• 제목/요약/키워드: Disease management

검색결과 5,618건 처리시간 0.038초

Incidence and outcome of congenital anomalies of the kidney and urinary tract detected by prenatal ultrasonography: a single center study (산전 초음파로 발견된 선천성 신 요로 기형의 발생률과 임상 결과: 단일 기관 연구)

  • Lim, Gina;Lee, Joo Hoon;Park, Young Seo;Kim, Kun Seok;Won, Hye-Sung
    • Clinical and Experimental Pediatrics
    • /
    • 제52권4호
    • /
    • pp.464-470
    • /
    • 2009
  • Purpose : This study assessed the incidence and outcome of congenital anomalies of the kidney and urinary tract (CAKUT) detected by prenatal ultrasonography Methods : There were 906 cases of CAKUT detected by prenatal ultrasonography and postnatally confirmed at the Asan Medical Center from October 1989 to October 2007. We investigated the incidence and outcome of these cases by reviewing medical records retrospectively. Results : The order of incidence was hydronephrosis, multicystic dysplastic kidney (MCDK), duplex kidney, vesico-ureteral reflux (VUR), single kidney, hydroureteronephrosis, ectopic kidney, polycystic kidney, ureterocele, and posterior urethral valve (PUV). There were 520 cases (57.4%) of hydronephrosis, and 20% of these needed an operation due to significant obstruction. MCDK was associated with other CAKUT in 25.4% of all cases. Approximately 57.9% of duplex kidney cases needed surgical treatment due to ureterocele and VUR. VUR had a male: female ratio of 10:1. Two out of seven cases of autosomal recessive polycystic kidney had progressed to chronic renal failure. Patients with PUV were relatively uncommon, and one out of nine cases progressed to end-stage renal disease. Conclusion : CAKUTs detected by prenatal ultrasonography were composed of various anomalies, and almost all of them had a good outcome without any intervention. However, in some cases, recurrent urinary tract infection or renal failure occurred, especially in bilateral cases. For further management, a long-term multicenter study is needed to investigate the precise incidence and outcome of each anomaly in the general population.

Surgical Treatment of Pulmonary Aspergillosis (III) (폐 국균증의 외과적 치료(제 3보))

  • 정성철;김우식;배윤숙;유환국;정승혁;이정호;김병열
    • Journal of Chest Surgery
    • /
    • 제36권7호
    • /
    • pp.497-503
    • /
    • 2003
  • Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

The Need for a Well-Organized, Video-Assisted Asthma Education Program at Korean Primary Care Clinics

  • Kim, Yee Hyung;Yoo, Kwang Ha;Yoo, Jee-Hong;Kim, Tae-Eun;Kim, Deog Kyeom;Park, Yong Bum;Rhee, Chin Kook;Kim, Tae-Hyung;Kim, Young Sam;Yoon, Hyoung Kyu;Um, Soo-Jung;Park, I-Nae;Ryu, Yon Ju;Jung, Jae-Woo;Hwang, Yong Il;Lee, Heung Bum;Lim, Sung-Chul;Jung, Sung Soo;Kim, Eun-Kyung;Kim, Woo Jin;Lee, Sung-Soon;Lee, Jaechun;Kim, Ki Uk;Kim, Hyun Kuk;Kim, Sang Ha;Park, Joo Hun;Shin, Kyeong Cheol;Choe, Kang Hyeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
    • /
    • 제80권2호
    • /
    • pp.169-178
    • /
    • 2017
  • Background: The purpose of this study was to assess the effect of our new video-assisted asthma education program on patients' knowledge regarding asthma and asthma control. Methods: Adult asthmatics who were diagnosed by primary care physicians and followed for at least 1 year were educated via smart devices and pamphlets. The education sessions were carried out three times at 2-week intervals. Each education period lasted at most 5 minutes. The effectiveness was then evaluated using questionnaires and an asthma control test (ACT). Results: The study enrolled 144 patients (mean age, $56.7{\pm}16.7years$). Half of the patients had not been taught how to use their inhalers. After participating in the education program, the participants' understanding of asthma improved significantly across all six items of a questionnaire assessing their general knowledge of asthma. The proportion of patients who made errors while manipulating their inhalers was reduced to less than 10%. The ACT score increased from $16.6{\pm}4.6$ to $20.0{\pm}3.9$ (p<0.001). The number of asthmatics whose ACT score was at least 20 increased from 45 (33.3%) to 93 (65.3%) (p<0.001). The magnitude of improvement in the ACT score did not differ between patients who received an education session at least three times within 1 year and those who had not. The majority of patients agreed to the need for an education program (95.8%) and showed a willingness to pay an additional cost for the education (81.9%). Conclusion: This study indicated that our newly developed education program would become an effective component of asthma management in primary care clinics.

The Study on the Relationship between Changes of Rumen Microflora and Bloat in Jersey Cow (저지종 젖소의 반추위 내 미생물 균총 변화와 고창증 발병간의 상관관계 연구)

  • Kim, Sang Bum;Oh, Jong Seok;Jeong, Ha Yeon;Jung, Young Hun;Park, Beom Young;Ha, Seung Min;Im, Seok Ki;Lee, Sung Sill;Park, Ji Hoo;Park, Seong Min;Kim, Eun Tae
    • Journal of The Korean Society of Grassland and Forage Science
    • /
    • 제38권2호
    • /
    • pp.106-111
    • /
    • 2018
  • This study was conducted to investigate the relationship between changes of rumen microflora and bloat in Jersey cow. Jersey cows (control age: 42 months, control weight: 558kg; treatment age: 29 months, treatment weight 507kg) were fed on the basis of dairy feeding management at dairy science division in National Institute of Animal Science. The change of microbial population in rumen was analyzed by using next generation sequencing (NGS) technologies due to metabolic disease. The diversity of Ruminococcus bromii, Bifidobacterium pseudolongum, Bifidobacterium merycicum and Butyrivibrio fibrisolvens known as major starch fermenting bacteria was increased more than 36-fold in bloated Jersey, while cellulolytic bacteria community such as Fibrobacter succinogenes, Ruminococcus albus and Ruminococcus flavefaciens was increased more than 12-fold in non-bloated Jersey. The proportion of bacteroidetes and firmicutes was 33.4% and 39.6% in non-bloated Jersey's rumen, while bacteroidetes and firmicutes were 24.9% and 55.1% in bloated Jersey's. In conclusion, the change of rumen microbial community, in particular the increase in starch fermenting bacteria, might have an effect to occur the bloat in Jersey cow.

Effect of Short Term Treatment with Different Dosage of Inhaled Flucatisone Propionate on Basal Cortisol Concentration (단기간 Fluticasone Propionate 투여 용량에 따른 가저 코르티솔 농도의 변화)

  • Kim, Hyun-Jung;Kim, Hyoung-Sik;Lee, Hong;Moon, Sung-Gi;Lim, Seok-Tae;Park, Ji-Hyun;Lee, Heung-Bum;Lee, Yong-Chul;Rhee, Yang-Keun
    • Tuberculosis and Respiratory Diseases
    • /
    • 제44권5호
    • /
    • pp.1063-1071
    • /
    • 1997
  • Backgroung : The efficacy of oral corticosteroids in the treatment of chronic asthma is undisputed, but their long-term use is associated with adverse side-effects, including supression of the hypothalamic-pituitary adrenal axis function, osteoporosis, weight gain, hypertension and impaired glucose tolerance. The introduction of inhaled corticosteroids in the early 1970's represented a significant therapeutic advance in the management of asthma, since these compounds combined high topical potency with low systemic activity. Fluticasone propionate is a new topically active synthetic glucocorticosteroid that combinds a high degree of efficacy with negligible systemic bioavailability. This study was perfomed to determine the effect of inhaled fluticasone propionate on the adreocortical supression in patients with bronchial asthma or chronic obstructive pulmonary disease. Method : The adrenocortical function was assessed by measurement of plasma cortisol concentration at 8 o'clock in morning and free cortisol in 24 hour urine collection at interval. Absolutely, no steroid was taken during pretreatment period of 10days. There after each subject inhaled fluticasone aerosol, in daily doses of 500 or 1000micrograms for 12days. The dose was delivered by metered dose inhaler(MDI). Results : The serum cortisol and 24hour urinary free cortisol were not decreased during the treatment period in patients with inhaled fluticasone propionate in daily doses of 500 micrograms. In contrast, serum cortisol was significantly decreased on 9th and 12th day(p less than 0.05). And, 24hour urinary free cortisol was also significantly decreased on 3rd and 12th day of treatement period(p less than 0.05) in patients with inhaled fluticasone in daily doses of 1000 micrograms. Conclusion : These results suggested that endogenous cortisol secretion was not supressed after short-term inhalation of fluticasone in daily dose of 500 micrograms, but in daily dose of 1000 micrograms, the endogenous cortisol secretion was supressed.

  • PDF

Characteristics of Pneumothorax in a Neonatal Intensive Care Unit

  • Lim, Ho-Seop;Kim, Ho;Jin, Jang-Yong;Shin, Young-Lim;Park, Jae-Ock;Kim, Chang-Hwi;Kim, Sung-Shin
    • Neonatal Medicine
    • /
    • 제18권2호
    • /
    • pp.257-264
    • /
    • 2011
  • Purpose: The development of postnatal pneumothorax and its common causes and clinical aspects were studied to promote early diagnosis and proper management. Methods: A retrospective study of neonates who were hospitalized in the neonatal intensive care unit at Soonchunhyang University Bucheon Hospital from 2001 to 2010 was performed. Term neonates were divided into a spontaneous pneumothorax group and a secondary pneumothorax group. The secondary group was divided into term and preterm groups. Results: Of 4,414 inpatients, 57 (1.3%) were diagnosed with pneumothorax. Of term newborn patients, 28 (80%) had a secondary pneumothorax, and seven (20%) had a spontaneous pneumothorax. No differences were observed for gender, birth weight, resuscitation, or duration of admission between the spontaneous and control groups. The duration of treatment with a thoracostomy (20 patients, 57%) was longer in the spontaneous group (5.4${\pm}$2.9 days vs. 2.7${\pm}$2.0 days) than that in the control group. Patients with respiratory distress syndrome (RDS) developed a pneumothorax 22.8 hours after surfactant treatment, whereas patients with transient tachypnea of the newborn (TTN), pneumonia, and meconium aspiration syndrome (MAS) developed pneumothorax after 16.6 hours. Of 50 patients with a secondary pneumothorax, 19 (38%) had RDS, 11 (22%) had MAS, 7 (14%) had TTN, and six (12%) had pneumonia. Among term newborns, 42.9% were treated only with 100% oxygen. Among preterm newborns, 72.6% and 27.3% needed a thoracostomy or ventilator care, respectively. Conclusion: A pneumothorax is likely to develop when pulmonary disease occurs in neonates. Therefore, it is important to carefully identify pneumothorax and provide appropriate treatment.

Development and Validation of Analytical Method for Nitroxoline in Chicken Using HPLC-PDA (HPLC-PDA를 이용한 닭고기 중 Nitroxoline 분석법 개발)

  • Cho, Yoon-Jae;Chae, Young-Sik;Kim, Jae-Eun;Kim, Jae-Young;Kang, Ilhyun;Lee, Sang-Mok;Do, Jung-Ah;Oh, Jae-Ho;Chang, Moon-Ik;Hong, Jin-Hwan
    • Korean Journal of Environmental Agriculture
    • /
    • 제32권1호
    • /
    • pp.70-77
    • /
    • 2013
  • BACKGROUND: Nitroxoline is an antibiotic agent. It is used for the treatment of the second bacterial infection by the colibacillosis, salmonellosis and viral disease of the poultry. When the nitroxoline is indiscreetly used, the problem about the abuse of the antibiotics can occur. Therefore, this study presented the residue analytical method of nitroxoline in food for the safety management of animal farming products. METHODS AND RESULTS: A simple, sensitive and specific method for nitroxoline in chicken muscle by high performance liquid chromatograph with PDA was developed. Sample extraction with acetonitrile, purification with SPE cartridge (MCX) were applied, then quantitation by HPLC with C18 column under the gradient condition with 0.1 % tetrabutylammonium hydroxide-phosphoric acid and methanol was performed. Standard calibration curve presented linearity with the correlation coefficient ($r^2$) > 0.999, analysed from 0.02 to 0.5 mg/L concentration. Limit of quantitation in chicken muscle showed 0.02 mg/kg, and average recoveries ranged from 72.9 to 88.1 % in chicken muscle. The repeatability of measurements expressed as coefficient of variation (CV %) was less than 12 % in 0.02 and 0.04 mg/kg. CONCLUSION(S): Newly developed method for nitroxoline in chicken muscle was applicable to food inspection with the acceptable level of sensitivity, repeatability and reproducibility.

Clinical Analysis of Ectopic Kidney in Children (소아 이소성 신장의 임상적 고찰)

  • Yook Jin-Won;Kim Ji-Hong;Kim Myung-Joon;Kim Pyung-Kil
    • Childhood Kidney Diseases
    • /
    • 제3권2호
    • /
    • pp.196-202
    • /
    • 1999
  • Purpose : When the mature kidney fails to reach its norml location in the renal fossa, the condition is known as ectopic kidney. Presenting symtoms can be various and it generally depend on the associated anomaly. Beside urologic anomalies such as hydronephrosis and vesicoureteral reflux, various anomalous vascular net work, skeletal anomaly or genital anomaly can be observed in this condition. Methods : Sixteen children with ectopic kidney was studied retrospectively to analyse initial presentation, accompanied anomaly and prognosis. Results : 56% of the children were accompanied with other urologic anomalies such as true incontinence and vesicoureteral reflux that required surgical treatment. 31% of children were either diagnosed incidentally during evaluation of other non-urologic disease or during follow-up evaluation of abnormal antenatal renal sonogram. Conclusion : Ectopic kidney can be often misdiagnosed as tumorous condition or as a surgical condition depend on the abnormal location of the kidney. Careful evaluation using abdominal sonogram, DMSA, VCUG and abdominal CT scan should be performed in order to search for associated anomalous condition and for proper management.

  • PDF

Role of Police for Enhancement of Elderly Safety (노인안전 강화를 위한 경찰의 역할)

  • Cha, Min-Kyu;Kwack, Dae-Gyung
    • Korean Security Journal
    • /
    • 제41호
    • /
    • pp.387-408
    • /
    • 2014
  • South Korea already became an aging society, and is now in the process of becoming an aged society. With increasing elderly population, elderly safety issues such as traffic accidents and elderly suicides are becoming important problems. Elderly victimization are increasing, and elderly safety accident is also becoming an imporotant social problem. The police is doing various activities for elderly safety. The police is conducting programs for the elderly, such as a prevention program for fraud against elderly, and safety checks and traffic safety education for preventing elderly traffic accidents. Also, there's a program of providing regular visits for a lone elderly, expansion of CCTV network and fingerprint registration to prevent elderlies with Alzheimer's disease going missing. However, these programs are not done on a national scale, but rather limited to local police stations. The purpose of this study is to seek police roles for enhancing elderly safety, due to lack of police activity in this area. Recommendation for police roles in enhancing elderly safety is to first conduct routine crackdowns on fraud against elderly and also conduct education programs for preventing fraud. Also, crimes such as elderly abuse is lead by elderly protection agencies, but considering elderly abuse is a crime, the police should take a leading role. Also, to prevent elderly suicide, meticulous management of elderlies with high suicide risk is necessary, and elderly protection areas should be designated to prevent traffic accidents. Also, elderlies should be induced to turn in their driver's license. To conduct these matters of elderly safety, an organization exclusively charged with elderly safety is necessary. Elderly safety is a broad concept, and since police alone cannot handle the task of ensuring elderly safety, the police should take on a leading role in cooperative efforts with various institutions of the government, non-profit organizations and the community to establish a social saftey net for elderly safety.

  • PDF

Combined Chemotherapy and Radiotherapy versus Radiotherapy alone in the Management of Localized Angiocentric Lymphoma of the Head and Neck (국한성 두경부 혈관 중심위 림프종에서 화학방사선 병용치료법과 방사선치료 단독요법의 비교)

  • Chang Sei Kyung;Kim Gwi Eon;Lee Sang-Wook;Park Hee Chul;Pyo Hong Ryull;Kim Joo Hang;Moon Sun Rock;Lee Hyeong Sik;Choi Eun Chang;Kim Kwang Moon
    • Radiation Oncology Journal
    • /
    • 제20권1호
    • /
    • pp.17-23
    • /
    • 2002
  • Purpose : To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. Materials and Methods : Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20~70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1~6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. Results : Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.