• Title/Summary/Keyword: Secondary Disease

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Effects of and barriers to hospital-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

  • Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
    • Physical Therapy Rehabilitation Science
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    • v.9 no.2
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    • pp.82-89
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    • 2020
  • Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.

Systemic Pemphigus Vulgaris: A Case Report (전신성 심상성 천포창의 치험례)

  • Seo, Bo-Mmie F.;Seo, Je-Won;Oh, Deuk-Young;Ahn, Sang-Tae;Rhie, Jong-Won
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.687-690
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    • 2011
  • Purpose: Pemphigus vulgaris, a rare autoimmune blistering disease of the skin and mucous membranes remains a challenging disease to treat. Management is focused on immunotherapy against autoimmune antibodies that target keratinocyte cell adhesion molecules, and antibiotics preventing secondary infections. There is no established dressing protocol and skin is usually manipulated the least amount possible in order to minimize irritation. The authors suggest that early initiation of aggressive bathing and debridement of skin lesions, with nutritional support, is essential in accelerating resolution. Methods: A 40 year-old male previously diagnosed with pemphigus vulgaris was admitted due to exacerbation of mucocutaneous lesions involving the epidermis and mucosa of the whole body. Steroids, immunosuppressants, intravenous immunoglobulin and antibiotics were administrated, but infection and de-epithelialization progressed, while his general condition deteriorated with a weight loss of over 20 kilograms. The plastic surgery department intervened with daily bathing, debridement of unhealthy debris and non-traumatizing coverage of growing epithelium. Total parenteral nutrition and mobilization with rehabilitation therapy was initiated as early as possible. Results: After bathing, healthy epithelium gradually covered the patient's entire body, while his general condition improved with a corresponding weight gain of 14 kgs. Conclusion: Treatment of pemphigus vulgaris focuses on immunotherapy and infection control. However, an equal amount of attention should be laid on early intervention with daily dressings including bathing and irrigation, nutritional support, and exercise as this accelerates resolution of existing infections, promotes healthy epithelialization and leads to faster recovery.

Study on Establishment of criteria for Heart Disease in Oriental Medicine (심병증 진단요건의 표준 설정을 위한 연구)

  • Choi Sun Mi;Park Kyung Mo;Jeung Chan Gil;Sung Hyun Jea;Ahn Kyoo Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.4
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    • pp.845-851
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    • 2003
  • The objective is to establish the standard of criteria for differential diagnosis of signs and symptoms. This study selected signs and symptoms related to heart which stands for Fire(火) as a kind of five phase(五行). Eleven experts was asked to evaluate the adequateness of criteria which was developed by Korea Institute of Oriental Medicine(KIOM) and to suggest the amendment of them. To implement the study, we used the questionnaire which asks about the diagnosis criteria for an insufficiency of the heart-qi(心氣虛證), deficiency of the heart blood(心血氣證), deficiency of the heart-yin(心陰虛證), insufficiency of the heart-yang(心陽虛證), exuberant fire due to hyperactivity of the heart(心火亢盛證), stagnation of the heart blood(心血瘀阻證), heart disturbed by phlegm-fire(痰火擾心證), attack of the heart by retainedfluid(水氣凌心證). Every criteria consists of primary symptoms, secondary symptoms, tongue findings. and pulse findings. In perspectives of the classification of patterns for signs and symptoms and criteria for diagnosis, the result shows that the previous standard doesn't have so many problem. So many of experts were agree with the criteria which was suggested but the trend is that they use, in their actual practice, less than the criteria. Additionally, they pointed that every element in a criterion should have the different weight value, criteria for the overlapped pattern should be added, and, in future, criteria which are based on clinical investigation should be established.

Clinical and Endocrine Characteristics of Patients with McCune-Albright Syndrome (McCune-Albright 증후군의 임상적 및 내분비학적 특징)

  • Kwun, Yoojin;Kim, Yoo-Mi;Kim, Ja-Hye;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.2
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    • pp.120-125
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    • 2013
  • Purpose: McCune-Albright syndrome (MAS) is caused by activating mutations in the GNAS gene, resulting in peripheral precocious puberty, caf$\acute{e}$-au-lait spots, and polyostotic fibrous dysplasia (POFD). The aim of the present study was to describe the diverse clinical and endocrine characteristics of patients with MAS. Methods: Seven patients with MAS were included in this study and medical charts were reviewed retrospectively for following parameters: patient's sex and age at diagnosis, POFD, ovarian cysts, and precocious puberty. Results: The mean age at diagnosis was $5.8{\pm}4.2$ years. One patient was male (14%) and the other six patients were female (86%). Peripheral precocious puberty was associated with 6 patients (86%). Five patients manifested premature menarche as early as 2 to 5 years of age. Letrozole was administered to 4 patients, tamoxifen to one patient and GnRH agonist to one patient. Five females developed ovarian cysts. Thyroid function tests were performed in all patients and one patient showed hyperthyroidism (14%) and has been treated with methimazole. One patient presented with pseudohypoparathyroisdism, phosphaturia, calciuria suggesting hypophosphatemic rickets. Six patients (86%) revealed POFD. One patient had symptoms of optic nerve compression and secondary esotropia and 2 patients had bone pain. Conclusion: This study described clinical characteristics and endocrine complications of patients with MAS. Careful physical examinations with history taking and serial endocrine function tests should be needed to detect complications such as endocrinologic hyperfunction and POFD.

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Effects of the Coronavirus Disease 2019 (COVID-19) Pandemic on Outcomes among Patients with Polytrauma at a Single Regional Trauma Center in South Korea

  • Kim, Sun Hyun;Ryu, Dongyeon;Kim, Hohyun;Lee, Kangho;Jeon, Chang Ho;Choi, Hyuk Jin;Jang, Jae Hoon;Kim, Jae Hun;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.155-161
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    • 2021
  • Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

Cancer of Unknown Primary Site Mimicking Retroperitoneal Fibrosis (후복막강섬유화증으로 오인된 원발 부위 불명암 1예)

  • Park, Chan Keol;Yoo, Su-Jin;Yoo, In Seol;Kim, Jinhyun;Shim, Seung Cheol;Yeo, Min-kyung;Kang, Seong Wook
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.575-581
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    • 2018
  • Retroperitoneal fibrosis (RPF) is a rare disease characterized by marked fibro-inflammatory tissue in the retroperitoneum. Approximately 70% of cases of RPF are idiopathic, while the rest can be secondary to several other causes. The diagnosis is mainly obtained by imaging modalities such as computed tomography (CT). However, histological examination should be considered when the clinical manifestations and imaging studies suggest malignancy. In particular, in malignant diseases with retroperitoneal metastases, abnormal collagen plaques are formed from an exuberant desmoplastic response, which may not be distinguishable from RPF on CT scans. Therefore, even if CT suggests RPF, biopsy is essential to identify malignant disease because it typically results in a fatal prognosis. Here, we report a case of metastatic adenocarcinoma of unknown primary site that developed only in the retroperitoneum and was initially diagnosed as RPF based on CT findings.

siRNAs Derived from Cymbidium Mosaic Virus and Odontoglossum Ringspot Virus Down-modulated the Expression Levels of Endogenous Genes in Phalaenopsis equestris

  • Lan, Han-hong;Wang, Cui-mei;Chen, Shuang-shuang;Zheng, Jian-ying
    • The Plant Pathology Journal
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    • v.35 no.5
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    • pp.508-520
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    • 2019
  • Interplay between Cymbidium mosaic virus (CymMV)/Odontoglossum ringspot virus (ORSV) and its host plant Phalaenopsis equestris remain largely unknown, which led to deficiency of effective measures to control disease of P. equestris caused by infecting viruses. In this study, for the first time, we characterized viral small interfering RNAs (vsiRNAs) profiles in P. equestris co-infected with CymMV and ORSV through small RNA sequencing technology. CymMV and ORSV small interfering RNAs (siRNAs) demonstrated several general and specific/new characteristics. vsiRNAs, with A/U bias at the first nucleotide, were predominantly 21-nt long and they were derived predominantly (90%) from viral positive-strand RNA. 21-nt siRNA duplexes with 0-nt overhangs were the most abundant 21-nt duplexes, followed by 2-nt overhangs and then 1-nt overhangs 21-nt duplexes in infected P. equestris. Continuous but heterogeneous distribution and secondary structures prediction implied that vsiRNAs originate predominantly by direct Dicer-like enzymes cleavage of imperfect duplexes in the most folded regions of the positive strand of both viruses RNA molecular. Furthermore, we totally predicted 54 target genes by vsiRNAs with psRNATarget server, including disease/stress response-related genes, RNA interference core components, cytoskeleton-related genes, photosynthesis or energy supply related genes. Gene Ontology classification showed that a majority of the predicted targets were related to cellular components and cellular processes and performed a certain function. All target genes were down-regulated with different degree by vsiRNAs as shown by real-time reverse transcription polymerase chain reaction. Taken together, CymMV and ORSV siRNAs played important roles in interplay with P. equestris by down modulating the expression levels of endogenous genes in host plant.

Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study (고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB)

  • Cho, Hyunjoo;Jung, Hyejin;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

Study on Policy Improvement Measures to Respond to Infectious Diseases of Livestock through Field Investigation (현장 조사를 통한 가축전염병 대응 정책개선 방안 연구)

  • Park, Hyun Shik;Ham, Seung Hee;Lee, Jun
    • Journal of the Society of Disaster Information
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    • v.17 no.2
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    • pp.275-288
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    • 2021
  • Purpose: The purpose of this study is to analyze the characteristics of animal carcasses treatment and quarantine management of infectious diseases of livestock, and to present the effectiveness of quarantine and follow-up management of livestock infectious diseases. Method: Actually, a livestock epidemic occurred and the burial site and burial management facility that treated livestock carcasses were visited on-site to analyze the management status and problems. Result: The burial method of livestock outbreaks of livestock infectious diseases and the long-term follow-up management accordingly requires a large amount of manpower and budget to be spent. For example, it can be seen that it is an inefficient quarantine system. Conclusion: It is necessary to review plans for the establishment of integrated livestock infectious animal carcasses treatment facilities at the level of metropolitan cities, districts, and municipalities with the government, where there is no fear of secondary infectious disease transmission and no follow-up management is required.

A Case of Segmental Vitiligo Occurring Where Herpes Zoster Occurred Previously as an Isotopic Response (제목을입력해주세요대상포진 발생 부위에 발생한 분절형 백반증 1예: Isotopic 반응)

  • Kim, Jung Yup;Lee, Yun Ho;Lim, Jae Yun;Choi, Ju-Yeon;Min, Joon Hong;Choi, Young Jun;Nam, Jae-Hui;Kim, Won-Serk;Lee, Ga-Young
    • Korean journal of dermatology
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    • v.56 no.9
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    • pp.543-547
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    • 2018
  • Wolf's isotopic response is defined as the occurrence of a new skin disorder at the site of another unrelated skin disease that has already healed. In most cases of isotopic response, the initial dermatosis is herpes infection, and the most frequent second dermatoses are granulomatous reactions. Various interpretations of this phenomenon have been attempted. However, the exact mechanism has not been identified yet. Herein, we report a case in which the secondary disease was segmental vitiligo that appeared over the same dermatomes of herpes zoster. A 71-year-old woman presented with well-defined, depigmented patches on the left chest and back. She had been diagnosed with herpes zoster on the same dermatomes and treated with an antiviral agent 3 years ago. Histological examination showed decreased basal melanin pigments and melanocytes. Consequently, the patient was diagnosed with segmental vitiligo based on the clinical and histological findings.