• Title/Summary/Keyword: Frequent disease

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Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy

  • Kim, Ji Eun;Park, Se Jin;Oh, Ji Young;Jeong, Hyeon Joo;Kim, Ji Hong;Shin, Jae Il
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.99-102
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    • 2016
  • Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.

Prognostic Factors and Therapeutic Outcomes in 22 Patients with Pleomorphic Xanthoastrocytoma

  • Lim, Sungryong;Kim, Jeong Hoon;Kim, Sun A;Park, Eun Suk;Ra, Young Shin;Kim, Chang Jin
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.281-287
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    • 2013
  • Objective : Pleomorphic xanthoastrocytoma (PXA) is a rare primary low-grade astrocytic tumor classified as WHO II. It is generally benign, but disease progression and malignant transformation have been reported. Prognostic factors for PXA and optimal therapies are not well known. Methods : The study period was January 2000 to March 2012. Data on MR findings, histology, surgical extents and adjuvant therapies were reviewed in twenty-two patients diagnosed with PXA. Results : The frequent symptoms of PXA included seizures, headaches and neurologic deficits. Tumors were most common in the temporal lobe followed by frontal, parietal and occipital lobes. One patient who died from immediate post-operative complications was excluded from the statistical analysis. Of the remaining 21 patients, 3 (14%) died and 7 (33%) showed disease progression. Atypical tumor location (p<0.001), peritumoral edema (p=0.022) and large tumor size (p=0.048) were correlated with disease progression, however, Ki-67 index and necrosis were not statistically significant. Disease progression occurred in three (21%) of 14 patients who underwent GTR, compared with 4 (57%) of 7 patients who did not undergo GTR, however, it was not statistically significant. Ten patients received adjuvant radiotherapy and the tumors were controlled in 5 of these patients. Conclusion : The prognosis for PXA is good; in our patients overall survival was 84%, and event-free survival was 59% at 3 years. Atypical tumor location, peritumoral edema and large tumor size are significantly correlated with disease progression. GTR may provide prolonged disease control, and adjuvant radiotherapy may be beneficial, but further study is needed.

Analysis of prognostic factors affecting poor outcomes in 41 cases of Fournier gangrene

  • Hahn, Hyung Min;Jeong, Kwang Sik;Park, Dong Ha;Park, Myong Chul;Lee, Il Jae
    • Annals of Surgical Treatment and Research
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    • v.95 no.6
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    • pp.324-332
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    • 2018
  • Purpose: We present our experience involving the management of this disease, identifying prognostic factors affecting treatment outcomes. Methods: The patients treated for Fournier gangrene at our institution were retrospectively reviewed. Data collected included demographics, extent of soft tissue necrosis, predisposing factors, etiological factors, laboratory values, and treatment outcomes. The severity index and score were calculated. Multivariate regression analysis was used to determine the association between potential predictors and clinical outcomes. Results: A total of 41 patients (male:female = 33:8) were studied. The mean age was 54.4 years (range, 24-79 years). The most common predisposing factor was diabetes mellitus (n = 19, 46.3%). Sixteen patients (39.0%) were current smokers. Seven patients had chronic kidney disease. The most frequent etiology was urogenital lesion (41.5%). The mortality rate was 22.0% (n = 9). Multivariate regression analyses showed that extension of necrosis beyond perineal/inguinal area and pre-existing chronic kidney disease were significant and independent predictors of mortality. Extension of necrosis beyond perineal/inguinal area was a significant predictor of increased duration in the intensive care unit and hospital stay. In addition, pre-existing chronic kidney disease was a significant predictor of flap reconstruction in the wound. Conclusion: Fournier gangrene with extensive soft tissue necrosis and pre-existing chronic kidney disease was associated with poor prognosis and complexity of patient management. Early recognition of dissemination and premorbid renal function is essential to reduce mortality and establish a management plan for this disease.

Feline Demographics and Disease Distribution in the Republic of Korea

  • Lee, Jongseok;Pak, Son-il;Lee, Kija;Choi, Hojung;Lee, Youngwon;Park, Inchul;Choi, Sooyoung
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.217-225
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    • 2022
  • The population of pet cats has increased significantly, from 0.3% in 2002 to 5.6% in 2017. Large-scale feline demographic and disease data from Korea are lacking. The aim of this study was to investigate the demographic data (breed, sex, and age) and disease distribution of cats who visited private veterinary practices in Korea. Data including breed, sex, age, and disease, were compiled from 32,728 electronic medical records from 30 selected private veterinary practices, between January 1, 2016, and December 31, 2017. Diseases were classified based on the International Classification of Diseases 11 by the World Health Organization, and then compared and cross-analyzed according to breed, sex, and age. Korean shorthair was the most common breed. There was a high distribution of young cats, with 77.6% of the cats under 4 years of age, and an average age of 2.5 years. Diagnoses related to preventative medicine were the most frequent and diagnoses common to young cats had higher incidence. This demographic data and information about disease distribution can be used as a basis for future research and may be helpful for determining priorities in the diagnosis of diseases and establishing strategies for health management in cats.

The importance of SPT(Supportive Periodontal Therapy) for prevention of peri-implant disease (임상가를 위한 특집 1 - Peri-implant disease를 방지하기 위한 Supportive Periodontal Therapy(SPT)의 중요성)

  • Park, Su Jung
    • The Journal of the Korean dental association
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    • v.51 no.12
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    • pp.630-636
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    • 2013
  • During the past decade, the use of osseointegrated implants as a foundation for prosthetic replacement of missing teeth has become highly predictable and successful. SPT(Supportive Periodontal Therapy) identified as regular visits to the therapist for periodontal control and maintenance in a well-organized scheme, the number of appointments per year following a pre-designed subject-tooth/implant-site risk assessment method. Peri-implant disease was a frequent finding in subjects having natural healthy dentition and in subjects without periodontitis. Supportive periodontal program were found to be strongly related to implant survival. This study demonstrates that regular maintenance reduces the risk for peri-implant inflammation significantly as compared with irregular maintenance. This underlines the value of the SPT in enhancing the long-term outcomes of implant therapy, particularly in subjects affected by periodontitis, in order to control reinfection and limit biological complications. It is highly recommended to maintain implant patients under a strict supportive periodontal treatment protocol that might contribute to implant survival, and regular maintenance reduces the risk for periimplant inflammation significantly as compared with irregular maintenance. Ideally, patients may be informed on the beneficial effect of a regular patient-related post-therapy care before implant insertion.

Rheumatiod Arthritis: An Updated Overview of Latest Therapy and Drug Delivery

  • Kesharwani, Disha;Paliwal, Rishi;Satapathy, Trilochan;Paul, Swarnali Das
    • Journal of Pharmacopuncture
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    • v.22 no.4
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    • pp.210-224
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    • 2019
  • Rheumatoid arthritis is a severe autoimmune disorder, related to joints. It is associated with serious cartilage destruction. This causes disability and reduces the excellence of life. Numerous treatments are existed to combat this disease, however, they are not very efficient and possess severe side effects, higher doses, and frequent administration. Therefore, newer therapies are developed to overcome all these limitations. These include different monoclonal antibodies, immunoglobulins, small molecules used for immunotherapy and transgenes for gene therapy. One of the main goals of these new generation therapeutics is to address the underlying distressing biological processes by specifically targeting the causative agents with fewer systemic side effects and greater patient console. It is very fortuitous that loads of progressive investigations are going on in this field and many of them have entered into the successful clinical trial. But till date, a limited molecule has got FDA clearance and entered the market for treating this devastating disease. This review highlights the overview of conventional therapy and advancements in newer therapeutics including immunotherapy and gene therapy for rheumatoid arthritis. Further, different novel techniques for the delivery of these therapeutics of active and passive targeting are also described.

Risk Factors of Cerebrovascular Disease According to the Level of Blood Pressure among the Prospective Tele-medicine Users (재택진료 잠재적 이용자의 혈압 수준에 따른 뇌혈관 질환 위험요인 분포)

  • Song, Hee-Young;Park, So-Mi;Hwang, Sung-Oh
    • Journal of Korean Biological Nursing Science
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    • v.6 no.2
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    • pp.31-42
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    • 2004
  • Purpose: This study was undertaken to investigate bio-medical and behavioral risk factor of stroke according to the level of blood pressure among the prospective tele-health users. Method: A descriptive study was conducted using interviews with a structured questionnaire. Of the households in the village, 24 households were selected for inclusion in the study. Among all of the residents from these households, a total of 48 residents who completed all the blood tests as well as the questionnaire. Results: Among bio-medical risk factors including demographic characteristics, physiologic variables, and health history, only triglyceride(TG) was significantly different among normal, prehypertension, and hypertension groups(F=3.78, p<.05). However, regarding behavioral variables, those who were classified as prehypertension and hypertension group reported more frequent drinking, those who were in prehypertension group reported highest scores of stress and lowest frequency of exercise, and those who were in normal and hypertension group showed higher scores of interest on health and lower scores of perceived seriousness of disease and health knowledge than those who were in prehypertension group. Conclusion: Identification and implementation of modifiable risk factors of stroke according to the level of blood pressure are crucial for health care utilizing tele-medicine.

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Diagnosis Analysis of Patient Process Log Data (환자의 프로세스 로그 정보를 이용한 진단 분석)

  • Bae, Joonsoo
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.42 no.4
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    • pp.126-134
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    • 2019
  • Nowadays, since there are so many big data available everywhere, those big data can be used to find useful information to improve design and operation by using various analysis methods such as data mining. Especially if we have event log data that has execution history data of an organization such as case_id, event_time, event (activity), performer, etc., then we can apply process mining to discover the main process model in the organization. Once we can find the main process from process mining, we can utilize it to improve current working environment. In this paper we developed a new method to find a final diagnosis of a patient, who needs several procedures (medical test and examination) to diagnose disease of the patient by using process mining approach. Some patients can be diagnosed by only one procedure, but there are certainly some patients who are very difficult to diagnose and need to take several procedures to find exact disease name. We used 2 million procedure log data and there are 397 thousands patients who took 2 and more procedures to find a final disease. These multi-procedure patients are not frequent case, but it is very critical to prevent wrong diagnosis. From those multi-procedure taken patients, 4 procedures were discovered to be a main process model in the hospital. Using this main process model, we can understand the sequence of procedures in the hospital and furthermore the relationship between diagnosis and corresponding procedures.

A Clinical Study of the Pediatric Patients Visiting Emergency Center (응급실 방문 환아에 대한 임상적 고찰)

  • Kim Shin Jeong;Moon Sun Young
    • Child Health Nursing Research
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    • v.5 no.1
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    • pp.97-106
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    • 1999
  • The purpose of this study was to provide basic data of nursing intervention through understanding disease pattern of pediatric patients. Data were collected from 3,016 patients who visited emergency center of I university Hospital during one year period from January to December, 1997. The results were as follows : 1. The most common type of disease was respiratory disease (26.7%). 2. According to the developmental age, toddler (35%) ranked first followed by preschooler(22.1%), infant(18.5%), schooler(16.0%), adolescent (5.6%), neonate (2.7%). 3. The proportion of males to females, male patients(59.8%) outnumbered female(40.2%) by the ratio of 1.48 ; 1. 4. Visiting patients were seasonally more frequent in spring(29.8%) and summer (29.3%) than fall or winter. 5. Comparing weekly distribution, week end involing holiday outnumbered week day(48.5%). 6. The visiting time predominattly high from 8 : 00 PM to 0 : 00 AM(29.8%) during a day. 7, The majority duration of stay at Emergency center was 1-6 hours. 8. Most patients dischrged from the emergency center in good condition(76.5%).

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Treatment of obstructive sleep apnea in children

  • Ahn, Young-Min
    • Clinical and Experimental Pediatrics
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    • v.53 no.10
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    • pp.872-879
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    • 2010
  • Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.