• 제목/요약/키워드: Illness duration

검색결과 251건 처리시간 0.033초

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

  • 홍재락;유민규;정재만;김영준;손말현
    • Tuberculosis and Respiratory Diseases
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    • 제43권5호
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    • pp.693-700
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    • 1996
  • 연구배경: 1980년대 들어서 폐결핵의 치료는 INH, RFP, EMB(또는 SM)의 6개월 표준 단기 요법이 정착되었고 치료 성적 또한 괄목한 만한 향상을 보여왔으나 초치료 실패 및 재치료 실패 환자에서는 약제 내성 및 약제 부작용으로 인한 치료 중단이 큰 문제가 되었다. 1980년대 개발된 Quinolone 계통의 항생제인 OFX은 감영성 호흡기 질환 치료제로서의 역할을 할 뿐만 아니라, 최근에는 결핵 치료제로 사용되고 있다. 이에 따라 저자들은 PTA, CS, PAS, OFX을 사용하여 폐결핵 환자들의 재치료 또는 재재치료의 임상효과를 알아보았다. 방법: 1993년 3월부터 1995년 8월까지 국립 공주 결핵병원에 입원하였던 객담내 결핵균 양성 환자중 초치료및 재치료에 실패한 환자로 추척이 가능한 66명을 대상으로하여 후향적 조사를 하였다. 결과: 1) 객담내 균음전 객담 도말 양성 환자 66명 중 42 명(64%)이 15개월내에 객담내 균음전되었다. 2) 흉부 X-선상의 호전은 경증에서는 3명(75%), 중등중에서는 23명(64%), 중증은 12명(46%)이었고, 전체적으로는 38명(58%)에서 호전되었다. 4) 질병 기간에 따른 균 음전율은 각100%(병력이 1년미만), 88%(1-3년), 80%(3-5년) 그리고 52%(5년이상)이었다. 5) 부작용 PTA의 부작용은 위장판 장애(소화불량, 구역, 구토, 복통등)와 경한 간기능 장애를 보여주었고, CS은 정신상태 이상(주로 불면과 감정장애)이 8명(12%)에서 있었으며, 경련은 없었다. PAS에 의한 위장 장애는 오심, 구토, 복부 불쾌감과 같은 위장장애가 대부분으로 41명(62%)에서 관찰되었다(Table 5). 결론: 폐결핵 치료 역시 다른 모든 질환과 마찬가지로 환자의 병력이 젊을수록, 흉부 X-선상의 병변이 적을수록 좋은 성적을 보였으며, 38명(58%)의 경우에는 X-선상의 호전을 보였으나 일부에서는 매우 제한적이고 더 이상의 호전을 기대하기가 어려울 것으로 생각되는 예도 있었다. 부작용으로는 위장장애(소화장애, 오심, 구토, 변비, 설사)가 주가 되었으며, 위장장애는 대부분의 경우에서는 규칙적인 증상 치료로 많은 호전을 가져 왔다. 또한 무엇보다도 전문가에 의한 적절한 치료약제의 결정과 지속적인 항결핵제 복용을 위한 정기적인 의사와의 면담 및 추후검사가 필요할 것으로 생각된다.

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

  • 구애진;박진박;이종일;진혜경;김예니
    • 생물정신의학
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    • 제19권4호
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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.

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

  • 임중화;유종민;장선영;김현경;이준석;윤상협;김진성;류봉하;류기원;한숙영
    • 대한한방내과학회지
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    • 제25권2호
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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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악관절 강직증에 관한 임상적 연구 (CLINICAL STUDY OF TEMPOROMANDIBULAR JOINT ANKYLOSIS)

  • 송민석;민병일
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제17권1호
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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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소아청소년 자폐 스펙트럼장애에서 메칠페니데이트 사용의 임상적 특징에 대한 후향적 분석 (Clinical Characteristics of Methylphenidate Use in Korean Children and Adolescents with Autism Spectrum Disorder : A Retrospective Study)

  • 박진박;이종일;진혜경;민혜지;황준원;김예니
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권3호
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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.

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

  • 장중현;박사영
    • Tuberculosis and Respiratory Diseases
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    • 제46권5호
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    • pp.709-717
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    • 1999
  • 연구배경 및 방법 : BOOP는 미만성 간질성 폐질환의 일종으로 기질화폐렴의 특별한 한 형태로도 구분되는 아주 특별한 임상병리 소견을 가진 질환이다. 임상적으로는 내원 수주전부터 감기 유사증상을 앓다가 점차 악화되는 호흡곤란 증세로 내원하여 마치 폐렴양 소견을 보이며, 병리학적으로 폴립형의 육아 조직이 세기관지내에 충전되어 관강내 용종양 조직을 형성하고 폐포관에까지 침범된 기질화된 폐렴의 소견을 보인다. 최근, 저자등은 본원에서 경험한 다섯 증례와 국내의 학술지상에 증례 보고된 19예를 합하여 그 임상적 특성에 대해 분석해 보고 국외의 문헌보고 결과들과 비교분석하고자 하였다. 결 과 : 국내 환자들의 평균연령은 54세이었으며 여성에서 약간 더 많이 발생하였다. 병원에 내원한 주증상은 호흡 곤란 및 기침이었으며 그 지속기간은 평균 41일이었다. 흉부진찰에서 흡기시 악설음이 흔히 관찰되었고 여러 혈액학적 검사소견은 저산소혈증외에는 비특이적이었으며 이들 소견만으로는 폐렴과 구분하기 어려웠다. 폐활량검사에서는 제한성 혹은 폐쇄성과의 혼재형 환기장애가 주소견이었으며 방사선학적으로는 양측성, 반상의 비엽성 폐포침윤을 보였고 고해상 컴퓨터단층촬영에서 잘 확인되었다. 다른 간질성폐질환과는 달리 부신피질호르몬의 치료에 잘 반응하여 양호한 예후 및 경과를 보였다. 상기 국내의 결과는 국외 문헌보고에서 얻은 결과와 비교시에 대체적으로 유사 소견을 보였으나 국내는 여자에서 더 흔히 발생한 차이가 있었으며 엑스선 소견 및 임상경과 등에 대해서는 좀더 추적조사를 하여 비교해야 할 것으로 판단된다. 결 론 : 폐렴양 소견을 보이는 환자에서 적절한 치료에도 불구하고 임상양상이 비전형적이고 진행시에는 임상소견 및 방사선학적 소견 등을 BOOP의 관점에서 재점검해야 할 것이다. 이 질환은 부신피질호르몬제에 비교적 빠른 반응을 보이며 조기 진단으로 완치가 가능하지만 성급한 치료종결시 재발이 잘 되며 급격한 호흡부전으로 사망할 수도 있는 질환이므로 BOOP가 의심되고 치료에도 병이 진행성일 때 적기에 조직검사를 통해 확진함이 중요하다.

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

  • 임정은;김기현;황현서
    • Journal of Acupuncture Research
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    • 제17권2호
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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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인슐린 비의존성 당뇨환자의 자기효능, 지식, 자기간호행위와 대사조절간의 관계 (A Study of the Relationship of Self-Efficacy, Knowledge, and Self-Care Behavior to Metabolic Level in Patients with NIDDM)

  • 이숙희
    • 기본간호학회지
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    • 제10권2호
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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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관상동맥질환자의 강인성, 자기효능과 건강행위 이행과의 관계 (The Relationship between Hardiness.Self Efficacy and Compliance in Coronary Artery Disease Patients)

  • 김숙영
    • 동서간호학연구지
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    • 제3권1호
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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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류마티스 관절염 환자의 수면 및 관련 요인에 관한 연구 (A Study on Sleep in Rheumatoid Arthritis Patients)

  • 김금순;유경희
    • 기본간호학회지
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    • 제6권2호
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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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