• Title/Summary/Keyword: Limited-disease

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만성질환 관리 평가도구를 이용한 보건소 만성질환 관리수준 평가 (Evaluating Chronic Care of Public Health Centers in a Metropolitan City)

  • 최용준;신동수;강민아;배상수;김재용
    • 보건행정학회지
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    • 제24권4호
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    • pp.312-321
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    • 2014
  • Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu;Song, Hyun;Lee, Seok In;Moon, Mi Hyung;Kim, Hwan Wook;Jo, Gyun Hyun
    • Journal of Chest Surgery
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    • 제47권2호
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    • pp.106-110
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    • 2014
  • Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

3-Dimensional fasciectomy: A highly efficacious common ground approach to Dupuytren's surgery

  • Miranda, Benjamin H;Elliott, Charlotte;Kearsey, Christopher C;Haughton, David N;Webb, Mark R;Harvey, Ian;Fahmy, Fahmy S
    • Archives of Plastic Surgery
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    • 제45권6호
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    • pp.557-563
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    • 2018
  • Background Numerous Dupuytren's fasciectomy techniques have been described, each associated with unique surgical challenges, complications and recurrence rates. We describe a common ground surgical approach to Dupuytren's disease; 3-dimensional fasciectomy (3DF). 3DF aims to address the potential contributors to the high recurrence rate of Dupuytren's disease and unite current limited fasciectomy practice that varies considerably between surgeons. Methods We describe the 3DF principles; raising thin skin flaps (addressing dermal involvement), excising diseased palmar fascia with a 3-5 mm clearance margin (treating highly locally recurrent conditions) and excising the vertical septae of Legueu and Juvara (providing deep clearance, hence addressing all potentially involved pathological tissue). The surgical outcomes between traditional limited fasciectomy (LF) and 3DF are compared. Results From the 786 operations included (n=585), postoperative recurrence rates were significantly lower for the 3DF group (2/145, 1.4%) than the LF group (72/641, 11.2%) (P= 0.001), and the time to recurrence was significantly longer ($5.0{\pm}0years$ vs. $4.0{\pm}0.2years$; P<0.0001). With recurrence excluded, there were no differences between the postoperative complication rates for 3DF (5/145, 3.5%) and LF (41/641, 6.4%) (P=0.4). Conclusions Our results suggest that 3DF leads to lower recurrence rates and a longer disease-free period for patients, without increasing complications. 3DF provides a safe, efficacious, common ground surgical approach in the treatment of Dupuytren's flexion deformity.

Clinical presentation and treatment outcomes of primary ocular adnexal MALT lymphoma in Thailand

  • Seresirikachorn, Kasem;Norasetthada, Lalita;Ausayakhun, Sakarin;Apivatthakakul, Atitaya;Tangchittam, Sirima;Pruksakorn, Vannakorn;Wudhikarn, Kitsada;Wiwatwongwana, Damrong
    • BLOOD RESEARCH
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    • 제53권4호
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    • pp.307-313
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    • 2018
  • Background Primary ocular adnexal extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (POML) is the most common subtype of lymphoma involving the eyes in Thailand. We sought to assess the characteristics and treatment outcomes of patients with POML in Thailand. Methods We retrospectively reviewed patient data and included patients diagnosed with POML between January 2004 and December 2016 at Chiang Mai University Hospital and King Chulalongkorn Memorial Hospital, Thailand. We collected and analyzed patients' clinical characteristics and treatment outcomes. Results Among 146 patients with lymphoma involving the eyes, 121 (82%) were diagnosed with POML. Sixty-four (52.9%) were women with median age 58 (range, 22-86) years. The most common presenting symptom was orbital mass (71.1%). Common sites of origin were the orbit (46.3%) and lacrimal gland (34.7%). At presentation, 22.3% of patients had bilateral eye involvement. About half of patients had stage I disease (N=59, 56.2%) and 20% had stage IV. Most patients (73.3%) had a low-risk International Prognostic Index. Radiotherapy was the main treatment for patients with limited-stage disease (66.7% in stage I and 56.5% in stage II). The overall response rate was 100% with complete response rates 80%, 77.3%, and 64.7% for stages I, II, and IV, respectively. Five-year progression-free survival (PFS) and overall survival were 66.1% and 94.0%, respectively. For patients with limited-stage disease, radiotherapy significantly improved PFS compared with treatment not involving radiotherapy (5-year PFS 89.9% vs. 37.3%, P=0.01). Conclusion We revealed that POML has good response to treatment, especially radiotherapy, with excellent long-term outcome.

Analysis of Endophytic Bacterial Communities and Investigation of Core Taxa in Apple Trees

  • Yejin Lee;Gyeongjun Cho;Da-Ran Kim;Youn-Sig Kwak
    • The Plant Pathology Journal
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    • 제39권4호
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    • pp.397-408
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    • 2023
  • Fire blight disease, caused by Erwinia amylovora, is a devastating affliction in apple cultivation worldwide. Chemical pesticides have exhibited limited effectiveness in controlling the disease, and biological control options for treating fruit trees are limited. Therefore, a relatively large-scale survey is necessary to develop microbial agents for apple trees. Here we collected healthy apple trees from across the country to identify common and core bacterial taxa. We analyzed the endophytic bacterial communities in leaves and twigs and discovered that the twig bacterial communities were more conserved than those in the leaves, regardless of the origin of the sample. This finding indicates that specific endophytic taxa are consistently present in healthy apple trees and may be involved in vital functions such as disease prevention and growth. Furthermore, we compared the community metabolite pathway expression rates of these endophyte communities with those of E. amylovora infected apple trees and discovered that the endophyte communities in healthy apple trees not only had similar community structures but also similar metabolite pathway expression rates. Additionally, Pseudomonas and Methylobacterium-Methylorobrum were the dominant taxa in all healthy apple trees. Our findings provide valuable insights into the potential roles of endophytes in healthy apple trees and inform the development of strategies for enhancing apple growth and resilience. Moreover, the similarity in cluster structure and pathway analysis between healthy orchards was mutually reinforcing, demonstrating the power of microbiome analysis as a tool for identifying factors that contribute to plant health.

Production of Surfactin and Iturin by Bacillus licheniformis N1 Responsible for Plant Disease Control Activity

  • Kong, Hyun-Gi;Kim, Jin-Cheol;Choi, Gyoung-Ja;Lee, Kwang-Youll;Kim, Hyun-Ju;Hwang, Eul-Chul;Moon, Byung-Ju;Lee, Seon-Woo
    • The Plant Pathology Journal
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    • 제26권2호
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    • pp.170-177
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    • 2010
  • Bacillus licheniformis N1, previously developed as a biofungicide formulation N1E to control gray mold disease of plants, was investigated to study the bacterial traits that may be involved in its biological control activity. Two N1E based formulations, bacterial cell based formulation PN1E and culture supernatant based formulation SN1E, were evaluated for disease control activity against gray mold disease of tomato and strawberry plants. Neither PN1E nor SN1E was as effective as the original formulation N1E. Fractionation of antifungal compounds from the bacterial culture supernatant of B. licheniformis N1 indicated that two different cyclic lipopeptides were responsible for the antimicrobial activity of the N1 strain. These two purified compounds were identified as iturin A and surfactin by HPLC and LCMS. The purified lipopeptides were evaluated for plant disease control activity against seven plant diseases. Crude extracts and purified compounds applied at 500 ${\mu}g/ml$ concentration controlled tomato gray mold, tomato late blight and pepper anthracnose effectively with over 70% disease control value. While iturin showed broad spectrum activity against all tested plant diseases, the control activity by surfactin was limited to tomato gray mold, tomato late blight, and pepper anthracnose. Although antifungal compounds from B. licheniformis N1 exhibited disease control activity, our results suggested that bacterial cells present in the N1E formulation also contribute to the disease control activity together with the antifungal compounds.

Development and Characterization of Monoclonal Antibodies against Nucleoprotein for Diagnosis of Influenza A Virus

  • Nguyen, Hong Phuong;Kwak, Chaewon;Heo, Chang-Kyu;Cho, Eun Wie;Yang, Jihyun;Poo, Haryoung
    • Journal of Microbiology and Biotechnology
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    • 제28권5호
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    • pp.809-815
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    • 2018
  • Influenza, which is a highly contagious disease caused by the influenza A virus, continues to be a major health concern worldwide. Although the accurate and early diagnosis of influenza virus infection is important for controlling the spread of this disease and rapidly initiating antiviral therapy, the current influenza diagnostic kits are limited by their low sensitivity. In this study, we developed several new influenza nucleoprotein (NP)-specific monoclonal antibodies (mAbs) and compared their sensitivity and specificity of those with commercially available anti-NP mAbs. Three mAbs, designated M24.11, M34.3, and M34.33, exhibited higher reactivities to recombinant NPs and A/Puerto Rico/8/1934 (H1N1) viral lysates compared with the commercial mAbs, as assessed using enzyme-linked immunosorbent assays. M34.3 and M34.33 showed higher reactivities with A/California/04/09 (pandemic H1N1) and A/Philippines/2/82 (H3N2) viral lysates than the commercial mAbs. In contrast, M24.11 had marked reactivity with H3N2 but not with pandemic H1N1. Immunofluorescent confocal microscopy showed that the three mAbs effectively detected the presence of influenza virus in lung tissues of mice infected with A/Puerto Rico/8/1934. These results indicate that the newly developed M34.3 and M34.33 mAbs could be useful for the development of influenza diagnostics.

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

  • Ahn, Eunsuk;Lee, Jin-ha
    • 치위생과학회지
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    • 제21권3호
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    • pp.133-139
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    • 2021
  • Background: Smoking in adolescence leads to an intensified addiction to nicotine when physical and mental growth has not yet been completed. With the advent of e-cigarettes, the rate of e-cigarette use among Korean adolescents has been steadily increasing. To date, studies on e-cigarettes and oral health, especially on the relationship between smoking styles and oral health in adolescents, are limited. Therefore, this study aimed to identify the risk factors for oral health problems caused by the repeated use of conventional cigarettes and e-cigarettes. Methods: This explanatory research study compared the adolescents' experiences of periodontal disease symptoms according to smoking type through a secondary analysis of the original data from the 15th Adolescent Health Behavior Survey (2019). Cross-analysis was performed to compare the smoking patterns according to the adolescents' general characteristics. Finally, a binary logistic regression analysis was performed to determine how smoking characteristics affect the adolescents' experience of periodontal disease symptoms. Results: In terms of patients' general characteristics, significant differences were observed in sex, school level, grades, household economic status, type of residence, and father's education level between adolescents who smoked conventional cigarettes alone and those who smoked both conventional cigarettes and e-cigarettes (p<0.05). After checking the factors affecting the smoking pattern and the experience of periodontal disease symptoms in adolescents, it was found that the duplicate smoking group was more likely to experience periodontal disease symptoms (odds ratio, 1.20) than the group that smoked conventional cigarettes alone (p<0.05). Conclusion: Duplicate smokers experienced more symptoms of periodontal disease than those who smoked cigarettes alone. Based on the findings of this study, smoking cessation counseling according to the smoking type and differentiated education for oral health promotion should be provided.

19세기 말 20세기 초 질병 어휘와 언어횡단적 실천 (Disease-Related Vocubulary and its translingual practice in Late 19th to Early 20th century)

  • 이은령
    • 사상체질의학회지
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    • 제31권1호
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    • pp.65-78
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    • 2019
  • Objectives This study aims to investigate how the Korean disease-related vocabulary is established or changed when it is translated into French or English. Through this, we examine changes in the meaning of diseases and the ecosystem of disease-related vocabulary in transition period of $19^{th}$ to $20^{th}$ century. Methods Korean disease-related vocabulary are extracted from a total of 148,000 Korean headwords included in our corpus of three bilingual dictionaries. Among them, the scope of analyisis is limited to group of vocabularies that include a high frequency words, disease(病) and symptom(症). Results The first type of change is the emergence of a neologism. In this case, coexistence of existing vocabulary and new words is observed. The second change is the appearance of loan words written in Hangul. The third is the case where the interpretation of meaning is changed while maintaining the word form. Finally, the fourth change is that the orthographic variants are displayed while maintaining the meaning of the existing vocabulary. Discussion Disease-related vocabulary increased greatly between 1897 and 1931. The increasing factor of vocabulary was the emergence of coined words, compound words and the influx of foreign words. The Korean language and the Western language made a new lexical form in order to introduce a new unknown concept to the Korean. We could also confirm that the way in which English word expanded its semantic field by modifying the way of representing the meaning of Korean Disease-related vocabulary.

5-HT 수용체 길항제를 이용한 파킨슨 환자의 정신 증상의 치료 (Psychosis in Parkinson's Disease-Treatment with 5-HT Receptor Antagonist)

  • 고성범;박건우;이대희
    • 생물정신의학
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    • 제4권1호
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    • pp.132-135
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    • 1997
  • Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson'disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.

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