;Jeong, Nam-Joo;Kim, Young-Jung;Jung, Ju-Young;Kang, Tae Jin
    • Natural Product Sciences
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    • v.19 no.2
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    • pp.173-178
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    • 2013
  • The protective effect of SAPP, an extract from a novel herbal complex, on acute liver injury was investigated using mouse animal model in this study. The content of total phenol in SAPP was increased at dose dependent manner. Consistent with the content of total phenol, SAPP showed the significant anti-oxidative effects on 1, 1-diphenyl-2-picrylhydrazyl (DPPH) method. Acute liver injury was induced by D-galactosamine (D-GalN) in mouse. Treatment with SAPP significantly reduced the level of alanine transaminase (ALT) and aspartate transaminase (AST) in serum. Histological observation revealed that whereas D-GalN treated mouse showed vacuolization of hepatocytes, sinusoidal dilation and congestion, loss of cell boundaries and ballooning degeneration, loss of architecture and cell necrosis, treatment with SAPP improved D-GalN-induced liver injury. These results suggest that SAPP shows protective effects against D-GalN-induced hepatotoxicity in vivo acute mouse model.

Phenotype of Chronic Obstructive Pulmonary Disease Based on Computed Tomography-Defined Underlying Pathology

  • Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.85 no.4
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    • pp.302-312
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    • 2022
  • Chronic obstructive pulmonary disease (COPD) is a complex and heterogeneous disease. Not all patients with COPD respond to available drugs. Identifying respondents to therapy is critical to delivering the most appropriate treatment and avoiding unnecessary medication. Recognition of individual patients' dominant characteristics by phenotype is a useful tool to better understand their disease and tailor treatment accordingly. To look for a suitable phenotype, it is important to understand what makes COPD complex and heterogeneous. The pathology of COPD includes small airway disease and/or emphysema. Thus, COPD is not a single disease entity. In addition, there are two types (panlobular and centrilobular) of emphysema in COPD. The coexistence of different pathological subtypes could be the reason for the complexity and heterogeneity of COPD. Thus, it is necessary to look for the phenotype based on the difference in the underlying pathology. Review of the literature has shown that clinical manifestation and therapeutic response to pharmacological therapy are different depending on the presence of computed tomography-defined airway wall thickening in COPD patients. Defining the phenotype of COPD based on the underlying pathology is encouraging as most clinical manifestations can be distinguished by the presence of increased airway wall thickness. Pharmacological therapy has shown significant effect on COPD with airway wall thickening. However, it has limited use in COPD without an airway disease. The phenotype of COPD based on the underlying pathology can be a useful tool to better understand the disease and adjust treatment accordingly.

The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine - (30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 -)

  • Yoon, Jinwon;Choi, Sungyong;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.19 no.1
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

The Role of Innate and Adaptive Immune Cells in the Immunopathogenesis of Chronic Obstructive Pulmonary Disease

  • Nurwidya, Fariz;Damayanti, Triya;Yunus, Faisal
    • Tuberculosis and Respiratory Diseases
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    • v.79 no.1
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    • pp.5-13
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    • 2016
  • Chronic obstructive pulmonary disease (COPD) is a chronic and progressive inflammatory disease of the airways and lungs that results in limitations of continuous airflow and is caused by exposure to noxious gasses and particles. A major cause of morbidity and mortality in adults, COPD is a complex disease pathologically mediated by many inflammatory pathways. Macrophages, neutrophils, dendritic cells, and CD8+ T-lymphocytes are the key inflammatory cells involved in COPD. Recently, the non-coding small RNA, micro-RNA, have also been intensively investigated and evidence suggest that it plays a role in the pathogenesis of COPD. Here, we discuss the accumulated evidence that has since revealed the role of each inflammatory cell and their involvement in the immunopathogenesis of COPD. Mechanisms of steroid resistance in COPD will also be briefly discussed.

Experience of Patients Living with Chronic Renal Failure (만성신부전 환자의 체험)

  • 강성례;이병숙
    • Journal of Korean Academy of Nursing
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    • v.31 no.4
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    • pp.525-537
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    • 2001
  • The Purpose of the study was to understand the experience of chronic renal failure patients for the qualified individual care for them. The purpose of this study was to explore the experience of patients living with chronic renal failure and to identify the meaning and structure of their experience. The subjects were four patients, two females and two males. The age range was from 21 to 54. Data was collected with a few in-depth interviews by the authors until the data was fully saturated. The framework and methodology of this study was based on Parse′s "Human Becoming methodology," an existential phenomenological research methodology. The findings of this study were as follows. Three experience structures of chronic renal failure patients were : 1. Sufferings and conflicts originated in the frustration caused by uncurable disease. 2. Dependence upon God and significant others with complex emotions. 3. Acceptance of sufferings, emerging hope for serving people, and gratitude for living. In conclusion the experience of chronic renal failure patients could be described from the findings (three structures) as "Experiencing the sufferings, conflicts originated in the frustration caused by uncurable disease, dependence upon God and significant others with complex emotion, acceptance of the suffering and hope for serving people, and gratitude for living." The three structures of the lived experience of patients with chronic renal failure, the findings of this study, could be explained by the three concepts of "Theory of Human Becoming," the first structure could be explained with values, the second with revealing-concealing, and the third with transforming.

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The Biological Approach of Chronic Pain (만성동통에 대한 정신시체의학적 접근 -생물학적 접근-)

  • Oh, Byoung-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.1
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    • pp.91-97
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    • 1995
  • Pain is a complex symptom consisting of a sensation underlying potenial disease and associated emotional state. Acute pain is a reflex biological response to injury, in contrast, chronic pain consists of pain of a mininum of 6 months duration and associates with physical, emotional past experience, economic resources of the patient, family and society. Moreover, chronic pain is characterized by physiological affective and behavioral responses that are quite different than those of acute pain. The different type of stimuli exciting pain receptor are mechanical, thermal and chemical stimli and chronic pain are concerned with three of all stimli. The major three components of pain central(Analgesia) system in the brain and spinal cord are 'periaqueductal gray area of the mesencephalon', 'the raphe magnus nucleus' and 'pain inhibitory complex located in the dorsal horns of the spinal cord'. But unfortunately, the central biochemical mechanisms of chronic pain are not clearly defined. To proper management of chronic pain, comprehensive urderstanding as a psychosomatic aspect and multidisciplinary therapeuti-team approach must be emphasized.

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Effects of Herbal Complex, YJ-1, on Atopic Dermatitis in NC/Nga Mice Model (NC/Nga 마우스에서 생약 복합 조성물 YJ-1의 아토피성 피부염 치료 효능)

  • Lee, Geum-Seon;Lee, Ki-Man;Shim, Hong;Kim, Jin-Hong;Cheong, Jae-Hoon;Kang, Tae-Jin
    • YAKHAK HOEJI
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    • v.56 no.2
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    • pp.92-98
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    • 2012
  • This study was conducted to determine if YJ-1, a novel herbal complex from a mixture of six oriental herbs (Hydnocarpi Semen, Sesami Semen, Dictamni Radicis Cortex, Momordicae Semen, Xanthii Fructus, and Sophorae Radix), has therapeutic properties for the treatment of atopic dermatitis (AD). Using AD like symptom-induced NC/Nga mice by 1-chloro 2,4-dinitrobenzene (DNCB), the effectiveness of YJ-1 on AD was evaluated. Elidel cream$^{(R)}$ (1% pimecrolimus) was used as a control. Dermal application of YJ-1 reduced major clinical signs of AD such as erythema, pruritus, lichenification, edema/escoriations, and dryness. Interestingly, YJ-1 more improved AD-related symptoms including decrease of spleen weight, IL-4, and IgE level in the serum as well as reduction of scratching counts and clinical skin severity in the NC/Nga AD mouse model. Especially, treatment of YJ-1 at 20% in NC/Nga mice more effected than Elidel cream. These results suggest that the ointment of YJ-1 may enhance the process of AD healing by alleviating allergic reaction and has potential for therapeutic reagent for the treatment of AD.

Concept Analysis of Health Equilibrium in the Community-dwelling Elderly With Chronic Diseases (만성질환 노인의 건강 평형감에 대한 개념분석)

  • Kim, Jeong Soo
    • Journal of Korean Public Health Nursing
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    • v.26 no.3
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    • pp.428-439
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    • 2012
  • Purpose: The purpose of this study was to define and clarify the concept of 'equilibrium' in community-dwelling elderly persons with chronic diseases. Methods: A hybrid model was used for development of the concept of equilibrium. The model included a field study conducted in Seoul, Korea. Participants in this study included 12 elderly persons with chronic diseases who were taking medicine regularly. Results: The concept of equilibrium was found to be a complex phenomenon having meaning in two dimensions: the family-friendly and social relation-oriented dimensions. Four attributes and nine indicators were defined. Conclusion: Equilibrium was defined as the state of having health recognition, will power, and motive power (family-friendly dimension) and having a feeling of participation (social relation-oriented). Therefore, nurses who work with elderly persons with chronic disease in the community should be aware of the attributes and indicators of equilibrium in order to enhance the equilibrium of their elderly clients with chronic diseases.

Pharmacokinetic and Pharmacodynamic Modeling of Levodopa in Parkinson Disease

  • Holford, Nick H.
    • Proceedings of the PSK Conference
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    • 2002.10a
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    • pp.220-222
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    • 2002
  • The concentration effect relationship (pharmacokinetic pharmacodynamic model, PKPD) of drugs used for Parkinson's disease is complex. The benefits and adverse effects of drug treatment have to be considered in terms of short term and long term effects. Acute effects, observed over hours and days, reflect symptomatic benefit while chronic effects, observed over months and years, also reveal influences on the progress of the disease. (omitted)

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