• Title/Summary/Keyword: Complex Chronic Disease

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Study on Syndrome Differentiation of Gastritis by Korean Standard Classification of Dsease and Cause of Death (한국표준질병 사인분류에 따른 위염(胃炎)의 한의학적 변증 연구)

  • Park, Mi Sun;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.5
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    • pp.255-263
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    • 2017
  • This article is for understanding relations between the classifications of gastritis and syndrome differentiation types of Korean Medicine through research on syndrome differentiations of clinically applied gastritis and literature of Korean Medicine. Clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI) from 1995 to 2015. Conclusions are as follows. First, disease mechanism of chronic gastritis are qi stagnation, damp stagnation, heat obstruction, blood stasis obstruction, yin damage, damage to collaterals with healthy qi deficiency and pathogenic qi. And qi movement stagnation is shown through the status of chronic gastritis. Second, chronic superficial gastritis belongs to qi aspect syndrome and mainly pathogen excess syndrome. And the key mechanisms are congestion and disharmony of stomach qi sometimes combined with liver depression, food accumulation and dampness-heat. Third, chronic atrophic gastritis belongs to qi-blood syndrome and deficiency-excess complex syndrome with the root of spleen qi deficiency and stomach yin deficiency and the tip of blood stasis, qi stagnation. And key mechanism is damage to collaterals with healthy qi deficiency and toxin-blood stasis. Forth, pathogen excess syndromes are shown at the early stage of chronic gastritis and healthy qi deficiency syndromes after the middle stage. Qi deficiency is shown at the beginning of the disease and yin deficiency at the late stage. And qi deficiency is related with superficial gastritis and yin deficiency with atrophic gastritis.

Factors Affecting Unmet Healthcare Needs among Adults with Chronic Diseases (만성질환을 가진 성인의 미충족 의료 영향요인)

  • Han, Ji-Young;Park, Hyeon-Sook
    • Research in Community and Public Health Nursing
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    • v.32 no.2
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    • pp.131-139
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    • 2021
  • Purpose: In adults with chronic diseases, unmet healthcare needs are likely to increase the risk of worsening the illness and complications. This study was conducted to explore factors affecting unmet healthcare needs among adults with chronic diseases. Methods: A cross sectional study was performed using the data from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2017. The sample of this study consisted of 6,104 adults with chronic diseases. The data were analyzed by Rao-Scott 𝑥2 test and logistic regression using complex samples analysis. Results: The proportion of subjects who experienced unmet healthcare needs was 10.9% of adults with chronic diseases. The factors affecting unmet healthcare needs of adults with chronic diseases were age, gender, employment status, household income, subjective health status, activity limitation, and perceived stress. Conclusion: The findings of this study suggest that various factors may be associated with their unmet healthcare needs. Finally, the development of strategies to reduce unmet healthcare needs for people with chronic diseases should consider the associated factors presented in the study.

Strategies for Renal Protection in Cardiovascular Interventions

  • Ziad A. Ali;Javier Escaned;Dariusz Dudek;Jai Radhakrishnan;Keyvan Karimi Galougahi
    • Korean Circulation Journal
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    • v.52 no.7
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    • pp.485-495
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    • 2022
  • Coronary artery disease is highly prevalent in chronic kidney disease (CKD) and is a risk factor for contrast-associated acute kidney injury (CA-AKI), a complication of cardiovascular procedures that require contrast administration (e.g., coronary angiography, percutaneous coronary intervention [PCI]). CA-AKI has a major impact on morbidity, mortality, and healthcare resource utilization. The incidence of CA-AKI is particularly high in patients with pre-existing CKD, advanced age and comorbidities that increase the likelihood of CKD. The focus of the present review is to provide a brief overview on the assessment of the risk for and prevention of CA-AKI in patients undergoing angiography and PCI, including recognition of the important patient- and procedure-related factors that may contribute to CA-AKI. Preventive and treatment strategies, the mainstay of which is volume repletion by normal saline, are briefly discussed. The main focus of the review is placed on technical details of contrast minimization techniques, including ultra-low contrast angiography and zerocontrast PCI. Operator competence in such techniques is important to ensure that procedural challenges in patients with CKD, like vessel calcification, multivessel disease and complex anatomical subsets, are effectively addressed by PCI while minimizing the risk of CA-AKI.

Searching for Hidden, Painful Osteochondral Lesions of the Ankle in Patients with Chronic Lower Limb Pain - Two Case Reports -

  • Ri, Hyun Su;Lee, Dong Heon;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.26 no.2
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    • pp.164-168
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    • 2013
  • It is easy to overlook osteochondral lesions (OCLs) of the ankle in patients with chronic lower limb pain, such as complex regional pain syndrome (CRPS) or thromboangiitis obliterans (TAO, Buerger's disease). A 57-year-old woman diagnosed with type 1 CRPS, and a 58-year-old man, diagnosed with TAO, complained of tactile and cold allodynia in their lower legs. After neurolytic lumbar sympathethic ganglion block and titration of medications for neuropathic pain, each subject could walk without the aid of crutches. However, they both complained of constant pain on the left ankle during walking. Focal tenderness was noted; subsequent imaging studies revealed OCLs of her talus and his distal tibia, respectively. Immediately after percutaneous osteoplasties, the patients could walk without ankle pain. It is important to consider the presence of a hidden OCL in chronic pain patients that develop weight-bearing pain and complain of localized tenderness on the ankle.

The Frozen Elephant Trunk Technique: European Association for Cardio-Thoracic Surgery Position and Bologna Experience

  • Marco, Luca Di;Pantaleo, Antonio;Leone, Alessandro;Murana, Giacomo;Bartolomeo, Roberto Di;Pacini, Davide
    • Journal of Chest Surgery
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    • v.50 no.1
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    • pp.1-7
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    • 2017
  • Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted. However, the FET technique is associated with a non-negligible incidence of spinal cord injury, due to the extensive coverage of the descending aorta with the excessive sacrifice of intercostal arteries. The indications for the FET technique include chronic thoracic aortic dissection, acute or chronic type B dissection when endovascular treatment is contraindicated, chronic aneurysm of the thoracic aorta, and chronic aneurysm of the distal arch. The F ET technique is also indicated in acute type A aortic dissection, especially when the tear is localized in the aortic arch; in cases of distal malperfusion; and in young patients. In light of the great interest in the FET technique, the Vascular Domain of the European Association for cardio-thoracic Surgery published a position paper reporting the current knowledge and the state of the art of the FET technique. Herein, we describe the surgical techniques involved in the FET technique and we report our experience with the F ET technique for the treatment of complex aortic disease of the thoracic aorta.

Factors Associated with HINT-8 Index (Korean Health-Related Quality of Life Instrument with Eight Items), Focusing on Health Habits, Hand Grip Strength, Chronic Diseases, Mental Health, and Nutrient Intake Status in Korean Older Adults: Based on Korea National Health and Nutrition Examination Survey 2019 Data (우리나라 고령자의 HINT-8 (한국형 건강 관련 삶의 질 측정도구)에 따른 건강습관 및 근력, 만성질환, 정신건강, 영양소 섭취상태 분석: 2019 국민건강영양조사자료)

  • Hye-Sang Lee
    • Journal of the Korean Dietetic Association
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    • v.30 no.2
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    • pp.112-124
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    • 2024
  • This study investigated the factors associated with HINT-8 (Korean health-related quality of life instrument with eight items), including health habits, hand grip strength, chronic disease, chewing function, mental health, and nutrient intake. In this study, the health-related quality of life (HRQoL; HINT-8) was assessed using the data from the 2019 Korea National Health and Nutrition Examination Survey (KNHANES VIII) among Koreans aged over 65, with HINT-8 being evaluated based on the general characteristics. Of the participants from KNHANES VIII, 1,455 subjects were analyzed using SPSS statistics complex samples (Windows ver. 27.0). The HINT-8 score was significantly lower in females and in those aged 75 years or older, lowest educational level, lowest income level, and single households. Logistic regression analysis, adjusted for the general characteristics, revealed a significant association between a lower HINT-8 group and various factors: low aerobic physical activity (OR=1.71, 95% CI=1.25~2.35), low hand grip strength (OR=1.34, 95% CI=1.02~1.78), chewing difficulties (OR=2.17, 95% CI=1.62~2.92), poor self-rated health status (OR=6.11, 95% CI=4.42~8.45), stressful mental status (OR=3.57, 95% CI=2.27~5.63) and poor calcium status (OR=1.45, 95% CI=1.11~1.88). On the other hand, this study could not reveal a significant association between a lower HINT-8 group and factors such as smoking, drinking, chronic disease, and nutrient intake status, except for calcium intake. This study suggests that HINT-8 is associated with aerobic physical activity, hand grip strength, chewing function, mental health, and calcium intake, but not with smoking, drinking, chronic disease, and nutrient intake.

Hepatoprotective Effect of Alnus japonica and Portulaca oleracea Complex on Alcohol-induced Liver Injury Mice Models by Anti-oxidation Activity

  • Dong ki Hong;Soodong Park;Jooyun Kim;Jaejung Shim;Junglyoul Lee
    • Korean Journal of Plant Resources
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    • v.36 no.3
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    • pp.198-206
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    • 2023
  • The effectiveness of the extracts of Alnus japonica and Portulaca oleracea, which are effective in improving alcohol-induced liver damage, was confirmed using acute and chronic alcoholic liver injury animal models. In the acute alcoholic liver injury model, dieting Alnus japonica and Portulaca oleracea complex (ALPOC) at a dose of 50 mg/kg showed no significant change in liver or body weight, while measured plasma ALT activity to be deficient (28.12 U/ml) compared to the alcohol intake group (42.5 U/ml), and confirmed that restored it to an average level. It showed an improvement of 34.9% compared to the alcohol intake group. AST activity confirmed that it showed a very effective liver protection activity by showing a gain of 12.6%. The chronic alcoholic liver damage animal model demonstrated that ALT showed an improvement effect of 25%, and AST showed an effect similar to that of the positive control group, Hovenia extract. In addition, through H&E staining analysis, observed that the ALPOC improved the necrosis and bleeding of the liver. And the ALPOC group showed intense antioxidant activity of 127% or more compared to the alcohol intake group, and this was confirmed to have a very high activity, which is more than 20% higher than that of the hovenia fruit extract.

Endoscopy Finding of Patients Who Complained of the Upper Digestive Symptoms after Taking Oriental Herb Decoctions

  • Kim, Dong-Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.4
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    • pp.987-992
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    • 2008
  • This study was carried out to understand the macroscopic aspects of the digestive system symptoms occurring after taking oriental herb complex decoction as observing morphological changes in esophagus, stomach and duodenal bulb by endoscopy of upper gastrointestinal tract when these symptoms developed. The subjects of this study were 46 patients (male 22, female 24, mean age : $54.72{\pm}14.26$ years) who were chosen among ones who took oriental herb complex decoction for medical care and developed symptoms related to the gastrointestinal tract while taking an oriental herb decoction, which were assumed that the digestive symptoms were newly developed because of administration. The subjects were given morphological examination by endoscopy of the upper gastrointestinal tract. As a result of the endoscopy operated due to the digestive symptoms developed during the administration of oriental herb decoction, there were 2 cases of esophagitis, 5 cases of acute gastritis, 1 case of chronic gastritis A type, 15 cases of chronic gastritis B type, 1 case of duodenitis, 1 case of gastric ulcer, 1 case of gastric polyp, 2 cases of intestinal metaplasia, 1 case of gastric ptosis and 17 cases of normal findings which didn't have any abnormality macroscopically with endoscopy. With regards to the patients who complained of the digestive symptoms after taking oriental herb decoction, it has been found that the symptoms occurred as the oriental herbal medicine taken by the patients who had the digestive symptoms at ordinary times influenced on the gastrointestinal tract. Especially, many of them were had chronic gastritis and functional dyspepsia in the past. The disease accompanying macroscopic lesions at endoscopy which occurred due to the oriental herb decoction as direct cause, was acute gastritis, and it was the prescription to cure the pains and inflammations of skeletomuscular disease.

CUBN mutation: a benign genetic cause of proteinuria?

  • Hyun Kyung Lee
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.19-25
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    • 2023
  • Proteinuria is an important risk factor for renal and cardiovascular disease. It is associated with a risk for glomerulonephritis, chronic kidney disease, and end-stage renal disease. Therefore, if persistent proteinuria is detected, kidney biopsy is considered to diagnose and treat the underlying disease. Recently, variants in the cubilin (CUBN) gene, which is associated with albuminuria, have been reported. This gene encodes cubilin, a membrane glycoprotein receptor expressed in the renal proximal tubules. Cubilin is a component of the megalin and cubilin-amnionless complex that mediates albumin reabsorption into the proximal tubules through endocytosis. A defect in cubilin leads to a reduction in albumin reuptake, resulting in albumin-dominant proteinuria. Although numerous controversies exist, several reports suggest that cubilin defects lead to proteinuria with a high portion of albuminuria but may not impair renal filtration function. If albuminuria due to reduced cubilin function is confirmed as a benign condition, we can consider using genetic studies to detect CUBN mutations in patients with proteinuria and they may not require any treatment or kidney biopsy. Here, we review recent papers on CUBN mutations and discuss the prognosis and management of individuals with this mutation.

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.