• Title/Summary/Keyword: Illness duration

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Hepatosplenic Scanning with $^{198}Au$ Colloidal Gold in Chronic Myelogenous Leukemia (만성골수성백혈병(慢性骨髓性白血病)에 있어서 $^{198}Au$교질(膠質)을 사용(使用)한 간비주사소견(肝脾走査所見))

  • Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.13 no.1_2
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    • pp.15-21
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    • 1979
  • From January 1975 to March 1978, 18 cases of chronic myelogenous leukemia diagnosed at Kyungpook National University Hospital were tested by hepatosplenic scanning with $^{198}Au$ colloidal gold. The photo scanning findings in relation to clinical and laboratory findings are following. 1) Male to female ratio was 2:1 and 2nd and 3rd decades were predominant. 2) No focal space-occupying lesion was noticed both in the liver and spleen. 3) 4 cases revealed well visualization of spleen, 7 cases poor visualization, and 7 cases nonvisualization. 4) No significant difference between well visualization group and poor visualization group was noted in clinical findings, liver function test and hematologic findings. 5) Cases with nonvisualization of the spleen tended to be associated with thrombocytopenia, decreased megakaryocytes in the marrow and longer duration of the illness.

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A Clinical Analysis of the Thyroid Cancer (갑상선암의 임상적 고찰)

  • Park Ki-Min;Kang Hyung-Kil;Kim Lee-Su;Lee Bong-Hwa
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.213-220
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    • 1997
  • Background: Thyroid cancer is a relatively rare neoplasm and its incidence varies geographically and ethnically around the world. Thyroid cancer is the most common endocrine malignancy, but it has a wide spectrum of biologic behavior, histologic appearance, and management. Purpose: The purpose of the study was to analyse and evaluate all aspects of the clinical consideration in thyroid cancer. Method: Between 1986 and 1995, a retrospective analysis of 77 thyrod cancer patients admitted at the Department of Surgery, Hangang Sacred Heart Hospital, Hallym University was made to assess clinical entities. Result: By the pathological classification, the papillary carcinoma was the most common type(83.1%). Male to female ratio was 1 : 5.4 and most prevalent age group was noted from fourth decade to fifth decade(46.8%). The most common duration of illness between the appearance of the symptoms and the treatment was below 6 months(44.2%), and the most common symptom was the palpable mass at the anterior portion of the neck(96.1%). Most cases of the thyroid cancer were appeared as cold nodule in the $^{99m}$Tc-thyroid scan(95.7%). In the site of tumor location, the right and left lobe was distributed similarly. In the extent of tumor, incidence of intrathyroidal location was 41.6%, and that of the metastasis to the cervical lymph nodes was 44.2% and that of the direct capsular invasion was 27.3%, and incidence of both involved case was 13%. Surgical procedures were total thyroidectomy alone in 27 cases(35.1%) or with modified neck dissection in 6 cases(7.8%), or with radical neck dissection in 2 cases (2.6%), near total thyroidectomy alone in 22 cases(28.6%), ipsilateral lobectomy with isthmectomy alone in 12 cases(15.6%) or with modified neck dissection in 1 case(1.3%), and biopsy only in 7 cases(9.1%). The most common postoperative complications were transient hypoparathyroidism(5.2%) and transient unilateral recurrent laryngeal nerve paralysis(5.2%). Conclusion: The major problem of management of thyroid cancer include a wide spectrum of clinical behaviour of this tumor entity, the lack of reliable prognostic factors and lack of an objective assessment of the various treatment modalities. But because of showing the favorable prognosis for most thyroid cancer, appropriate and aggressive management should be recommended.

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A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area (일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구)

  • Jang, In-Sun
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.2
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients (류마티스 관절염 환자 배우자의 부담감)

  • Choi, Kyung-Sook;Eun, Young;Ham, Mee-Young
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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The Effects of Treatment of Korean Medicine for Superior Labrum Anterior to Posterior Lesions: A Retrospective Chart Review

  • Park, Ju-Hun;Cho, Hyun-Woo;Park, Han-Bin;Yoo, Dong-Hwi;Kim, Sang-Gyun;Kwon, Oh-Hoon;Choi, Kang-Eah;Choi, Seong-Hun;Chu, Hong-Min;Jang, Jong-Won
    • Journal of Acupuncture Research
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    • v.37 no.1
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    • pp.49-58
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    • 2020
  • Background: This study aimed to investigate the clinical effectiveness of treatment of Korean medicine on superior labrum anterior to posterior (SLAP) lesions. Methods: A total of 55 inpatients diagnosed with SLAP lesions by magnetic resonance imaging, were investigated from May 1st, 2014 to May 31st, 2019 at Haeundae Jaseng Hospital of Korean Medicine. The patients were sorted by gender, age, causing factor, illness duration, period of hospitalization, SLAP lesion type, complications, and treatments. Treatments included acupuncture, pharmacopuncture, Chuna therapy, herbal treatment, and physiotherapy. After treatment, the Numeric Rating Scale, Shoulder Pain and Disability Index, and European Quality of Life 5-Dimension questionnaire were used to evaluate treatment effect. Results: There were more males than females in this study (1:0.83). Patients were more likely to be in their 50s (38.18%), have an unknown etiology (70.91%), and be in the subacute disease stage (41.82%). According to the SLAP lesion type, most of the inpatients had Type 2 lesions (69.09%). For inpatients diagnosed with SLAP lesions, the mean shoulder numeric rating scale score decreased from 5.55 ± 0.90, to 4.07 ± 1.18 (p < 0.001), the mean Shoulder Pain and Disability Index score decreased from 50.35 ± 18.36, to 39.90 ± 19.34 (p < 0.001), and the mean European quality of life 5-dimension index increased from 0.70 ± 0.16, to 0.75 ± 0.13 (p < 0.01) after treatment. Conclusion: Treatment of Korean medicine effectively decreased pain and increased the quality of life of the patients with SLAP lesions in this study.

Uncertainty, Social Support & Powerlessness in Mothers of Handicapped Children (장애아 어머니의 불확실성, 사회적 지지 및 무력감)

  • Park Eun Sook;Oh Won Oak
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.151-166
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    • 1999
  • The purposes of this study were to measure the degree of perceived uncertainty, social support & powerlessness, to examine the relationship between the perceived uncertainty, social support & powerlessness and then to find the predictors of powerlessness in mother's of handicapped children. The subjects of this study consist of 102 mothers of handicapped children, registered at rehabilitation & handicapped children school. Data was collected from September 1998 to March 1999. The tools used in this study were Mishel's the Parents' Perception of Uncertainty Scale (28 item, 4 likert scale), Miller's Powerlessness measurement Scale(28 itewt 4 likert scale) & Cohen's Interpersonal Support Evaluation List (40 items, 4 likert scale). Data was analyzed by t-test, ANOVA, Duncan comparison, Pearson Correlation coefficient & Stepwise multiple regression Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high(Mn 2.50). The degree of perceived uncertainty by the four components were followed as : lack of clarity(2.69), unpredictability(2.56), ambiguity(2.56) & lack of information(2.46). The degree of perceived uncertainty of the mothers of handicapped children revealed to be influenced significantly by age of children, admission experience, disability types of children. 2. The degree of mothers' powerlessness was measured to be slightly high(Mn 2.14). The degree of perceived powerlessness of the mothers with handicapped children revealed to be influenced significantly by age of children, duration of illness admission experience,8E marital status of the mothers. 3. Mothers perceived their social support to be slightly high(Mn 2.71). The degree of perceived social support revealed to be influenced significantly by sex of children, married state of mothers. 4. Mothers' uncertainty was related positively to the mothers' powerlessness(r=.33, p=.0008). And also mothers' powerlessness was related inversely to social support(r=-.50, p=.0001). But, mothers' uncertainty was not related to social support significantly. 5. To analyze the variables which affect powerlessness, stepwise regression was implemented. As a result, about 61% of the powerlessness were explained by social support, marital status of the mothers and perceived uncertainty. Based upon these results, it is recommended that the nurses, who are caring handicapped children and their families, provide various support programs for them to overcome their difficulties. Also programs which decrease the uncertainty & powerlessness used social support multidimensionally & individually are recommended to be developed.

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The Efficacy and Safety of Moclobemide Twice Daily : An Open Trial in Patients with Major Depressive Disorder (1회 2회 분복 투여하는 Moclobemide의 효과와 안전성 : 주요우울장애 환자에서 개방 시험)

  • Yoon, Jin-Sang;Lee, Hyung-Young;Kook, Seung-Hee;Choi, Young
    • Korean Journal of Biological Psychiatry
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    • v.3 no.1
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    • pp.102-108
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    • 1996
  • This was an open trial to evaluate the efficacy and safety of moclobemide twice daily for treatment of Korean patients with major depressive disorder(DSM-III-R). The duration of the trial was 6 weeks with the initial dose of moclobemide being fixed lor the first two weeks at 300mg/day(150mg twice daily, each token after morning and evening meals). Thereafter, when necessary, the dose was allowed to increase to 600mg/day or decrease to 150mg/day according to the seventy of the depression and/or the tolerability of the drug. Hypnotics and/or sedatives from a benzodiazepine group could be concomitantly administered at usual dosage. Patients were assessed at baseline and at days 14, 28 and 42. Efficacy was primarily judged on the Hamilton Rating Scale for Depression(HAM-D) and Beck Depression Inventory(BDI). Patients had to score at least 17 respectively an both scales to enter the trial. Secondary efficacy parameters included Clinical Global Impression(CGI) for severity of illness and improvement. Safety and tolerability were judged on reported adverse events, vital signs and laboratory parameters. In addition, there was a series of questions and assessments for the psychiatrists and patients to complete at the end of the trial Twenty nine patients completing trial were included in the analysis of efficacy : of thirty one patients participating in the safety and tolerability analysis, those who withdraw voluntarily without particular reasons or violated the treatment schedule were not included. The efficacies as determined by HAM-D, BDI or CGI were found to be significant compared to baseline. The number of responders defined as patients with a total score of 10 or less or with a total score of 50% or less of the baseline score on HAM-D and BDI were 17(59%) and 18(62%) respectively. Regarding safety and tolerability, nine patients(29%) reported mild adverse events probably related to moclobemide : of these one patient dropped out because of poor tolerability : however, there were no appreciable changes in blood pressure, pulse rate, body weight or laboratory parameters for all patients over the trial period. Furthermore, the physicians' and patients' opinions at final evaluation showed that moclabemide has a good antidepressant effect as well as a favorable tolerability. In conclusion, a twice-daily dosage schedule with maclobemide is recommendable for the treatment of Korean patients with major depressive disorder since its efficacy and safety were demonstrated in this study.

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A Cohort Study of Children and Adolescents Victims with Sexual Abuse in Korea and Their Initial Assessment Results (아동청소년 성폭력 피해자들을 위한 코호트 연구 : 코호트 구축과 초기 평가 결과)

  • Kim, Kyung-Yoon;Lee, Na-Hyun;Cheon, Keun-Ah;Song, Dong-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.13-24
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    • 2019
  • Objectives : The goals of the study are how to establish the cohort systems for the children and adolescents victims with sexual abuse in Korea and to identify the risk and protective factors that influence mental health in child sexual abuse (CSA). This is initial assessment data based on the analysis of cohort variables for baseline evaluation of subjects. Methods : We constructed the cohort systems for CSA victims recruited by Seoul Sunflower Children Center, CSA victims protection center. The initial assessment data which consisted of demographic and psychological inventories of CSA victims and their parents/families, psychiatric diagnoses were the results of statistical analysis of 65 subjects under 19 years old for 3 years 7 months. Results : The initial data were followings : female participants, N=56; mean age, 11.6 (SD=4.5); the most sexual assault, molestation 71.8%; victims, family and acquaintance 87.1%; 61.5% of the subjects diagnosed with psychiatric disorder; 29.2% diagnosed with PTSD and 23.1% diagnosed with depression. Mean duration for abuse to report is 1.5 years. Mean score of IES-R-K, TSCYC-avoidant and CBCL-problematic behavior were increased above clinical cut-off. Conclusions : CSA victims tend to have high risks in mental health problem. The cohort study could provide the risk and protective factors of CSA in mental health, and construct the predictive model for mental illness in Korea.

Morphologic Alterations in Amygdala Subregions of Adult Patients with Bipolar Disorder

  • Lee, Hyun-Jae;Han, Kyu-Man;Kim, Aram;Kang, Wooyoung;Kang, Youbin;Kang, June;Won, Eunsoo;Tae, Woo-Suk;Ham, Byung-Joo
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.22-31
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    • 2019
  • Objectives Previous studies have revealed inconsistent results on amygdala volume in adult bipolar disorder (BD) patients compared to healthy controls (HC). Since the amygdala encompasses multiple subregions, the subtle volume changes in each amygdala nucleus might have not been fully reflected in the measure of the total amygdala volume, causing discrepant results. Thus, we aimed to investigate volume changes in each amygdala subregion and their association with subtypes of BD, lithium use and clinical status of BD. Methods Fifty-five BD patients and 55 HC underwent T1-weighted structural magnetic resonance imaging. We analyzed volumes of the whole amygdala and each amygdala subregion, including the anterior amygdaloid area, cortico-amygdaloid transition area, basal, lateral, accessory basal, central, cortical, medial and paralaminar nuclei using the atlas in the FreeSurfer. The volume difference was analyzed using a one-way analysis of covariance with individual volumes as dependent variables, and age, sex, and total intracranial volume as covariates. Results The volumes of whole right amygdala and subregions including basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area in the right amygdala of BD patients were significantly smaller for the HC group. No significant volume difference between bipolar I disorder and bipolar II disorder was found after the Bonferroni correction. The trend of larger volume in medial nucleus with lithium treatment was not significant after the Bonferroni correction. No significant correlation between illness duration and amygdala volume, and insignificant negative correlation were found between right central nucleus volume and depression severity. Conclusions Significant volume decrements of the whole amygdala, basal nucleus, accessory basal nucleus, anterior amygdaloid area, and cortico-amygdaloid transition area were found in the right hemisphere in adult BD patients, compared to HC group. We postulate that such volume changes are associated with altered functional activity and connectivity of amygdala nuclei in BD.

Surgical outcome of extrahepatic portal venous obstruction: Audit from a tertiary referral centre in Eastern India

  • Somak Das;Tuhin Subhra Manadal;Suman Das;Jayanta Biswas;Arunesh Gupta;Sreecheta Mukherjee;Sukanta Ray
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.350-365
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    • 2023
  • Backgrounds/Aims: Extra hepatic portal venous obstruction (EHPVO) is the most common cause of portal hypertension in Indian children. While endoscopy is the primary modality of management, a subset of patients require surgery. This study aims to report the short- and long-term outcomes of EHPVO patients managed surgically. Methods: All the patients with EHPVO who underwent surgery between August 2007 and December 2021 were retrospectively reviewed. Postoperative complications were classified after Clavien-Dindo. Binary logistic regression in Wald methodology was used to determine the predictive factors responsible for unfavourable outcome. Results: Total of 202 patients with EHPVO were operated. Mean age of patients was 20.30 ± 9.96 years, and duration of illness, 90.05 ± 75.13 months. Most common indication for surgery was portal biliopathy (n = 59, 29.2%), followed by bleeding (n = 50, 24.8%). Total of 166 patients (82.2%) had shunt procedure. Splenectomy with esophagogastric devascularization was the second most common surgery (n = 20, 9.9%). Nine major postoperative complications (Clavien-Dindo > 3) were observed in 8 patients (4.0%), including 1 (0.5%) operative death. After a median follow-up of 56 months (15-156 months), 166 patients (82.2%) had favourable outcome. In multivariate analysis, associated splenic artery aneurysm (p = 0.007), isolated gastric varices (p = 0.004), preoperative endoscopic retrograde cholangiography and stenting (p = 0.015), and shunt occlusion (p < 0.001) were independent predictors of unfavourable long-term outcome. Conclusions: Surgery in EHPVO is safe, affords excellent short- and long-term outcome in patients with symptomatic EHPVO, and may be considered for secondary prophylaxis.