• Title/Summary/Keyword: Older patients

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Prevalence Rates of Risk Factors of Metabolic Syndrome, and Its Related with Obesity Indices Among the Health Checkup Examinees (건강검진 수검자들의 대사증후군 위험인자별 유병률 및 비만지표와의 관련성)

  • Park, Kyu-Ri;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.153-162
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    • 2016
  • The aim of this study was to estimate the prevalence of the metabolic syndrome risk factors for adults in the general population, understand the relationship of each factor with the obesity indicators, and examine the relevance and validity for predicting the metabolic syndrome in obese indicators. The study subjects were 1,051 adults aged 20 years and over, who underwent a health package check-up at the Korea Association of Health Promotion, D-branch from Feb. to Nov. 2014. As a result, the prevalence rates of metabolic syndrome of the study subjects were 21.5%, and the prevalence rates of the metabolic risk factors were as follows: 31.8% of men and 41.6% of women for abdominal obesity; 35.6% of men and 17.3% of women for TG; 17.6% of men and 34.2% of women for HDL-C; 53.5% of men and 35.9% of women for blood pressure; and 14.9% of men and 6.8% of women for FBS. The prevalence rates of metabolic syndrome were significantly higher in the older age group, in the group with the higher BMI, and in the group of higher level of drinking frequency. In the predictive indicators of obesity on metabolic syndrome risk factors, the waist / height ratio was higher than other indicators. Conclusively, WHtR appeared to be a useful indicator to show abdominal obesity and is better in selecting metabolic syndrome patients compared to other obesity indicators.

Attitudes toward Complementary and Alternative Medicine in Suwon City (수원시 주민의 대체의학 수용실태 조사)

  • Chun, Ki-Hong;Song, Hyun-Joug;Park, In-Whee;Yoo, Seung-Chul;Song, Mi-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.2
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    • pp.162-169
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    • 1999
  • Objectives: The aim of this study was to investigate the attitudes toward complementary and alternative medicine among 1,490 residents(339 households) in Suwon city. Methods: All respondents were asked about types, frequency, effects, side-effects, views, and cost of complementary or alternative medicine through a questionnaire from July 24th to 27th. Six therapies were investigated: diet; acupuncture/ massage/ chiropractic etc., mind control such as Ki/ Yoga/ spiritual therapy/ relaxation therapy etc.; nutritional supplements, cultural remedies; and Herb medications Results: The results of this survey were as follows: 35.6% of respondents had experiences with at least one or more types of complementary and alternative medicine. The average number of different types of therapies used was 3.4. More experience with various types of therapies were found among those respondents of higher education, older age group, higher income, married group, religious group than among the opposite groups of respondents. Herb medications were used most frequently(39.8%), followed by minor grains(37.9%), Ginseng(23.8%), Boshintang(21.5%), acupuncture(20.3%), Gaesojou(15.3%) Gingko nut(12.0%), mushroom(11.5%), Cupping therapy(10.2%), and black goat(0.0%). Acupuncture and Herb medications were used for treatment of hypertension the most frequently; minor grains or silkworm for treatment of diabetic mellitus; vegetables for treatment of obesity; acupuncture, Cupping Therapy, Herb medications for treatment of rheumatism; and acupuncture, Herb medications, or exercises for treatment of Cerebro Vascular Accident(CVA). The average costs of treatment were 108,000 Won for hypertension, 87,200 Won for diabetic mellitus, 16,800 Won for obesity, 68,800 Won for rheumatism, and 87,500 Won for CVA. Among 10.9% of respondents, there were 13 cases of side-effects with acupuncture, Herb medications, and Gaesojou. Among the cases of side-effects, majority was due to Herb medications. Respondents reported that Cupping Therapy was the most effective, followed by acupuncture, Ginseng, Gingko nut, Boshintang, black goat, minor grains, Gaesojou, Herb medications, vegetables, and mushroom. In response to the views of complementary and alternative medicine which they had used, they recommended minor grains first, followed by Ginseng, acupuncture, Gingko nut, Cupping Therapy, vegetables, Boshintang, black goat, mushroom and Herb medications. In contrast, they did not recommend Herb medications, acupuncture, nor Gaesojou. Conclusions: These findings indicate that many people use various complementary and alternative medicine without any guidelines for treatment of serious chronic diseases not even to invigorate themselves. It is, therefore, suggested that medical doctors or scientists verify the true effects or side-effects from the most common complementary or alternative therapies through experiments. Also medical doctors should provide a comfortable atmosphere for discussion among doctors and patients who would like to try these therapies.

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A Case of Membranoproliferative Glomerulonephritis Type II (Dense Deposit Disease, DDD) (막성증식성 사구체신염 제 II형 (Dense Deposit Disease, DDD) 1례)

  • Kwon Hae Sik;Oh Seung-Jin;Lee Young-Mock;Kim Ji Hong;Kim Pyung-Kil;Kang Hae Youn;Jeong Hyeon Joo;Choi In Joon
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.188-195
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    • 2001
  • Type II membranoproliferative glomerulonephritis (Dense deposit disease) is an acquired primary glomerular disease characterized by electron microscopic evidence of a continuous dense membrane deposition replacing the lamina densa. It is a subtype of idiopathic membra- noproliferative glomerulonephritis, and was described as a separate entity by Berger and Galle in 1963. It frequently occurs in older chilren and young adults and the clinical course is variable, but is generally progressive. The presenting feature is nephrotic syndrome in many patients, and proteinuria and hematuria are also seen frequently. The purpose of this paper is to present a case of DDD (Dense deposit disease) from a 10 year old boy who was diagnosed as a acute poststreptococcal glomurulonephritis with protenuria, hematuria, and facial edema by renal biopsy 4 years ago. (J, Korean Soc Pediatr Nephrol 2001 ; 5 : 188-95)

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Consumption Values on the Intention to Re-use on Geriatric Hospitals (노인요양병원 재이용 의사에 영향을 미치는 소비가치 요인)

  • Kwon, Jin
    • The Journal of the Korea Contents Association
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    • v.13 no.12
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    • pp.921-930
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    • 2013
  • Objective: After introduction of the Elderly Long Term Care Insurance, number of geriatric hospitals increased greatly. However, few studies were conducted on the satisfaction of the patients of the geriatric hospitals especially on the intention to reuse geriatric hospitals. Methods: The current study modified Sheth's consumption value model, useful for the development of an effective marketing strategy for geriatric hospitals, and tested it in Korean circumstances. The survey was conducted at two municipal hospitals and three private hospitals in Seoul and Gyeonggi Province between August 1 and September 30 of 2012. Data were collected from 472 inpatients who are 60 years or older. The structured research tool was developed and distributed. Factor analysis and hierarchical logistic regression analysis were conducted using SPSS(version 14.0) Results: The result of the research suggested that the satisfaction on rehabilitation services, which is a functional value, among the consumption values was the strongest factor on the intention to reuse geriatric hospitals. Impression of high-end luxury, reliability of care, and outside locus of control on health followed. Conclusion: It is recommended that geriatric hospitals ought to improve rehabilitation programs, facilities, and equipments and enhance kindness of staff to encourage intention to reuse geriatric hospitals.

Evaluating Economic Value of Heat Wave Watch/Warning Information in Seoul and Busan in 2016: Focused on a Cost of Heat Wave Action Plan and Sample of Patients (2016년 서울과 부산지역 폭염특보 정보의 경제적 가치 평가 -폭염대책 비용과 환자 자료를 중심으로-)

  • Kim, In-Gyum;Lee, Seung-Wook;Kim, Hye-min;Lee, Dae-Geun
    • The Journal of the Korea Contents Association
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    • v.20 no.5
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    • pp.525-535
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    • 2020
  • This study aims to evaluate the economic value of the heat wave watch/warning (HW/W) forecast provided by the KMA (Korea Meteorological Administration) for the public sector. Local govermenments of Korea currently use the HW/W forecasts as a major input variable to determine the preparative requisite level for reducing potential damage by extreme heat events. To assess the value of the HW/W, which is not a marketable commodity, a decision-making model taking into account the cost and loss was established. The 'cost' variable was defined as the heat wave countermeasures budget for Seoul and Busan in 2016, and the 'loss' variable was set as the amount of health insurance claims for those 65 and older obtained from the Health Insurance Review and Assessment Service. Using this model, the value of the HW/W in 2016 was calculated as KRW 4,133M and KRW1,090M for Seoul and Busan, respectively. In addition, if the KMA reduces the False Alarm of the HW/W by a single instance, the value will be increased by KRW 76.6M and KRW 16.8M for the two cities. The results of this study are useful in quantitatively estimation of the value of the HW/W forthe public sector.

Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia over three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Powell, Kate;Eckert, Marion;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2431-2440
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

Selective Contralateral Exploration in Pediatric Inguinal Hernia (소아서혜부탈장의 선택적 편대측 시험절개)

  • Lee, Myung-Duk
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.18-26
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    • 1995
  • For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

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Evolutionary Patterns with Age of Acetylcholinesterase Activity of Rect al Suction Biopsies in Hirschsprung's Disease (Hirschsprung씨 질환에서 직장 흡인 생검의 Acetylcholinesterase 활성도의 연령에 따른 변화)

  • Park, Woo-Hyun;Choi, Soon-Ok;Kim, Sang-Pyo;Chang, Eun-Soak;Paik, Tae-Won
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.1-7
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    • 1995
  • The acetylcholinesterase(ACHE) activity in 37 biopsies from the patients with Hirschsprung's disease was analyzed for histochemical patterns according to age, and its evolutional behavior was also assessed. The histochemical criterion used for the diagnosis of Hirschsprung's disease was that of Chow, i.e., "the presence of many coarse discrete cholinergic fibers in the muscularis mucosae and in the immediately subjacent submucosa regard less of an infiltration of cholinergic fibers in the lamina propria." The acetylcholinesterase activity in Hirschsprung's disease was further classified into 3 patterns, advocated by de Brito and Maksoud : Pattern I-many thick fibers exclusively in the muscularis mucosae and submucosa(newborn pattern). Pattern II-many thin fibers in the muscularis mucosae and submucosa with a clear infiltration of cholinergic fibers in the lamina propria(classical pattern). Pattern III-an intermediate pattern showing morphological characteristics of the two patterns with predominance of one or the other. Of 37 biopsies, Pattern 1 was seen exclusively in 16 biopsies taken from the neonates. Pattern III was 11 of 37 biopsies and it was mainly seen in children between 2 to 12 months of age. Pattern II was seen in all 3 biopsies of older than 1 year of age and in 6 ones of 3 to 12 months of age. In summary, this study reinforces the impression that there is an evolutional character of the distribution and morphology of the cholinergic ACHE positive fiber with age. In other words, ACHE activity in Hirschsprung's disease appears to evolve with age from the newborn pattern to the intermediate pattern finally to the classical pattern.

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Clinical Analysis of Metastatic Tumors of Bone - Survivorship Analysis after Bony Metastasis - (전이성 골종양에 대한 임상적 분석 - 골전이 후의 생존분석 -)

  • Kim, Kyung-Je;Kang, Ho-Seong;Kim, Yon-Il;Shin, Byung-Joon
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.133-138
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    • 2001
  • Purpose : To analyze the clinical behaviors and survivorship of metastatic bone tumors. Materials and Methods : One hundred and ninty-eight metastatic bone tumors had been diagnosed from January 1982 to December 1998. Age and sex distribution, primary cancer types. metastatic sites, duration from diagnosed of primary tumors to bony metastases and survivorship were analysed. Results : Mean age was 57(24~86) years old. Lung(32.3%) and breast(16.2%) cancers were two most common primary foci. The spines was the most common site of metastases especially lumbar region(38%). Survivorship analysis was done in one hundred and fifteen patients who had been followed up. The mean survival period was 15.3 months. The survivorship of hepatoma(7.1 Mons), lung(8.72 Mons) and renal cell(4.8 Mons)cancers was relatively shorter and breast cancer(54.1 Mons) longest. Conclusion : The mean age of metastatic bone tumors of this study was older than the past reports. The axial skeletons especially spine was predominant metastatic site. The survivorship of metastatic bone tumor decreased sharply as time goes by, so early diagnosis is clue for longer survival after bony metastases.

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The Perceived Discomfort of Plateletpheresis Donors (성분 헌혈자가 혈소판 반출시 지각하는 불편감)

  • 김상돌
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.577-587
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    • 1997
  • Purpose : To collect and interpret basic data involving the discomfort level of platelet donors and to see which nursing interventions would help make plateletpheresis more comfortable. Methods : Using "the Platelet Donor's Discomfort Scale" developed by the researcher herself and reviewed by an expert panel, the severity of discomfort as well as factors contributing to the development of this discomfort were analyzed. This scale contained 59 items and each item was scored by the 4-point Likert manner. Between March 1, 1996 and May 31, 1996, 500 platelet donors(16 years of age and older) were enrolled in this study. The Statistical methods used were factor analysis, t-test, and ANOVA. The results were as follows : 1. The mean of the platelet donor's discomfort scale was 130, range 69-207, possible score ranging from 59-236. 2. The platelet donor's discomfort scale had psychological, environmental, physical, and time-related factors. The time- related factor was the highest positive correlation with the development of the discomfort. 3. In looking at the psychological and environmental factors of the discomfort scores, the 16-20 age group had significantly higher ratings than those of the 26-30 age group. The students' group had higher scores than the soldier's group, and those who used the V-50, MCS -3P, or the PCS Plus machines had higher scores than those who used the COBE Spectra machine(P<.05, respectively), 4. In relation to the physical factor of the discomfort score, the youngest group felt significantly more discomfort, the student's group had a higher score than the soldier's group, and those who used the V-50, MCS-3P, or or the PCS Plus machines had higher scores than those who used the COBE Spectra machine(P<.05, respectively). 5. The time related factor of the discomfort score had the highest scores in every variable, however, statistically significant differences were not found between any of the variables(P>.05). Conclusion : Based on the above results, it can be oserved that the time-related factor was the most important factor influencing discomfort. The age and job of the donor, as well as the type of machine used, were significant variables in predicting the level of discomfort, regardless of psychological, environmental, and physical factors. This data could be used to determine nursing interventions that would relieve some of the discomfort of patients, as well as donors, undergoing plateletpheresis. Furthermore, consideration of the donor's time, introduction of a platelet donor pool system, publicity and education about platelet donation are required.

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