• 제목/요약/키워드: Multiple chronic diseases

검색결과 261건 처리시간 0.03초

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

  • 배수현;박미소;이시우;백영화;류호룡;김기연
    • 동의신경정신과학회지
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    • 제31권2호
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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.

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

  • 최홍식;고중화;김광문;김광현;김민식;김영모;김찬우;김춘동;김형태
    • 대한후두음성언어의학회지
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    • 제9권2호
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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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만성(慢性) B형(型) 간염환자(肝炎患者) 삶의 질(質) (Quality of Life in Chronic Viral B Hepatitis Patients)

  • 김헌수;이민규
    • 정신신체의학
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    • 제6권1호
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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
    • 대한의생명과학회지
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    • 제15권4호
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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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한.양방 협진체계 개발에 관한 연구 (A Study on Cooperative Medical Treatment System between Oriental and Western Medical Practitioners)

  • 이동희;류규수
    • 한국병원경영학회지
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    • 제3권1호
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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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만성질환 입원노인의 가족지지 및 일상생활 수행능력과 우울과의 관련성 (The Association between Family Support, Activities of Daily Living and Depression among Hospitalized Older Patients with Chronic Diseases)

  • 김정이;류소연;한미아;최성우
    • 농촌의학ㆍ지역보건
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    • 제41권1호
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    • pp.13-26
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    • 2016
  • 본 연구는 종합 병원에 만성 질환으로 입원 한 노인 환자의 가족지지, 일상생활 수행능력 및 우울간의 관계를 파악하기 위해 수행하였다. 연구 대상자는 G광역시에 위치한 일개 종합병원에 만성질환으로 입원한 환자 100명을 대상으로 하였으며, 관련성을 알아보기 위하여 t-검정, 분산분석, 상관분석과 위계적 다중회귀분석을 이용하였다. 연구 결과, 연구 대상자의 가족지지 정도는 $49.95{\pm}8.68$점, 일상생활 수행능력 $8.65{\pm}2.65$점, 우울 $6.66{\pm}3.78$점이었다. 전체 연구 대상자의 64%가 경증 이상의 우울을 가지고 있었다. 위계적 다중회귀분석 결과, 사회인구학적 특성에 일상생활 수행능력을 포함하여 분석한 Model 1에서는 주관적 건강상태(${\beta}=2.894$, p<0.001)와 일상생활 수행능력(${\beta}=0.269$, p=0.04)이 노인 우울과 통계적으로 유의한 관련이 있었고, 사회인구학적 특성에 가족지지를 포함하여 분석한 Model 2의 경우, 노인 우울은 연령(${\beta}=1.483$, p=0.04), 주관적 건강상태(${\beta}=2.641$, p<0.001)와 가족지지(${\beta}=-0.144$, p<0.001)와 유의한 관련이 있었다. 사회인구학적 특성과 일상생활수행능력과 가족지지를 포함하여 분석한 Model 3의 결과, 노인우울은 주관적 건강상태(${\beta}=2.510$, p=0.001), 가족지지(${\beta}=-.135$, p<0.001)과 통계적으로 유의한 관련이 있었다. 이상의 연구결과를 통해 만성질환 입원노인들의 우울은 가족지지가 낮을수록, 주관적 건강상태가 나쁠수록 우울의 정도가 높음을 알 수 있었다. 노인 환자의 건강관리 방안을 마련할 때 가족지지 강화와 노인의 건강지각을 높일 수 있는 방안이 모색되어야 할 것으로 사료된다.

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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    • 제72권3호
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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.

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

  • 박정현;고혁재;심혁;양세훈;정은택
    • Tuberculosis and Respiratory Diseases
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    • 제50권5호
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    • pp.630-635
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    • 2001
  • 저자들은 발열, 복통 등의 임상증상을 보이며 복부 CT촬영 결과 다발성의 저음영 병변을 보였으며 초음파를 통한 비장 생검 결과 육아종성 염증소견을 보여 항 결핵제 치료 후에도 호전없어 비장절제를 시행한 비장결핵 1예와 항 결핵제로 치료하고 있는 비장결핵 1예를 각각 경험하였기에 이를 보고하는 바이다.

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

  • 히패쳉;이승철;정완영
    • 한국정보통신학회:학술대회논문집
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    • 한국해양정보통신학회 2009년도 추계학술대회
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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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A Novel Homozygous CLCNKB Mutation of Classic Bartter Syndrome Presenting with Renal Cysts in 6-year-Old Identical Twin Boys : A Case Report

  • Son, Min Hwa;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • 제25권1호
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    • pp.35-39
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    • 2021
  • Bartter syndrome is an autosomal recessive hypokalemic salt-losing tubulopathy, and classic Bartter syndrome is associated with mutations in the CLCNKB gene. While chronic hypokalemia is known to induce renal cyst formation in different renal diseases, renal cyst formation in Bartter syndrome is rarely reported. Russian six-year-old identical male twins were referred to our hospital for the evaluation of renal cysts, which were incidentally detected on abdominal sonography due to diarrhea. Both twins had shown symptoms of polydipsia, polyuria, and nocturia since they were one year olds. Vital signs including blood pressure were normal in both twins. Renal sonography revealed nephromegaly, increased echogenicity of renal cortex, and various sized multiple cysts in both kidneys for both twins. Laboratory findings included hyponatremia, hypokalemia, hypochloremia, and metabolic alkalosis. Bartter syndrome with renal cysts were suspected. Genetic analysis for both twins confirmed a homozygous c.1614delC deletion on exon 15 of the CLCNKB gene, which was confirmed as a previously unreported variant to the best of our knowledge. They were managed with potassium chloride, nonsteroidal anti-inflammatory drugs, and angiotensin-converting-enzyme inhibitors. Metabolic alkalosis, hypokalemia, hypochloremia, and polyuria partially improved during the short course of treatment. This is the first report of a homozygous mutation in the CLCNKB gene in an identical twin, presenting with renal cysts.