• Title/Summary/Keyword: Illness duration

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Clinical Effects of Prothinoamide, Cycloserine, Para-Aminosalicylic Acid, Ofloxasine in Retreatment of Pulmonary Tuberculosis (폐결핵 재치료 환자에서 Prothionamide, Cycloserine, Paraminosalicylic acid, Ofloxasine을 이용한 경구 4제 요법의 임상 효과)

  • Hong, Jae-Rak;Yoo, Min-Kyu;Jeong, Jae-Man;Kim, Young-Jun;Son, Mal-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.693-700
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    • 1996
  • Background : Antituberculous therapy is set a short-term therpy used isoniazid(INH), rifampin(RFP), ethambutol(EMB), pyrazinamide(PZA) from 1970s' and treatment rate has been very improved. But drug interruption or irregular medication due to side effects and resistance of drug are serious problem to retreatment cases, specially. Ofloxasine(OFX), developed from Quinolone at 1980's is effective not only other respiratory infectious disease but also pulmonary tube rculosis. And this is useful drug instead of injection agents for retreatment patients who have side effects to other drugs, lived far distance from medical clinics. So, we will evaluate theffectiveness as four oral drugs involving OFX. Method : A retrospective study was made through the regular follow up of smear positive cases,who treated by four drug, namely, prothionamide (PTA) cycloserine(CS), OFX, paraminosalicylic acid(pAS). Results: 1) Out of 66case with positive sputum AFB smear, 42(64%)cases achieved the negative conversion. 2) Considering the negative conversion in all group, 34 case (52%) of sputum conversion occured within first 6 months, on the extent of diease was minimal, moderate, far advanced pulmonary tuberculosis, sputum AFB smear negative response to treatment was 100%, 78%, 46% respectively. 3) The roentgenological improvement occured in 38(58%), extent of diease was minimal, moderately, far advanced pulmonary tuberculosis, Roentgenological improvement to retreatment was 75%, 64%, 46%. 4) When the drnation of patients illness was less than 1 year, 1 to 3 years, 3 10 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 100%, 88%, 80%, 52 %. 5) On side effects, major problems are gastrointestinal troubles, mild liver function abnormality, psychotic problemes, and skin problem(urticaria, itching sensation). Conclusion : The duration & extents of patients illness was shorter & minimal, sputum AFB smear negative response rate was better. Radiologic response is better as shorter duration and minimal extent of diease. But, as diease is longer duration & far advanced, sputum negative conversion & Roentgenological improvement is poor and limited. The adverse reaction was mainly observed gastrointestinal troubles(indigestion, abdominal pain, nausea, vomiting, diarrhea) and are well controled by symptomatic management in most patients, as regard to tolerance to the secondary drugs.

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Retrospective Analyses of Long-Term Use of SSRI in Children and Adolescents with Autism Spectrum Disorder (소아청소년 자폐성 스펙트럼 장애에서 SSRI 장기 사용에 대한 후향적 분석)

  • Goo, Ae-Jin;Park, Jin-Park;Lee, Jong-Il;Jhin, Hye-Kyung;Kim, Yeni
    • Korean Journal of Biological Psychiatry
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    • v.19 no.4
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    • pp.205-210
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    • 2012
  • Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

Analysis of symptom pattern through comprehensive diagnosis of Qui Xui Shui in patients with functional dyspepsia (기혈수변증(氣血水辨證)에 의한 기능성 소화불량 환자의 변증유형 분석)

  • Lim, Jung-Hwa;Ryu, Jong-Min;Jang, Sung-Young;Kim, Hyun-Kyung;Lee, Joon-Suk;Yoon, Sang-Hyub;Kim, Jin-Sung;Ryu, Bong-Ha;Ryu, Ki-Won;Han, Sook-Young
    • The Journal of Internal Korean Medicine
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    • v.25 no.2
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    • pp.224-237
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    • 2004
  • Background & Object : It is well known that functional dyspepsia is one of the most common diseases. While many dyspepsia patients have been helped with oriental medical therapy, there has not been a study based on the concepts of oriental medicine. The aim of this study was to perform a fundamental epidemiological survey and to analyse the symptom pattern of functional dyspepsia. Methods : 86 patients(27 males, 59 females) diagnosed with functional dyspepsia in Kyunghee Oriental Medical Center from May to December 2002 were involved in this investigation. The disease characteristics of functional dyspepsia(based on Rome criteria II) and the Qui Xue Shui diagnostic procedure were investigated by questionnaire and physical examination. The total score and composition ratio of each comprehensive diagnosis were calculated from the symptom score described in the questionnaire. Results : The total score from the Qui Xue Shui diagnostic procedure was found to be influenced by the number of functional dyspepsia symptoms(p=0.026) and the patient's own cognition of their current dyspeptic situation(p=0.006), in addition to digestive ability and general congnition(p=0.006), and was not associated with sex, duration of dyspeptic symptoms in one year, or the total illness period, In the composition ratio of the Qui Xue Shui diagnostic procedure, only Qui-yu(p=0.048) diagnosis was accurate regarding the number of symptoms in one year, total illness period, or the patients' own congnition of their current dyspeptic situation, But the value of the composition ratio among the total factors involved was most similar to that of sex. Conclusions : Thus, it is shown here that the total score of using the Qui Xue Shui diagnostic procedure is mainly dependent on dyspeptic symptoms and the patinets' own cognition of their current dyspeptic situation, and that regular symptom patterns in the Qui Xue Shui diagnostic procedure exist in dyspeptic patients.

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CLINICAL STUDY OF TEMPOROMANDIBULAR JOINT ANKYLOSIS (악관절 강직증에 관한 임상적 연구)

  • Song, Min-Seok;Min, Byong-Il
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.1
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    • pp.60-72
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    • 1995
  • Temporomandibular joint ankylosis is the movemental obstacle of mandible which depend on proliferation of bony or fibrous tissue in temporomandibular joint structure by various causes. In order to treat this, various surgical methods have been performed, but no operative methods have been produced consistently successful results. This research has been performed to the patients who had been operated due to temporomandibular joint ankylosis by studying classification, cause, onset, duration, anesthesia and treatment method, symptom, change of mouth opening, complication through medical record, X-ray, follow-up for being a help to proper selection of treatment method and evaluation of prognosis. The author obtained the following results by analyzing 44 cases among patients who had been operated due to temporomandibular joint ankylosis during 8 year hospitalization from 1986 to 1993 in Dept. of Oral & Maxillofacial Surgery of Seoul National University Hospital. 1. The occurrence was in the order of below 10, 20's, 10's, 30's. The average of occurrence was 12.95. Illness period was 50.0% within 10 years and 50% beyond 10 years. The average period of illness was 13.33 years. 2. Trauma occupied 54.5% of causes and inflammation occupied 45.5%. Men had more occurrences due to trauma and there was no difference in case of inflammation. 3. In nasotracheal intubations for general anesthesia, the cases of using fiberoptic laryngoscope occupied 40.9%, direct or blind nasotracheal intubation occupied 40.9% and the cases of using tracheostomy occupied 18.2%. 4. In operative approaching methods, submandibular & preauricular approach were mainly applied, and in operative methods, high condylectomy(Group I) occupied 11.4%, arthroplasty without interpositional material following condylectomy or gap ostectomy(Group II) occupied 11.4%, with interpositional material following high condylectomy (Group III) occupied 40.9%, and using condylar reconstruction following condylectomy or gap ostectomy(Group IV) occupied 36.6%. 5. In change of mouth opening reformed after surgery, Group III showed the best result of average 23.5mm, Group IV showed 16.3mm, Group I showed 14.9mm and Group II showed 10.2mm of reformation. Summarizing the results as written above, it is considered that early treatment is important as soon as possible in Temporomandibular joint ankylosis. It is recommended in surgical method what can lead to postoperative early movement maintaining anatomaical & functional form, and then the development of various surgical methods will be requested.

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Clinical Characteristics of Methylphenidate Use in Korean Children and Adolescents with Autism Spectrum Disorder : A Retrospective Study (소아청소년 자폐 스펙트럼장애에서 메칠페니데이트 사용의 임상적 특징에 대한 후향적 분석)

  • Park, Jin-Park;Lee, Jong-Il;Jhin, Hea-Kyung;Min, Hae-Ji;Hwang, Jun-Won;Kim, Ye-Ni
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.154-160
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    • 2012
  • Objectives : The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods : Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results : We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was $26.2{\pm}11.1$mg/day and mean duration of treatment was $31.9{\pm}28.7$ months. Mean CGI-S score improved significantly from baseline to endpoint (from $5.4{\pm}0.6$ to $4.1{\pm}0.9$ ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion : The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.

Twenty Four Cases of Idiopathic Bronchiolitis Obliterans Organizing Pneumonia, Reported in Korea and a Review of Literatures (국내 보고된 특발성 폐쇄성세기관지염 기질화폐렴 24예와 문헌 고찰)

  • Chang, Jung-Hyun;Park, Sa-Yong
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.709-717
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    • 1999
  • Background & Method : Bronchiolitis obliterans organizing pneumonia(BOOP) is a specific clinicopathologic condition characterized by chronic inflammatory interstitial infiltrates. Cryptogenic form of BOOP presents subacute clinical course of flu-like illness, such as cough, fever, dyspnea with exertion and other constitutional symptoms. Pathologically it shows the presence of granulation tissue filling the lumen of terminal and respiratory bronchioles, extending into distal airspaces. Recently, we reviewed 24 cases of idiopathic type of BOOP, 5 cases of our hospital and another 19 cases on Korean literatures, and compared with reviewed data from foreign literatures. Results : Mean age was 54 years old and there was female preponderance in domestic reports. Their common presenting symptoms were dyspnea and cough, and mean duration of illness was 41 days. On chest examination, inspiratory crackle was a common finding. The laboratory findings were nonspecific except hypoxemia. Lung function studies revealed restrictive defect or combined obstructive and restrictive pattern in most patients. Bilateral patchy and nonsegmental alveolar opacities constituted characterized radiographic finding, highlighted on high resolution computed tomogram. It showed a favorable prognosis with an excellent responsiveness to corticosteroid therapy. The clinical features and laboratory findings were similar between domestic and foreign cases except female preponderance in Korean cases. Conclusion : If the clinical course is atypical or pregressive under proper treatment, clinicians should reevaluate clinical features and radiographic findings under the consideration of BOOP. Tissue confirmation would be recommended for the definitive diagnosis of BOOP.

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The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture (흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察))

  • Lim, Jeoung-Eun;Kim, Kee-Hyun;Hwang, Hyeon-Seo
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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A Study of the Relationship of Self-Efficacy, Knowledge, and Self-Care Behavior to Metabolic Level in Patients with NIDDM (인슐린 비의존성 당뇨환자의 자기효능, 지식, 자기간호행위와 대사조절간의 관계)

  • Lee Sook-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.171-180
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    • 2003
  • Purpose: The purpose of this study was to investigate the relationship of self-efficacy, knowledge about the disease, and self-care behavior to the metabolic level in patients with NIDDM. Method: Data were collected from March 15 to April 15, 2001. Participants in the study were 48 patients with NIDDM who were seen regularly at the endocrinology out-patient department of Gwangju Christian Hospital. The data were collected through individual interviews and patient blood samples. The data were analyzed with SPSS/PC+, using t-test, ANOVA, Pearson correlation coefficients and Cronbach's Alpha. Result: 1. The mean score for self-efficacy was $71.37{\pm}15.56$, knowledge $15.00{\pm}2.84$, self-care behavior $63.18{\pm}13.10$. The mean score for HbAlc level was $7.66{\pm}1.77%$, HDL cholesterol level, $46.22{\pm}13.04 mg/dl$ and total cholesterol level, $187.93{\pm}41.45 mg/dl$. 2. There was a significant difference between patients with a spouse and those without one (t=-2.08, p=0.042), in knowledge according to level of obesity (t=5.14, p=0.010), duration of illness (t=3.22, p=0.031) and presence of complications related to diabetes (t=-2.58, p= 0.013). There were no significant differences in self-care behavior, but there were significant differences in sugar metabolic level according to sex (t=-2.02, p=0.050). 3. The correlation between diabetic patients' self-efficacy, knowledge and self-care behaviour and metabolic control was significantly related only to self-efficacy and self-care behavior (r=.692, p=0.000). Conclusion: It is necessary to improve self-efficacy, knowledge, and self-care behavior for patients with NIDDM by using nursing intervention programs to promote and maintain metabolic control.

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The Relationship between Hardiness.Self Efficacy and Compliance in Coronary Artery Disease Patients (관상동맥질환자의 강인성, 자기효능과 건강행위 이행과의 관계)

  • Kim, Sook-Young
    • Journal of East-West Nursing Research
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    • v.3 no.1
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    • pp.83-95
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    • 1998
  • The purpose of this study was to investigate the relationship between hardiness-self efficacy and compliance in coronary artery disease patients. The subjects for the study were 106 patients who admitted to S medical center or visited to outpatient clinic. The instruments used for this study included a questionnaire of general characteristics, compliance, health related hardiness and self efficacy. The data were analyzed by using mean, t -test, ANOVA, Scheffe test, Pearson correlation. The results of this study were as follows: 1. The average score for compliance was 70.75, for the hardiness was 87.35, for the self efficacy was 59.04. 2. The relationship between the variables of compliance and hardiness self efficacy was significant. Compliance was significantly related to hardiness(r=.47, p<.01), suggesting that the person with high hardiness got higher compliance scores. The three dimensions of health related hardiness were control, commitment, challenge. Control(r=.513, p<.01), commitment(r=.258, p<.05), challenge(r=.419, p<.01), were significantly related to compliance. A slight but significant correlation was also found between compliance and self efficacy(r=.21, p<.05). 3. In the relationship between general characteristics variables and compliance there were significant differences in marital status(t =3.43, p<.01), duration of illness(F=4.98, p<.01), hospitalized experience(t=2.04, p<.05), educational experience(t=2.66, p<.01). From the above results, it can be concluded that ; Hardiness and self efficacy were found as important factors of the compliance in coronary artery disease patients. These results suggest that nursing intervention to increase the level of hardiness and self efficacy should be developed.

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A Study on Sleep in Rheumatoid Arthritis Patients (류마티스 관절염 환자의 수면 및 관련 요인에 관한 연구)

  • Kim Keum-Soon;Yoo Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.198-210
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    • 1999
  • This study is to investigate sleep patterns of rheumatoid arthritis patients through a survey research. The subjects for this study were 97 patients registered in Hanyang University Hospital Rheumatoid Arthritis Center, and the period of data collection was from July 15, 1998 to August 30, 1998. The research instruments used in this study were the measures of sleep, pain, and fatigue, and SPSSWIN 8.0 Program was used for data analysis. The research results are as follows ; The patients went to bed between 11 and 12 p.m., but many of them found difficulty in falling asleep within 5 minutes. They woke up quite early at around 4 to 6 o'clock in the morning and remained in bed about 1 hour. Only 39 percent of the subjects reported satisfaction with their sleep. Fifty six percent of the subjects took a nap, generally did in the afternoon and 22.7 percent of them napped for half an hour. They suffered sleep disturbance, but their sleep environments were calm and comfortable, and they turn off the light when they went to sleep. As for the quality of sleep, over 50 percent of the subjects reported not being able to sleep deeply, 30 percent of the subjects woke up frequently during sleep, 60 percent experienced frequent arousal after sleep onset. Over 90 subjects slept for 6 to 8 hours. This shows that even though they had rheumatoid arthritis, the patients remained in bed for a sufficient period of time. They also reported waking up or turning frequently during sleep. The sense of fatigue from sleep disturbance scored a relatively high 35.84 points on average against the possible score of 64 points. Behavior for sleep promotion was very active. Sleep disturbance occurred in proportion to the sense of fatigue and pain, and was negatively correlated with quality of sleep. The pain had positive correlations with the illness duration, sleep disturbance and had a negative correlation with the quality of sleep.

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