• 제목/요약/키워드: Middle-aged Patients

검색결과 239건 처리시간 0.023초

A New Complex Minimally Invasive Thread Lift Method for One-Time Three-Step Fixation of the Face and Neck Soft Tissues

  • Zhukova, Olga;Dydykin, Sergey;Kubikova, Eliska;Markova, Natalia;Vasil'ev, Yuriy;Kapitonova, Marina
    • Archives of Plastic Surgery
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    • 제49권3호
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    • pp.296-303
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    • 2022
  • Background In recent years thread lift has become widespread; however, existing methods need to improve their long-term outcome, which requires considering topographic anatomy of face and neck, especially the ligamentous apparatus. This study aims to assess the effectiveness and safety of an innovative method of one-time three-step thread facelift, which provides an additional support to the ligamentous structures of the upper, middle, and lower thirds of the face and neck. Methods The study included 357 patients aged 32 to 67 years with various morphotypes of aging. The original method of thread lift was applied, and its effectiveness was followed up for to 2 years. The Wrinkle Severity Rating Score (WSRS) and Global Aesthetic Improvement Scale (GAIS) scores were used for assessment by investigators, independent observers, and patients. Statistical significance was determined using paired t-test and chi-square test. Results The mean WSRS score was 3.88 ± 0.88 before the thread lift, 1.93 ± 0.81 one month after the procedure, and 2.36 ± 0.85 after 2 years of follow-up. The mean GAIS was 4.80 ± 0.04 one month after thread lift, and 4.01 ± 0.04 after 2 years, while in the patients' assessment Global Satisfaction Scale was 4.86 ± 0.02 and 4.10 ± 0.02, respectively. There were no clinically significant complications throughout the observation period. Conclusion The new method of one-time three-step thread fixation of the soft tissues of the face and neck demonstrated a high degree of satisfaction by both experts and patients after 2 years of follow-up. It showed high efficacy and safety, including in the group of patients with pronounced age-related changes of the skin of face and neck.

노인장기요양보험 재가보호서비스를 이용하는 노인성 치매환자 가족의 돌봄평가와 가족기능과의 관계 (The Relationship of Caregiving Appraisal and Family Function among Senile Dementia Patients' Families using In-home Services for the Long-Term Care Insurance)

  • 이정은;고일선
    • 한국융합학회논문지
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    • 제9권8호
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    • pp.319-330
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    • 2018
  • 본 연구의 목적은 노인장기요양보험 재가보호서비스를 이용하는 노인성 치매환자 가족의 돌봄경험에 대한 평가와 가족기능과의 관계를 파악하기 위함이다. 본 연구의 대상자는 경기도 I병원 치매예방센터에서 DSM-IV기준에 의해 치매를 진단받고 노인장기요양보험 재가보호서비스를 이용하고 있는 65세 이상의 노인성 치매환자 가족구성원 121명을 대상으로 하였다. 연구결과 대상자의 평균 연령은 $53.80{\pm}10.86$세로 여성이 75.2%이었고 그 중 딸이 37.2%로 가장 많았다. 대상자의 돌봄평가는 중립적 인식의 요구감이 가장 높았고 긍정적 인식인 숙련감, 만족감이 그 다음으로 높았다. 대상자의 가족기능은 보통정도였고 영역별로 정서적 기능이 가장 높았던 반면, 의사소통이 가장 낮았다. 대상자의 돌봄평가 중 긍정적 인식의 만족감이 높고 중립적 인식의 요구감이 낮을수록 가족기능이 높았다. 추후 노인성 치매환자 가족의 돌봄에 대한 요구감을 줄이고 만족감을 향상시키며 가족의 정서적 기능과 의사소통을 증진시키기 위한 간호중재개발이 필요하다.

12주 규칙적인 유산소 트레이닝이 제 2형 당뇨(T2DM) 환자의 간 효소(Hepatic enzyme)에 미치는 영향 (Effects of 12 Weeks Regular Aerobic Training on Hepatic Enzyme in Type 2 Diabetes Mellitus (T2DM) patients.)

  • 김영일;곽이섭
    • 생명과학회지
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    • 제19권6호
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    • pp.804-808
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    • 2009
  • 본 연구에서는 12주 유산소 트레이닝 전에 비해 트레이닝 후, 간 기능을 나타내는 효소들이 모두 감소함을 나타냈으나 모두 통계적으로 유의한 차이는 나타내지 못했으며 이는 트레이닝이 간 기능에 영향을 미치지 못한 선행연구[5,15]들에서와 같은 결과를 나타냈다. 하지만 부분적으로 전체 대상자 13명 중 3명(23%)의 간 효소들 즉, 임상적 비정상을 나타낸 알부민(albumin), 토탈빌리루빈(total bilirubine), AST가 트레이닝 후, 정상적인 임상수치로 돌아와 규칙적인 12주 유산소 트레이닝이 제 2형 당뇨(T2DM) 환자의 간 효소에 통계적으로 유의한 차이는 나타내지 못했지만 임상적 판단 수치에 영향을 미친 것은 사실이다. 하지만 모든 비정상적인 간 기능 효소가 정상으로 회기한 것도 아니며 통계적으로 유의한 차이도 나지못했기 때문에 제 2형 당뇨환자(T2DM)의 간 기능 효소를 증진시키는 데 있어 운동 트레이닝의 효과는 성급히 판단하기 어려우며 운동 강도와 기간 등 좀 더 세분화고 다양한 연구가 필요하다고 생각된다.

중장년층에서의 외상성 견관절 탈구 (Primary Traumatic Anterior Shoulder Dislocation in the Middle-aged And Elderly Patients)

  • 이광원;류창수;김하용;안재훈;염진섭;김환정;최원식
    • Clinics in Shoulder and Elbow
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    • 제3권2호
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    • pp.75-78
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    • 2000
  • Purpose: The purpose of this study was to review primary traumatic anterior shoulder dislocation in the 40 years and older to determine the incidence of recurrence, rotator cuff injury and associated fractures. Materials and Methods: From May, 1991 to October, 1998, seventeen patients were available to participate in the study. The average age was 55 years(range, 40 to 75 years). Follow-up averaged 27 months(range, 12 to 48 months). There were 12 men and 5 women. 10 right and 7 left shoulders were involved. Any participant with a history of shoulder pain and limitation of motion was excluded from the study. Each shoulder was evaluated with UCLA shoulder functional assessment. Results: The overall results were excellent in 9 patients(52.9%), good in 3 patients(17 .6%), fair in 3 patients(17.6%), and poor in 2 patients(11.7%). Surgical treatment of the associated rotator cuff and greater tuberosity fracture injuries resulted in 5 patients with excellent(55.6%), 3 patients with good(33.3%) and I patient with poor(11.1 %) and Nonsurgical treatment of the associated injuries resulted in 2 patients with excellent(33.3%), 3 patients with fair(50%), 1 patient with poor(16.7%)(P=0.025). Conclusion : Our findings on small number of patients suggest that the diagnosis of a rotator cuff and other pathologies should be approached aggressively by an MRI, CT arthrogram if significant pain and weakness are still present and early surgical repair of rotator cuff and greater tuberosity can lead to restoration of shoulder function and better outcomes in selected patients.

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Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen

  • Harhra, Nasser Aa;Basaleem, Huda O.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4347-4351
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    • 2012
  • Background: Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.

Differences in Prognostic Factors between Early and Late Recurrence Breast Cancers

  • Payandeh, Mehrdad;Sadeghi, Masoud;Sadeghi, Edris
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6575-6579
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    • 2015
  • Background: Breast cancer (BC) is the most frequent malignancy among females and is a leading cause of death of middle-aged women. Herein, we evaluated baseline characteristics for BC patients and also compared these variables across ealry and late recurrence groups. Materials and Methods: Between 1995 to 2014, among female breast cancer patients referred to our oncology clinic, eighty-six were entered into our study. All had distant metastasis. Early recurrence was defined as initial recurrence within 5 years following curative surgery irrespective of site. Likewise, late recurrence was defined as initial recurrence after 5 years. No recurrence was defined for survivors to a complete minimum of 10 years follow-up. Significant prognostic factors associated with early or late recurrence were selected according to the Akaike Information Criterion. Results: The median follow-up was 9 years (range, 1-18 years). During follow-up period, 51 recurrences occurred (distant metastasis), 31 early and 20 late. According to the site of recurrence, there were 51 distant. In this follow-up period, 19 patients died. Compared with the early recurrence group, the no recurrence group had lower lymph node involvement and more p53 positive lesions but the late recurrence group had lower tumor size. In comparison to no recurrence, p53 (odds ratio [OR] 6.94, 95% CI 1.49-32.16) was a significant prognostic factor for early recurrence within 5 years. Conclusions: Tumor size, p53 and LN metastasis are the most important risk factors for distance recurrence especially in early recurrence and also between of them, p53 is significant prognostic factor for early recurrence.

유방축소술의 최근 경향 및 수직반흔법과 역T자반흔법의 비교 (Recent Trend of the Reduction Mammaplasty and comparing with Vertical Reduction Method and Inverted T-scar Method)

  • 권기현;임영빈;조명수;신혜경;설정현
    • Archives of Plastic Surgery
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    • 제38권3호
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    • pp.300-308
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    • 2011
  • Purpose: The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. In order to satisfy that goal, variable reduction mammaplasty methods are performed, however, two methods such as vertical reduction method and inverted T-scar method are currently most used. We compared indications and advantages of the two methods and set up useful guidlines. Methods: For 15 years from 1995 to 2010, we experienced 84 patients (162 breasts). We performed vertical reduction method as Lejour's superior pedicle technique (45 patients) and inverted T-scar method as Goldwyn's inferior dermal flap technique (39 patients). We evaluated the result of the operation comparing patient's age, amount of resected tissue, complications and post-operative scars of the two methods. Results: The mean age was 36 years and the vertical reduction group was 3 years younger than inverted T-scar group. The mean breast tissue resection amount per one breast, inverted T-scar group (712 gm) was lagger than vertical reduction group (395 gm). Conclusion: There is no ideal method for reduction mammaplasty until now. However, we suggest that guide line, the vertical reduction method is effective for minimal and moderate macromastia in young and middle aged women and inverted T-scar method is appropriate for severe macromastia with ptosis in elderly women. Recently, all procedures tried shorter and smaller scar on the vertical line as small I, J or L shape scar, and inframammary fold as short inverted T-scar.

Prostate Cancer, High Cortisol Levels and Complex Hormonal Interaction

  • Fabre, Bibiana;Grosman, Halina;Gonzalez, Diego;Machulsky, Nahuel Fernandez;Repetto, Esteban M;Mesch, Viviana;Lopez, Miguel Angel;Mazza, Osvaldo;Berg, Gabriela
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권7호
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    • pp.3167-3171
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    • 2016
  • Prostate cancer (PCa) is one of the most common diseases in men. It is important to assess prognostic factors and whether high cortisol levels and complex hormonal interactions could be responsible for PCa development. We evaluated the relationship between cortisol, leptin and estrogens in 141 men, 71 with PCa and the remaining 70 constituting a low risk group (LRG). They were recruited for this study from a total of 2906 middle-aged men (ages 45-70 years) who completed an evaluation for prostatic diseases at the Urology Division, Hospital de Clínicas "$Jos{\acute{e}}$ de San $Mart{\acute{i}}n$", University of Buenos Aires, in May 2009. In this cross sectional study, cortisol, PSA, total-testosterone, free-testosterone, bioavailable testosterone, LH and estradiol were measured in serum. We observed increased cortisol levels in PCa patients as compared to LRG cases (p=0.004,). Leptin and estradiol levels were also higher in PCa patients (p=0.048; p<0.0001, respectively). Logistic regression analysis indicated that serum cortisol (OR: 1.110 (95% CI 1.016-1.213), p=0.022), estradiol (OR: 1.044 (95% CI 1.008-1.081), p=0.016) and leptin (OR: 1.248 (95% CI 1.048-1.487), p=0.013) explained 27% of the variance of dependent variables, even after adjusting for age, smoking, BMI and waist circumference. We found increased cortisol levels in PCa patients as compared to LRG, as well as an altered circulating hormonal profile.

Therapeutic Effect of Teriparatide for Osteoporotic Thoracolumbar Burst Fracture in Elderly Female Patients

  • Yu, Dongwoo;Kim, Sungho;Jeon, Ikchan
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.794-805
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    • 2020
  • Objective : Teriparatide is known as an effective anabolic agent not only for severe osteoporosis but also for bone healing and union. We explored the possibility of teriparatide as an alternative treatment option for osteoporotic thoracolumbar (TL) burst fracture. Methods : This retrospective study enrolled 35 female patients with mean age of 73.77±6.71 years (61-88) diagnosed as osteoporotic TL burst fracture with ≥4 of thoracolumbar injury classification and severity (TLICS) score and no neurological deficits. All patients were treated by teriparatide only (12 of group A), teriparatide plus vertebroplasty (12 of group B), or surgical fixation with fusion (11 of group C), and followed up for 12 months. Radiological outcomes were evaluated using radiological parameters including kyphotic angle (KA), segmental vertebral kyphotic angle (SVKA), compression ratio (CR), and vertebral body height (anterior [AH], middle [MH], posterior [PH]). Functional outcomes were evaluated using visual analog scale (VAS) and Macnab classification (MC). Results : There were no statistical significant differences in age, bone mineral density (-3.36±0.73), and TLICS score (4.34±0.48) among the three groups (p>0.05). Teriparatide was administered during 8.63±2.32 months in group A and B. In 12-month radiological outcomes, there were significant restoration in SVKA, CR, AH, and MH of group B and KA, SVKA, CR, AH, and MH of group C compared to group A with no radiological changes (p<0.05). All groups showed similar significant improvements in 12-month functional outcomes, although group B and C showed a better 1-month VAS, 1-month MC, 3-month MC compared to group A (p<0.05). Conclusion : Non-surgical treatment with teriparatide showed similar 12-month functional outcomes compared to surgical fixation with fusion. The additional vertebroplasty to teriparatide and surgical fixation with fusion were more helpful to improve short-term functional outcomes with structural restoration compared to teriparatide only.

Factors Affecting the Number of Stapler Cartridges in Complete Video-Assisted Thoracoscopic Surgery Lobectomy for Non-small Cell Lung Cancer

  • Yang, Young Ho;Lee, Seokkee;Lee, Chang Young;Kim, Dae Joon;Lee, Jin Gu;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • 제53권2호
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    • pp.53-57
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    • 2020
  • Background: Video-assisted thoracoscopic surgery (VATS) lobectomy has become the major surgical option for the treatment of non-small cell lung cancer (NSCLC). Endoscopic instruments such as stapler cartridges are essential for VATS procedures. In this study, we investigated the factors that affect the number of stapler cartridges used in VATS lobectomy. Methods: A retrospective analysis was conducted of patients who underwent complete VATS lobectomy for NSCLC from January 2013 to December 2015. Results: In total, 596 patients underwent complete VATS lobectomy. The average number of stapler cartridges used for VATS lobectomy was 5.3±1.9. The number of stapler cartridges used for VATS lobectomy was higher in men (5.5±1.9 vs. 5.0±18, p=0.006), those aged older than 70 years (5.5±2.1 vs. 5.1±1.7, p=0.038), those who underwent upper or middle lobectomy procedures (5.7±1.9 vs. 4.1±1.2, p<0.001), those with a higher fissure sum average (p<0.001), and those in whom surgery was performed by a surgeon with a preference for staplers (5.6±2.0 vs. 4.9±1.6, p<0.001). Conclusion: The number of stapler cartridges required to perform VATS lobectomy in NSCLC patients appears to be influenced by sex, age, the location of the tumor, the degree of fissure development, and the surgeon's preference.