• Title/Summary/Keyword: Disease patterns

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Patterns of failure after the reduced volume approach for elective nodal irradiation in nasopharyngeal carcinoma

  • Seol, Ki Ho;Lee, Jeong Eun
    • Radiation Oncology Journal
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    • v.34 no.1
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    • pp.10-17
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    • 2016
  • Purpose: To evaluate the patterns of nodal failure after radiotherapy (RT) with the reduced volume approach for elective neck nodal irradiation (ENI) in nasopharyngeal carcinoma (NPC). Materials and Methods: Fifty-six NPC patients who underwent definitive chemoradiotherapy with the reduced volume approach for ENI were reviewed. The ENI included retropharyngeal and level II lymph nodes, and only encompassed the echelon inferior to the involved level to eliminate the entire neck irradiation. Patients received either moderate hypofractionated intensity-modulated RT for a total of 72.6 Gy (49.5 Gy to elective nodal areas) or a conventional fractionated three-dimensional conformal RT for a total of 68.4-72 Gy (39.6-45 Gy to elective nodal areas). Patterns of failure, locoregional control, and survival were analyzed. Results: The median follow-up was 38 months (range, 3 to 80 months). The out-of-field nodal failure when omitting ENI was none. Three patients developed neck recurrences (one in-field recurrence in the 72.6 Gy irradiated nodal area and two in the elective irradiated region of 39.6 Gy). Overall disease failure at any site developed in 11 patients (19.6%). Among these, there were six local failures (10.7%), three regional failures (5.4%), and five distant metastases (8.9%). The 3-year locoregional control rate was 87.1%, and the distant failure-free rate was 90.4%; disease-free survival and overall survival at 3 years was 80% and 86.8%, respectively. Conclusion: No patient developed nodal failure in the omitted ENI site. Our investigation has demonstrated that the reduced volume approach for ENI appears to be a safe treatment approach in NPC.

The Meaning Of "In case of both Yin and Yang deficiency, treat with sweet medicinals(甘藥)" In the Huangdineijing (『황제내경(黃帝內經)』 "음양구부족자(陰陽俱不足者) 감약치지(甘藥治之)"에 대한 고찰)

  • Lyu, Jeong-ah
    • Journal of Korean Medical classics
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    • v.35 no.4
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    • pp.41-61
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    • 2022
  • Objectives : This paper aims to examine the clinical meaning of treating with sweet medicinals where acupuncture fails, through studying the verse, "In case of both Yin and Yang deficiency, treat with sweet medicinals" in the Huangdineijing. Methods : Related contents in the chapters 「邪氣藏府病形」, 「根結」, 「終始」, 「經脈」, 「九鍼論」 of the Lingshu were analyzed threefold. The circumstances of the application of the "In case of both Yin and Yang deficiency, treat with sweet medicinals" principle to the late Han East Asian medicine as written in the Shanghanzabinglun were examined, and its meaning was explored. Results : The 'Yin Yang' in the verse could be substituted with the Five Zhang and Six Fu, Blood and Qi, Form and Qi, Form and Jing, Form and Zhi, etc. In patients with deficiency in Qi, Blood, Yin and Yang, we can observe external symptoms such as narrow pulse pattern, symptoms in the throat or below the throat, thirst, and coarse voice. To apply sweet medicinals is to supplement the Jing from food, Spleen and Stomach, Middle Qi and Earth Qi which produces and maintains Qi, Blood, Yin and Yang. Therefore, it is essential in treating disease patterns with deficiency in both Qi, Blood, Yin and Yang, and cannot be substituted with other means of treatment such as acupuncture, moxibustion, and other manipulative therapies. Conclusions : Sweet medicinals were applied in disease patterns with throat thirst and narrow pulse patterns which could not be managed with general acupuncture or moxibustion in the time of the Huangdineijing's publication, as it holds the Earth virtue which could harmoniously supplement the body's Qi, Blood, Yin, and Yang. Later its application broadened, treating various conditions accompanying Qi, Blood, Yin, Yang deficiency, which expanded potential of medicine and contributed to the generalization of drug treatment.

A Study of Health Behavior through Comparative Analysis of Self-perceived Health Status and Health Examination Results (주관적 건강인식과 건강검진 결과의 비교분석을 통한 건강행위 연구)

  • 문상식;이시백
    • Korean Journal of Health Education and Promotion
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    • v.18 no.3
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    • pp.11-36
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    • 2001
  • The purpose of this study is to analyze health behavior by comparing the difference between self-perceived health status and health examination results. The study subjects consist of 7,702 people aged over 20, surveyed by Health Interview survey, Health Examination survey, Dietary Life survey, Health Consciousness and Behavior survey. Data used in the study are drawn from raw data from a 1998 National Health and Nutrition survey. General characteristics variables are sex, age, education level, residential area, marital status, occupation, and living standard while dichotomous variables, ‘not healthy’ and ‘healthy’ are used to measure self-perceived health status. Variables for health examination results are high blood pressure, high cholesterol, diabetes, liver diseases, liver inflammation, kidney diseases, normal weight, regular diet, optimum sleeping time(7-8 hours), regular health examination and health behavior practice group. Major findings of the study are as follows: 1) Analysis of self-perceived health status and health behavior by disease: Variables significantly correlated with high self-perceived health status have strong associations with high health behavior practice, which supports the hypothesis that as one has high self-perceived health status, one is more likely to practice health promoting behavior. The results of analysis of health behavior differences by dividing subjects into two categories, ‘cases of illness’ and ‘cases of no illness’ indicate that drinking, sleeping time, health examination are significant variables (p〈0.001, 0.05) whereas smoking, weight control, regular exercise, regular diet are not significant. 2) Analysis of disparity patterns between self-perceived health status and health examination: The hypothesis that health behaviors would be different according to the disparity pattern between self-perceived health status and health examination is supported as a result of χ2 test. Among Type I : Self-perceived health status is high and actual health status is good (no disease) Type II: Self-perceived health status is high and actual health status is poor(have disease) Type III: Self-perceived health status is low and actual health status is good(no disease) Type IN: Self-perceived health status is low and actual health status is poor(have disease) Type I and Type IV show no disparity, Type I shows the highest health promoting behavior whereas Type IV shows the lowest health promoting behavior. Type II, and III, compared to Type I, practise lower health promoting behavior. Multi-logistics regression analysis was conducted to find out the degree of impact on health behavior. Independent variables are general characteristics, self-perceived health status and health examination result and presence of illness, while the dependent variable is health promoting behavior. The analysis of the impact of self-perceived health status on the health promoting behavior shows that smoking, drinking, weight control, regular exercise, health examination practice, and/or regular diet are significantly correlated to self-perceived health status. High self-perceived health status is inversely related to high health promoting behavior. This finding supports the hypothesis that the higher one perceives one's health, the more likely one is to practice health promoting behavior. On the contrary, the presence of illness has little impact on health promoting behavior. 3) Multiple logistics analysis on how disparity patterns between self-perceived health status and health examination affect health behavior: The results of multiple logistics analysis made on health behavior variables compared to the standard variable are as follows: When analyzed on the standard of Type I, smoking is a significant risk factor for the Type IV. In case of drinking, all the patterns show a high probability of relative risk ratio. With regard to weight control, it is a risk factor for Type II while all the patterns show high probability of not practising when analyzed on the standard of type IV. Type III and IV show high probability of not doing regular exercise while Type IV, shows a high probability of not taking appropriate sleeping time. When analyzed on the standard of type IV, all the patterns show a high probability of not taking health examinations. Type III and IV show a high probability of not having regular meals. As for overall health promoting behavior, Type III and IV show a high relative risk ratio. These two groups have low self-perceived health status. It implies that self-perceived health status has significant impact on health promoting behavior. This is also supported by the fact that Type I with high self-perceived health status and no illness shows a high practice rate of health promoting behavior. Types II and III the groups with high disparity between self-perceived health status and health examination results, show a low practice rate of health promoting behavior when compared to Type I. Type IV, that is the group with low self-perceived health status and actual illness, shows the lowest practice of health promoting behavior. It is highly probable that this type proves to be the poorest health group.

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Molecular Epidemiology and Prevalence of Echovirus 30 in Zhejiang Province, China, from 2002 to 2015

  • Chen, Yin;Sun, Yi;Yan, Juying;Miao, Ziping;Xu, Changping;Zhang, Yanjun;Mao, Haiyan;Gong, Liming
    • Journal of Microbiology and Biotechnology
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    • v.27 no.12
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    • pp.2221-2227
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    • 2017
  • Echovirus serotype 30 (ECHO30) has been responsible for several recent worldwide outbreaks of viral meningitis. In Zhejiang Province, China, ECHO30 has been one of the main causes of viral meningitis for years. This study, using phylogenetic analysis of the VP1 gene, was performed to investigate the general molecular epidemiology and genetic patterns of ECHO30 circulating in Zhejiang Province between the years 2002 and 2015. The nucleotide sequences of ECHO30 VP1 showed that they were 64.8% identical with the prototype strain, Bastianni, while the amino acids were 84.9% identical. Phylogenetic analyses showed that ECHO30 in the Zhejiang area has diverged into two genotypes. Genotype I consists of strains isolated since 2002, whereas genotype II includes strains that were mainly isolated during the 2002 to 2004 outbreak. ECHO30 has been endemically circulating in both humans and the environment for a long period of time. Additionally, we evaluated the significance of recombination presented during the years 2005 to 2007 to demonstrate that recombination plays an important role in the prevalence of ECHO30 in the Zhejiang area.

Production of Plasma Leptin and Expression of Interferon-γ Inducible Protein-10 (IP-10), Monokine Induced by Interferon-γ (Mig) and Interleukin-8 (IL-8) mRNA in Kawasaki Disease

  • Lee, Young-Hwan;Kim, Won-Duk;Kim, Hee-Sun
    • IMMUNE NETWORK
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    • v.2 no.4
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    • pp.202-207
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    • 2002
  • Background: Kawasaki disease is an acute febrile illness with systemic vasculitis which primarily affects children, We examined the production of leptin in plasma and gene expressions of CXC chemokines in peripheral blood mononuclear cells from patients with Kawasaki disease. Methods: Consecutive 39 samples from 13 patients according to the different clinical stages (acute, subacute, convalescent) of Kawasaki disease were collected. The plasma leptin levels according to clinical stages of Kawasaki disease were examined by ELISA and the expression of IP-10, Mig and IL-8 mRNAs in 39 samples (13 samples of each stage) from 13 cases were examined by RT-PCR. Results: There were not significant changes of plasma leptin levels according to the clinical stages of Kawasaki disease. The mean values of plasma leptin concentrations during each of the stages (n=13, p>0.05, pg/ml) were $335.8{\pm}549.0$ in acute, $358{\pm}347.6$ in subacute, and $443.6{\pm}645.9$ in convalescent stage. The mRNAs of IP-10, Mig, and IL-8 were expressed in 13/13 (100%), 2/13 (15%), 9/13 (69%) during acute stage, 13/13 (100%), 6/13 (46%), 13/13 (100%) during subacute stage, and 13/13 (100%), 4/13 (31%), 10/13 (77%) during the convalescent stage, respectively. In three patients, the production of leptin and expression of IP-10 mRNA were dramatically decreased according to the process of the clinical stages. In five patients with prominent cervical lymphadenopathy, the expression of IL-8 mRNA during the subacute stage was more elevated than the acute and convalescent stages. Conclusion: This data suggests that the production of leptin and the gene expressions of IP-10, Mig and IL-8 seem to have no significant correlation to the clinical stages of Kawasaki disease. However, expression patterns of IP-10, Mig and IL-8 mRNA may be related to the specific clinical manifestations, and the expression of IP-10 may also be correlated to leptin levels with pericardial involvement.

Impact of Conventional and Electronic Cigarette Use on the Adolescents' Experience of Periodontal Disease Symptoms

  • Ahn, Eunsuk;Lee, Jin-ha
    • Journal of dental hygiene science
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    • v.21 no.3
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    • pp.133-139
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    • 2021
  • Background: Smoking in adolescence leads to an intensified addiction to nicotine when physical and mental growth has not yet been completed. With the advent of e-cigarettes, the rate of e-cigarette use among Korean adolescents has been steadily increasing. To date, studies on e-cigarettes and oral health, especially on the relationship between smoking styles and oral health in adolescents, are limited. Therefore, this study aimed to identify the risk factors for oral health problems caused by the repeated use of conventional cigarettes and e-cigarettes. Methods: This explanatory research study compared the adolescents' experiences of periodontal disease symptoms according to smoking type through a secondary analysis of the original data from the 15th Adolescent Health Behavior Survey (2019). Cross-analysis was performed to compare the smoking patterns according to the adolescents' general characteristics. Finally, a binary logistic regression analysis was performed to determine how smoking characteristics affect the adolescents' experience of periodontal disease symptoms. Results: In terms of patients' general characteristics, significant differences were observed in sex, school level, grades, household economic status, type of residence, and father's education level between adolescents who smoked conventional cigarettes alone and those who smoked both conventional cigarettes and e-cigarettes (p<0.05). After checking the factors affecting the smoking pattern and the experience of periodontal disease symptoms in adolescents, it was found that the duplicate smoking group was more likely to experience periodontal disease symptoms (odds ratio, 1.20) than the group that smoked conventional cigarettes alone (p<0.05). Conclusion: Duplicate smokers experienced more symptoms of periodontal disease than those who smoked cigarettes alone. Based on the findings of this study, smoking cessation counseling according to the smoking type and differentiated education for oral health promotion should be provided.

Atherosclerotic Cardiovascular Disease Risk and Statin Prescription Status in Korean Adult Patients (국내 성인환자에서 죽상동맥경화성 심혈관질환 위험도와 스타틴 처방 현황)

  • Kim, Jong Yoon;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.3
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    • pp.198-204
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    • 2021
  • Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy plays a pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of this study was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patient group. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVD or risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. High-intensity statin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of high-intensity statin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR; 12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescription rate was increased compared with low-intensity statin. However, there was no statistical significance between both statin prescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion: The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapy might be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.

Analysis of 『Jinguiyaolue』 Prescriptions using Database (데이터베이스를 이용한 『금궤요략』 처방(處方) 분석 연구)

  • Kim, SeongHo;Kim, SungWon;Kim, KiWook;Lee, ByungWook
    • Journal of Korean Medical classics
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    • v.32 no.3
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    • pp.131-146
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    • 2019
  • Objectives : The aim of this paper is to study the methodology for effectively analyzing the "Jinguiyaolue" prescriptions using database, and to explore possibilities of applying the data construction and query produced in the process to comparative research with other texts in the future. Methods : Using "Xinbianzhongjingquanshu(新編仲景全書)" as original script, the contents of "Jinguiyaolue" were entered into the database, in which one verse would be separated according to content for individual usage. Also, data with medicinal construction and disease pattern information of the previously constructed "Shanghanlun" database designed for comparison with other texts was applied for comparative analysis. Results : For input and analysis, 6 tables and 12 queries were made and used. Formulas were accessible by using herbal combinations, and applications of these formulas could be assembled for comparison. Formulas were also accessible by using disease pattern combinations, and combinations of herbs and disease pattern together were also applicable. In comparison with other texts, examples and frequency of usage of herbs could be relatively accurately compared, while disease patterns could not easily be compared. Conclusions : Herbal combinations, disease pattern combinations could yield related texts and herb/disease pattern combinations of the prescriptions in the "Jinguiyaolue", which shortened time needed for research among formulas in texts. However, standardization research for disease pattern is necessary for a more accurate comparative study that includes disease pattern information.

Failure of Ciprofloxacin Therapy in the Treatment of Community-Acquired Acute Pyelonephritis caused by In-Vitro Susceptible Escherichia coli Strain Producing CTX-Type Extended-Spectrum β-Lactamase

  • Seok, Hyeri;Cha, Min Kyeong;Kang, Cheol-In;Cho, Sun Young;Kim, So Hyun;Ha, Young Eun;Chung, Doo Ryeon;Peck, Kyong Ran;Song, Jae-Hoon
    • Infection and chemotherapy
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    • v.50 no.4
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    • pp.357-361
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    • 2018
  • While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.

,A Study on "Byun Jeung Rok(辨證錄)" Vol.7 (변증록(辨證錄) 권지칠(卷之七)에 대(對)한 연구(硏究))

  • Kim, Joo-Tae;Lee, Jong-Hwan;Song, Ji-Chung;Jeong, Heon-Young;Lee, Si-Hyeong
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.17 no.1
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    • pp.1-68
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    • 2011
  • The topic of this study is the translation of "Byun Jeung Rok Vol.VII(辨證錄七卷)". Byun Jeung Rok is a complete book of medicine which was written by Jin Sa tak(陣士鐸) in the early years of the Ching dynasty. Of this, the seventh volume is composed of 6 disease-patterns(病證) and 55 subtopics. Byun Jeung Rok(辨證錄) explains disease-patterns(病證) through the unique and outstanding perspective of the individual author. This topic was studied in hopes of helping later students by showing to the world, through its translation, the author's understanding of disease pattern. The organized characteristics of "Byun Jeung Rok(辨證錄) Vol.VII" is as follows. 1. Byun Jeung Rok based his theory on the traditional paradigm, Yin-Yang and Five phases. and criticized another doctor's misleading opinion by it. 2. Jin Sa tak thought it highly important to distinguish the internal injury and the external wound. and this view was influenced by Ming dynasty's doctors. 3. Jin Sa tak very often used providing nutrition to patients as a way of treatment. because he thought that a variety of diseases are caused by the weakness of organs.

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