• Title/Summary/Keyword: Multiple chronic diseases

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A Case of Acute Eosinophilic Pneumonia (급성 호산구성 폐렴 1예)

  • Lee, Ki-Hoon;Cho, Chul-Ho;Koh, Kwang-Kon;Moon, Tai-Hoon;Jang, Dong-Seob;Park, Chan-Sup;Kim, Jin-Joo;Kim, Joon-Mee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.99-104
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    • 1995
  • Most cases of eosinophilic pneumonia reported previously have followed a chronic course. The case presented here was acute in onset, suggesting a acute eosinophilic pneumonia. A model of criteria for acute and chronic eosinophilic pneumonia was made by Umeki in 1992. A previously healthy young man presented with cough, sputum, fever, and multiple small nodules on the chest radiograph. We confirmed eosinophilic pneumonia with bronchoalveolar lavage analysis and transbronchial lung biopsy. This case examplifies the recently descrived acute eosinophilic pneumonia.

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The Significance of Managing "Mibyeng" in Geriatric Health by Focusing on the Connection between Korean Medicine and Psychology: A Review (노년기 건강에 있어 미병(未病) 관리의 의의: 한의학과 심리학의 연관성을 중심으로)

  • Bae, Suhyun;Park, Miso;Lee, Siwoo;Beak, Younghwa;Yoo, Horyong;Kim, Giyeon
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.2
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    • pp.109-119
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    • 2020
  • Objectives: The aim of this study is to review the significance of managing "Mibyeong" in geriatric health in Korean medicine and psychology. Methods: We performed a literature search using OASIS, Koreantk, RISS, DBpia, and PubMed databases. We retrieved research articles using the keywords related to mibyeong (未病), sub-health (亞健康), Korean-medicine, psychology and geriatric health. Results: Both Korean medicine and psychology emphasize biological, psychological, and social balance and well-being. In addition, both value individual personality and constitution. Mibyeong is a Korean medical concept suggesting sub-health. Elderly individuals who are in a state of Mibyeong are frail and vulnerable to disorders and illness. Since depression, chronic diseases, low physical and mental activity have fatal outcomes in frail and elderly subjects, positive psychological support and active management of Mibyeong are very important. Conclusions: Geriatric health conditions are associated with chronic disease and multiple risk factors, including physiological, psychological, social, and economic conditions. A preventive and integrative approach is essential for geriatric health as prevention is better than cure for most geriatric diseases and illnesses.

Efficacy Profile of Cisapride in Laryngopharyngeal Reflux(LPR)-Related Symptoms(Open Multicenter Case Study & Open Multicenter Case Study between Cisapride & Ranitidine) (인후두위산역류증(Laryngopharyngeal Reflux : LPR) 관련 증상에 대한 시사프리드(Cisapride)의 효과)

  • 최홍식;고중화;김광문;김광현;김민식;김영모;김찬우;김춘동;김형태
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.9 no.2
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    • pp.115-127
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    • 1998
  • Laryngopharyngeal reflux(LPR) is one firm of the gastroesophageal reflux diseases(GERD). It is known to cause various kinds of otolaryngologic symptoms such as hoarseness, foreign body sensation in throat, chronic throat clearing, chronic cough, etc. Disease entities diagnosed by otolaryngologists as posterior laryngitis, globus pharyngeus should be suspected as LPR-related diseases. In this multi-center trial, we tried to evaluate the effect of cisapride(10mg tid) on LPR-related symptoms as the part I study(CIS-KOR-051) in 19 centers, and as the part II study(CIS-KOR-052) comparative evaluation of effect between cisapride(10mg tid) and ranitidine(150mg bid) on LPR-related symptoms in 4 centers. In part I study, efficacy of cisapride on LPR-related symptoms after 4 weeks was 53.5% and that of after 8weeks was 77.9% in per protocol(PPA) analysis group. In part II study, efficacy of the cisapride was much better than that of ranitidine not only from 8 weeks trial(p<0.001) but also from 4 weeks trial(p<0.021) in PPA group. In the multiple logistic regression analysis among the parameters which affect the efficacy of the treatment, cisapride prescribed group showed 10 times greater than that of ranitidine prescribed group(p<0.0001, Odds ratio : 10) in PPA group. LPR was proved by 24Hr double probe pHmetry in 13 patients out of 19 patients tested(68.4%). Thus these results indicated that inducing the improvement of motility functions could affect the amelioration of the LPR-related symptoms much better than reducing acid secretion from the stomach. And maybe it suggests that LPR-related symptoms mainly developed by the reduced motility functions of the esophagus and/or delayed gastric emptying.

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Quality of Life in Chronic Viral B Hepatitis Patients (만성(慢性) B형(型) 간염환자(肝炎患者) 삶의 질(質))

  • Kim, Hun-Soo;Lee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.35-45
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    • 1998
  • Objectives : The purpose of this study was to determine correlation between coping strategies to disease and quality of life in chrome viral B hepatitis patients ; to investigate difference of coping strategies to disease and quality in life between chronic viral B hepatitis patients and normal persons ; and to identify major variables related to quality in life of chronic viral B hepatitis patients. Methods: The authors used Weisman coping strategy scale for measuring coping ability and efficacies, and the questionnaire for measuring quality of life including physical, psychological, social and economical aspects and satisfaction of sexual life was made by authors based on related literatures. Data were collected through questionnaire survey over a period from Sep 15, 1994 to Nov 11, 1994. Subjects served for this study consisted of 94 chronic viral B hepatitis patients visited to department of internal medicine at one general hospital and 100 normal persons visited to one general hospital for routine check up of health. The collected data were analyzed by SAS and the statistical methods for analysis were Chisquare, t-test and multiple regression analysis. Results : 1) It was revealed that coping strategies to disease significantly correlated to individual's quality of life. 2) There was no significant difference in coping strategies to disease between chronic viral B hepatitis patients and normal persons. However, chronic viral B hepatitis patients showed the lower scroes of quality of life in physical, psychological and economical aspects. 3) The most important variables which were influenced upon quality of life were coping strategies to disease and satisfaction of sexual life. That is, the more active coping strategies to diseases and the higher satisfaction of sexual life, consequently the higher quality of life was. Especially male patient group or normal persons showed each other the higher scores of quality of life in physical and psychological area than female group or patient group. 4) No statistically significant difference in coping strategies to disease and quality of life was found between HBeAg positive group and HBeAg negative group. Conclusions : The authors suggest that chronic viral B hepatitis patients may show the lower score of quality of life than normal person. Therefore, quality of life assessment should become an integral part of all clinical area that seek to assess the effectiveness of treatment. Also, through the interdisciplinary approach, a comprehensive paradigm that can better account for the effects of chronic disease on the individual' s quality of life should be developed.

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Analysis of Protease and Antiprotease Concentrations in Retired Workers Exposed to Inorganic Dusts

  • Shin, Jae-Hoon;Hwang, Joo-Hwan;Lee, Kyung-Myung;Lee, Jong-Seong;Lee, Jeong-Oh;Choi, Byung-Soon;Kim, In-Sik
    • Biomedical Science Letters
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    • v.15 no.4
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    • pp.309-317
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    • 2009
  • Occupational exposure to inorganic dusts such as coal and silica has been identified as a chronic obstructive pulmonary disease (COPD) risk factor. This risk factor causes lung inflammation and protease-antiprotease imbalance. This abnormal inflammatory response of the lung induces parenchymal tissue destruction and leads to progressive airflow limitation that is characteristics of COPD. The aim of this study was to determine the relationship of proteases such as neutrophil elastase (NE) and matrix metalloproteinase (MMP)-9 and antiproteases such as alpha-1 antitrypsin (AAT) and tissue inhibitors of metalloproteinase (TIMP)-1 with lung function. The study population contained 223 retired workers exposed to inorganic dusts. We performed lung function test, including percent of forced expiratory volume in one second ($%FEV_1$) predicted and $%FEV_1$/forced vital capacity (FVC). We analyzed serum MMP-9, AAT, TIMP-1 and plasma NE concentrations by sandwich enzyme immunoassay. NE, AAT, and TIMP-1 concentrations in workers, who had $%FEV_1$<80% predicted, were higher than those of workers who had $%FEV_1{\geq}80%$ (P<0.05). Both AAT and TIMP-1 concentrations in workers with airflow limitation were higher than those of workers with normal airflow (P<0.05). $%FEV_1$ predicted showed significant negative correlation with AAT (r=-0.255, P<0.0l), TIMP-1 (r=-0.232, P<0.01), and NE (r=-0.196, P<0.01). $%FEV_1$/FVC predicted showed significant negative correlation with NE (r=-0.172, P<0.05). From the results of stepwise multiple regression analysis about $%FEV_1$ and $%FEV_1$/FVC, significant independents were NE (r=-0.135, P=0.001) and AAT (r=-0.100, P=0.013) in $%FEV_1$, and NE (r=-0.160, P=0.014) in $%FEV_1$/FVC. In the present study, there were significant correlations between airflow limitation and protease concentration and between airflow limitation and antiprotease concentration. Serum protease and antiprotease concentrations, however, may be affected by the biological and inflammatory responses. It is necessary to evaluate specimens more reflected the effects of proteases and antiproteases in the lung such as lung tissue, bronchoalveolar lavage fluid, and exhaled breath condensate (EBC).

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A Study on Cooperative Medical Treatment System between Oriental and Western Medical Practitioners (한.양방 협진체계 개발에 관한 연구)

  • Yi, Dong-Heui;Yoo, Kyu-Soo
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.34-61
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    • 1998
  • A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

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The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases (만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성)

  • Kim, Jeong Yi;Ryu, So Yeon;Han, Mi Ah;Choi, Seong Woo
    • Journal of agricultural medicine and community health
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    • v.41 no.1
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    • pp.13-26
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    • 2016
  • Purpose: This study was performed to identify the association between family support, activities of daily living (ADL) and depression among hospitalized older patients with chronic diseases. Methods: This study subjects were 100 elderly patients with chronic diseases including chronic respiratory diseases, diabetes mellitus and et al. in a general hospital. The collected data were patient characteristics, family support, ADL, and depression by structured questionnaire and medical chart review. The used statistical analyses were t-test, analysis of variance, Pearson's correlational analysis and multiple regression analysis. Results: The mean scores of family support, ADL and depression were $49.95{\pm}8.68$, $8.65{\pm}2.65$, $6.66{\pm}3.78$, respectively. The prevalence rate of depression was 64.0%. In simple analysis, the statistically significant associated factors with depression were age, spouse, economic status, social activity, subjective health status, and number of pain. Depression had statistically a significant positive correlation with ADL and a negative correlation with family support. The final result of hierarchial multiple regression analysis (Model 3), the factors related to depression were family support (b=-.135, p<.001), subjective health status (b=2.510, p=.001). Conclusions: It is necessary to develop and apply the program for controlling the depression of elderly patients with health education, reinforcement of supportive systems in hospital. And, further multidisciplinary studies should be done.

Prognosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic Diseases in Korea

  • Kwon, Jae-Cheol;Kim, Si-Hyun;Park, Sun-Hee;Choi, Su-Mi;Lee, Dong-Gun;Choi, Jung-Hyun;Yoo, Jin-Hong;Kim, Yoo-Jin;Lee, Seok;Kim, Hee-Je;Lee, Jong-Wook;Min, Woo-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.3
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    • pp.284-292
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    • 2012
  • Background: The aim of this study was to investigate therapeutic outcomes and assess factors associated with therapeutic outcomes in hematologic patients with invasive pulmonary aspergillosis (IPA). Methods: We analyzed all consecutive cases of IPA in adults with hematologic diseases from January 2008 to January 2009 at a Catholic Hematopoietic Stem Cell Transplantation (HSCT) Center in Seoul, Korea. Results: A total of 54 patients were identified. Underlying diseases were acute myelogenous leukemia (n=25), acute lymphoblastic leukemia (n=10), myelodysplastic syndrome (n=7), chronic myelogenous leukemia (n=3), multiple myeloma (n=3), severe aplastic anemia (n=2) and other hematologic diseases (n=4). Twenty six patients (48.2%) were assessed as having a favorable response, of which 16 patients (29.6%) showed complete response. Overall 12-week mortality and IPA attributable mortality were 38.9% (n=21) and 33.3% (n=18), respectively. In multivariate analysis, uncontrolled underlying disease (odds ratio [OR], 7.31; 95% confidence interval [CI], 1.49~35.94; p=0.014) was associated with an unfavorable response, and for 12-week mortality, uncontrolled underlying disease (OR, 11.79; 95% CI, 1.49~93.46; p=0.020) and hypoalbuminemia (OR, 9.89; 95% CI, 1.42~68.99; p=0.021) were significantly poor prognostic factors. Conclusion: IPA still remains as a poor therapeutic outcome, especially in patients with refractory hematologic diseases.

Two Cases of Spleen Tuberculosis (비장을 침범한 결핵 2예)

  • Park, Jeong-Hyun;Ko, Hyeck-Jae;Shim, Hyeok;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.630-635
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    • 2001
  • Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT findings of splenic tuberculosis are multiple, well-defined, round or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One patient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.

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Pre-diagnosis Management in WSN based Portable Healthcare Monitoring System (무선센서네트워크 기반 휴대용 헬스케어 모니터링 시스템을 위한 휴대폰 자체 간이진단 관리)

  • Hii, Pei-Cheng;Lee, Seung-Chul;Chung, Wan-Young
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.10a
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    • pp.538-541
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    • 2009
  • Increasing of number of people who suffered from long term chronic diseases which required frequent daily health monitoring and body check up in conjunction with the trendy uses of mobile phones and Personal Digital Assistants (PDAs) in various ubiquitous computing had make portable healthcare system a well known application today. A mobile phone based portable healthcare monitoring system with multiple vital signals monitoring ability at real time in WSN and CDMA network is developed. This system carries out real time monitoring and local data analysis process in the mobile phone. Any detection of abnormal health condition and diagnosis at earlier stage will reduce the risk of patient's life. As an extension to the existing model, a pre-diagnosis management system (PDMS) is designed to minimize the time consuming in pre-diagnosis process in the hospital or healthcare center. An alert is sent to the web server at the healthcare center when the patient detects his health is at critical state where the immediate diagnosis is needed. Preparation of diagnosis equipments and arrangement of doctor and nurses at the hospital side can be done earlier before the arrival of patient at the hospital with the help of PDMS. An efficient pre-diagnosis management increases the chances of diseases recovery rate as well.

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