• Title/Summary/Keyword: convalescent stage

Search Result 21, Processing Time 0.032 seconds

A Study on Clinical Characteristics of Patients with Mild Cognitive Impairment at Convalescent Hospitals (요양병원에 내원한 경도인지장애환자의 진료특성에 관한 연구)

  • Kim, Youn-Jeong;Kim, Doo Ree;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
    • /
    • v.9 no.8
    • /
    • pp.77-85
    • /
    • 2018
  • Dementia among the diseases occurring in the old age is recognized as a disease to be solved at the national level and systematic management is being carried out. However, the awareness and response of the mild cognitive disorder, which is the middle stage of normal aging and dementia, are insufficient and social costs are increasing every year. The subjects of the study were 303 hospitalized patients whose primary diagnosis was mild cognitive impairment (F067) in a nursing hospital located in one district in 2016. The number of days of hospitalization was shorter in autumn and longer in winter or in hospital discharge. The cost of treatment for patients with mild cognitive impairment is lower in autumn and higher in winter or in 'discharge' of medical treatment results. The total cost of medical treatment was high in the winter by season in the ADL 6-12 and ADL 13-20 groups. Difference in the cost of medical treatment according to the characteristics of medical treatment, the medical expenses were the highest when the number of corporal disease was 5 ~ 8. In the medical treatment results, the ADL 6-12 point group and the ADL 13-20 point group had high medical expenses in 'continue'. Considering the clinical characteristics of mild cognitive impairment and considering that 10-15% of the patients with mild cognitive impairment progress to dementia every year, early detection and treatment of mild cognitive impairment is an effective and potentially important task for reducing potential social and dementia patients.

Serum Nitric Oxide and Tumor Necrosis Factor-α Levels in Patients with Kawasaki Disease (가와사키병 환아에서 면역글로불린 투여 전후의 혈중 Nitric Oxide와 Tumor Necrosis Factor-α에 대한 연구)

  • Park, Ji Hye;Shin, Jee Seon;Hong, Young Mi
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.7
    • /
    • pp.772-778
    • /
    • 2005
  • Purpose : Kawasaki disease(KD) is a systemic panvasculitis that causes coronary artery lesions. KD is accompanied by immunoregulatory abnormalities. Nitric oxide(NO) can induce relaxation of blood vessels by activating guanylate cyclase in smooth muscle cells and high levels of NO may result in coronary artery lesions. We investigated tumor necrosis factor$(TNF)-{\alpha}$ and NO production before and after intravenous immunoglobulin(IVIG) therapy to study the roles of NO and $TNF-{\alpha}$ in KD with coronary artery lesions. Methods : Serum levels of NO and $TNF-{\alpha}$ were measured in 24 patients with KD(group I, eight patients with normal coronary artery; group II, 16 patients with coronary artery lesions) and 23 controls(group III, 13 afebrile controls; group IV, 10 febrile controls). Blood samples from each subject were drawn before and after IVIG therapy and in the convalescent stage. Serum concentrations of NO and $TNF-{\alpha}$ were measured by enzyme linked immuno sorbent assay. Results : The NO levels before IVIG therapy were significantly higher in group II than in group I, group III and group IV. After IVIG therapy the levels of NO were significantly higher in group I and group II than in group III. The $TNF-{\alpha}$ levels before IVIG therapy were significantly higher in group I and group II than in group III. The serum $TNF-{\alpha}$ and NO levels were higher before IVIG therapy and decreased through the convalescent stage in KD patients. In the acute stage of KD patients with coronary artery lesions, serum NO levels significantly correlated with white blood cells (r=0.43, P<0.05). Conclusion : The serum concentration levels of $TNF-{\alpha}$ and NO were abnormally high in KD patients and NO concentrations were statistically higher in the KD patients with coronary artery abnormalities than those without coronary abnormality during the early stage of the KD. These results suggest NO may be involved in the development of coronary artery lesions.

A Study on the Standardization In Diagnostic Criteria on Jung-Pung (中風) (중풍진단(中風診斷)의 표준화방안(標準化方案) 연구(硏究))

  • Shim, Hyun-Ki;Park, Se-Ki;Kim, Dong-Woo;Jun, Chan-Young;Han, Yang-Hee;Park, Jong-Hyeong
    • The Journal of Internal Korean Medicine
    • /
    • v.18 no.2
    • /
    • pp.332-357
    • /
    • 1997
  • The purpose of study is for the defining the diagnostic criteria of Jung-Pung (中風) which are confused or unclear partially or Oriental Medicine. The results were obstained as follows ; 1. The Diagnosis of Jung-Pung (中風) can be accomplished by the name of disease, symptomatic classification, Byun-Jeung (辨證), stage, assessment of neurological deficit. 2. The various expressive way on the names of Jung-Pung (中風) can be unified as Jung-Pung (中風). 3. The symptomatic classification of Jung-Pung (中風) can be Jung-Kyung-Rak (中經絡) and Jung-Jang-Bu (中臟腑) by unconsciousness. 4. The subclassification of Jung-Kyung-Rak(中經絡) is Kanyangpokhang Punghwa sangyo (肝陽暴亢 風火上擾證), PungDamErHyul BiJoMaecRak (風痰瘀血 痺阻脈絡證), DamYeolBusil PoongDamSangYo (痰熱腑實 風痰上擾證), KiHerhyulEr (氣虛血瘀證), YeumHer PungDong (陰虛風動證) and Jung-Jang-Bu (中臟腑) is PungHwa SangYo CheongGeu (風火上擾淸竅證), DamSeupMongSac ShimSin (痰濕蒙塞心神證), DamYeolNaeFe ShimGeu (痰熱內閉心竅證), WonKiFaeTal ShimSinChakRan(元氣敗脫心神錯亂證) 5. The classification of stages can be divided as stroke stage, convalescent stage, complicated deficit stage. 6. In Oriental Medicine there were few assessment methods of neurological deficit. Therefore we need to develop new assessment system or modification of Western Medicine. The Standardization in the diagnosis of Jung-Pung (中風) has not been well established, even though we had have many clinical experiences. So it is necessary to make a accurate diagnosis that can be done by multiple diagnostic assessment. Therefore the accurate diagnosis of Jung-Pung (中風) can be done by 5 factors, they are the name of diagnosis, symptomatic classification, Byun-Jeung (辨證), stage, the assessment of neurological dificit. And it can be applied in the planning of treatment.

  • PDF

An Overview of the Herbal Remedies for Severe Acute Respiratory Syndrome (SARS) in WHO Official Report (2004) (중증급성호흡기증후군(SARS) 치료에 사용된 한약 처방에 대한 고찰 - WHO 보고서(2004)에 사용된 처방을 중심으로)

  • Jang, In-Soo;Baik, You-Sang;Bae, Sun-Jae;Sun, Seung-Ho;Lee, Jae-Sung;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
    • /
    • v.30 no.3
    • /
    • pp.571-581
    • /
    • 2009
  • Background : Early in November 2002, severe acute respiratory syndrome (SARS) began to spread throughout thirty-two countries around the world. A total of 5,327 cases were reported in China, including 1,755 cases in Hong Kong and 655 in Taiwan. The total number of cases reported from Canada and Singapore was more than 200. The total number of SARS cases world-wide reached 8,437 with incidences. Mortality from SARS is estimated at around 11%. Under the guidance of the World Health Organization (WHO), clinical studies on the use of integrated herbal medicine and western medicine for treating SARS were carried out in China and Hong Kong. The official report suggested that integrated treatment was more effective than western medicine alone in clinical symptoms, lung inflammation, blood oxygen saturation, immunological functions and others. Objective : To overview the treatment principle and the prescriptions according to the regimens and the stages for SARS of the reports, and further to broaden our knowledge of treatment of acute infectious diseases using natural herbal medicine. Methods : We reviewed nine of WHO SARS reports that comprehensively described the principles and methods of treatment and summarized them into eight treatment methods. We analyzed the herbal formulae on the basis of their treatment principles, evaluated them in accordance with warm disease study, listed frequently used herbs, and assessed patent prescriptions and herbal injections that were mentioned in the reports. Results and Conclusion : The reports divided the course of SARS into 3 to 6 stages such as high fever stage, fastigium stage, and convalescent stage. Frequently used herbs were Radix Scutellariae, Radix Paeoniae, Radix Astragali, Semen Armeniacae, Radix Pseudostellariae, Radix Ophiopogonis, and Fructus Schizandrae. Herbal decoctions were the primary method of treatment, while extracts or injections were secondary. Prescriptions were mainly based on the warm disease study. SARS is a viral disease caused by corona virus, and herbal medicine is proven to be effective against it. We believe that evidences and experiences from SARS cases can be a good reference to further researches on acute infectious diseases.

  • PDF

Immediate Toe-to-Hand Transfer in Acute Hand Injuries (급성 수부 손상시 즉시 족지 전이술)

  • Woo, Sang-Hyun;Kim, Hak-Soo
    • Archives of Reconstructive Microsurgery
    • /
    • v.11 no.1
    • /
    • pp.19-28
    • /
    • 2002
  • From 1994-2001, 25 mutilated digits were reconstructed with immediate toe-to-hand transfer in acute hand injury in 21 patients. There were 15 cases of great toe-to-hand transfer(partial great toe transfer 8 cases, modified wrap-around procedure 2 cases, and trimmed great toe transfer 2 cases) for thumb reconstruction, 2 cases of second toe transfer for index reconstruction, and 4 cases of simultaneous two toe-to-hand transfer(great toe & second toe transfer 1 case, bilateral second-toe transfer 2 cases, combined second & third toe transfer 1 case) for reconstruction of multiple digit amputations. Two cases of emergency exploration(2/25, 8%) were successfully salvaged. The incidence of emergency exploration and postoperative infection was not significantly different from that of the elective toe-to-hand transfer cases. Duration of industrial insurance coverage was 225 days, which is much shorter than that of elective cases. Among 43% of patients maintained their original job even after injury and immediate toe-to-hand transfer. The subjective satisfaction self- assessment scores of aesthetic appearance and function on the new reconstructed thumb were 80 and 88 in average, respectively, over a total score of 100. These were higher than those of reconstruction of other digits, but lower than those of elective reconstruction. The donor site after harvest of the great toe was mostly unsatisfied in a view of appearance. Immediate toe-to-hand transfer provides many advantages over elective procedure in acute hand injuries such as single stage reconstruction, shortened convalescent period, early return to work and efficient socio-economic factor. Furthermore because there were no significant differences in success rate, frequency of complications or ultimate functional result, immediate toe-to-hand transfer is a safe and reliable procedure in case of limited indications for acute digits loss.

  • PDF

Changes of Lipid and Lipoprotein Compositions in Kawasaki Disease and its Impact on Cardiac Complications (가와사끼병에서 혈중 지질과 지단백의 변화와 심장 합병증에 미치는 영향에 관한 연구)

  • Yun, Sin Weon;Lee, Ho Seok;Kim, Dong Woon;Rhee, Kang Won;Jung, Young Soo
    • Clinical and Experimental Pediatrics
    • /
    • v.48 no.12
    • /
    • pp.1370-1377
    • /
    • 2005
  • Purpose : Delineation of serum lipid and lipoprotein values in children after Kawasaki disease(KD) is important because of the predilection of this disease for the coronary arteries. Methods : The KD group was composed of 51 patients who were hospitalized from Jan. 2002 to Dec. 2003. Control was 25 patients with non-KD febrile illness. The levels of total lipid, phospholipid, triglyceride, HDL-cholesterol(HDL-C), LDL-cholesterol, total cholesterol, apolipoprotein A1(apo A1), apolipoprotein B, and Lipoprotein(a) were measured and compared with Echocardiographic findings. Measurements were obtained in four time periods: acute febrile, subacute, convalescent phase and 1 year after KD. Results : HDL-C($33.64{\pm}7.49mg/dL$ vs $50.43{\pm}14.41mg/dL$, P<0.01) and apo A1($99.75{\pm}6.39mg/dL$ vs $113.34{\pm}11.35mg/dL$, P<0.05) were decreased more in the acute febrile period of KD than in the control, but these changes were not correlated with cardiac complications. All lipid profiles were markedly elevated in the subacute stage and normalized in the convalescent stage; there were no changes until 1-year follow up. There were no significant differences in the changes of lipid profiles, including Lp(a) and coronary dilatation, in any time periods. Conclusion : KD is associated with important abnormalities in lipid metabolism, but these changes were transient and appear to be due to the disease itself. These data lead us to infer that KD dose not cause such permanent changes in lipid abnormalities as to be considered a risk factor for atherosclerosis, beyond that caused by the disease itself.

A Survey for the Construction of Nursing Theory According to Korean Culture -Traditional View of Human and Expectation of Sick Role- (한국문화에 따른 간호정립을 위한 기초조사연구 I -전통적인 인간관과 환자역할기대를 중심으로-)

  • 박정숙
    • Journal of Korean Academy of Nursing
    • /
    • v.26 no.4
    • /
    • pp.782-798
    • /
    • 1996
  • This study was a survey done for the purpose of constructing a nursing theory according to Korean culture and to identify the traditional Korean view of humans and the expectations of the sick role, and to confirm changes from the traditional view of humans and expectations of the sick role according to general characteristics of the population. The subjects were all adults over 18 years old. 517 who lived in six large cities and 191 who lived in five rural communities. Data collection was done from November 19th, 1994 to January 19th, 1995 using a tool to measure the traditional view of humans and expectations of the sick role which was developed by the investigator through a literature review. Collected data were analyzed using frequency, percent, Cronbach alpha, 1-test, F-test and Scheffe post hoc contrasts, with the SAS program. The results of this study are summerized as follows : 1. The Traditional view of human score for all subject was 49.92, which shows that Korean traditional view of human is moderate. High scored items were "human need to live by making harmony with nature, not by overcoming the nature" (3.44), "Filial duty to parents and elders is important" (3.31), "Think of family more than a individual" (2.96). 2. The differences in the traditional view of humans between residential districts showed that the residents of Chungbuk(56.00), Kyungbuk(55.26), Chonbuk(51.32), Taegu(50.59) had a more traditional view of humans than those in Pusan(45.42) and Seoul (47.27). 3. The differences in the traditional view of humans according to general characteristics showed that rural community residents, males, older people, people with lower levels of education, married and house-resident groups had a significantly higher traditional view of humans than urban residents, females, younger people, people with a higher levels of education, single and apartment-resident groups. There were differences according to religion and job. Buddhism had a higher traditional view of humans than those of atheism, Christianity and Catholicism and physical workers, a significantly highers score, than technicians and professional workers. 4. Daily expected task performance during illnesses was lowest for patients with stroke (2.16) and psychosis(2.40), in which case almost no daily general tasks were expected, followed by arthritis 4.06, peptic ulcer 4.79, headache 4.99 and cough 5.58. The amount of expected role exemption during illnesses was also highest for stroke(2.25), followed by psychosis(2.08), arthritis(1.64), peptic ulcer(1.29), headache(1.16) and cough(1.09). The amount of daily task performance in the acute stage(3.05) was significantly lower than that of convalescent stage(4.95). 5. Total expectation of role exemption according to general characteristics showed that there was no significant differences in urban /rural community, marriage, level of education and religion. By sex, women showed higher expectation of role exemption during illnesses than men. By age, the 31-40 year old group showed lower expectation of role exemption than the 41-50 year old group or over the 61 year old group.or over the 61 year old group.

  • PDF

Clinical significance of matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 1 and 2 in Kawasaki disease (가와사끼병에서 Matrix metalloproteinase 9과 Tissue inhibitor of metalloproteinase 1, 2의 임상적 중요성)

  • Yun, Ki-Wook;Yun, Sin-Weon;Lee, Jung-Ju;Chae, Soo-Ahn;Lim, In-Seok;Choi, Eung-Sang;Yoo, Byoung-Hoon;Lee, Mi-Kyung
    • Clinical and Experimental Pediatrics
    • /
    • v.53 no.4
    • /
    • pp.510-518
    • /
    • 2010
  • Purpose : Kawasaki disease (KD) is a systemic vasculitis, a leading cause of pediatric acquired heart disease. Histopathological findings of coronary artery lesion (CAL) in KD indicate destruction of the coronary artery wall with diffuse vasculitis. Matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) might play central roles in this process. Special attention to MMP-9 has recently been emerging. This study was performed to investigate the clinical significance of MMP-9 and its inhibitors, TIMP-1 and TIMP-2, in KD. Methods : We compared 47 KD patients with 14 febrile controls. Serum MMP-9 and TIMP-1, TIMP-2 were measured by ELISA and compared according to clinical stages and coronary involvement. Results : In acute stage, MMP-9 and TIMP-1 were significantly higher, whereas TIMP-2 was lower, in KD than those in febrile controls ($P$<0.05). The elevated MMP-9 levels in acute phase significantly decreased during the subacute and convalescent phases ($P$<0.05). During acute phase, the MMP-9, TIMP-1, and MMP-9/TIMP-2 levels in the CAL group were lower than those in the non-CAL group, but they increased significantly in the subacute phase ($P$<0.05). MMP-9 has a positive correlation with TIMP-1 in the acute and subacute phases, and negative correlation with TIMP-2 in the subacute and convalescent phases ($P$<0.05). Conclusion : These results suggest that MMP-9, TIMP-1, and the imbalance in MMP-9 and TIMP-2 might play important roles on the pathophysiology of KD and especially on the development of CAL. However, further larger studies are needed.

The Changes of The Eye and a Correlation Depending on Watching a Smartphone and taking in Alcohol (스마트폰 시청과 알코올 섭취에 따른 눈의 변화와 상관관계)

  • Lee, Jeong-Yun;Yun, Eon-Jeong;Kim, Sung-Min;Hwang, Hye-Kyung;Park, Gyeung-Ju
    • Journal of Korean Ophthalmic Optics Society
    • /
    • v.18 no.4
    • /
    • pp.473-479
    • /
    • 2013
  • Purpose: This article tried to find the changes of the eye and a correlation depending on watching a smartphone and taking in alcohol. Methods: This paper conducted the refraction inspection, the radius of corneal curvature, tonometry and the corneal thickness measurement and analysis for 31 persons (18 males and 13 females) who have healthy drinking habit, not having the medical history of taking medicine related with disorders of the eye, a mental disease, systemic disease and alcohol metabolism. Results: Of respirations depending on watching a smartphone, the alcohol concentration was significantly decreased in 15 minutes, 30 minutes, 45 minutes, 60 minutes and the convalescent stage. (p<0.01, p<0.001) As the result of comparing the refraction inspection after and before watching a smartphone when drinking alcohol, there was a significant difference in the cylindrical power and the axis. (p=0.005, p=0.001) The change of intraocular pressure depending on watching a smartphone after drinking alcohol was decreased significantly from 30 minutes (p<0.001), and watching a smartphone didn't have any significant effect on the corneal thickness depending on the elapsed time from when drinking alcohol. Conclusions: Watching a smartphone and taking in alcohol had a significant effect on the cylindrical power and the axis. Watching a smartphone and taking in alcohol which may cause the visual function-strain are the factors that need to consider before the refraction inspection.

The Analysis of Risk Factors and Significance of Tumor Necrosis Factor(TNE)-$\alpha$ in Henoch-$Sch\ddot{o}nlein$ Nephritis (Henoch-$Sch\ddot{o}nlein$ 자반증 환아에서 신침범에 대한 위험인자 분석 및 tumor necrosis factor-$\alpha$의 의의)

  • Song Young-Jun;Ha Tae-Sun
    • Childhood Kidney Diseases
    • /
    • v.4 no.1
    • /
    • pp.40-47
    • /
    • 2000
  • Purpose: Renal involvement is the most important prognostic factor of HSP. Therefore, the pathogenesis and prognostic factors in renal involvement have been studied by many researchers. The aim of this study was to evaluate the clinical risk factors and the role of TNF-$\alpha$ in renal involvement of HS purpura. Methods: The subjects of this study were 12 patients of HS purpura, 7 patients of HS nephritis, and 5 age-matched controls. We have analysed the rist factors for renal involvement in clinical symptoms and collected the sera and urines of all subjects in acute and convalescent stage. The concentration of TNF-$\alpha$ in the collected sera and urines were measured by sandwich ELISA and compared with that of age-matched controls. Results: Statistical analysis showed that persistent purpura increased the risk of developing renal involvement (P=0.0018). and serum TNF-$\alpha$ levels in the acute stage of patients with renal involvement($11.45{\pm}7.01$ pg/ml) were significantly higher than those of without renal involvement($6.32{\pm}1.31$pg/m1) and of age-matched controls($5.99{\pm}1.34$pg/m1)(P=0.012, 0.027, respectively). However, urine TNF-$\alpha$ levels have no correlation with renal involvement. On investigation of serum TNF-$\alpha$ levels in acute stage of HS purpura, persistent purpura had a significantly higher increase(P=0.038). Conclusion: Serum concentration of TNF-$\alpha$ is a risk factor and has a predictable value along with clinical risk factors, such as, persistent purpura for renal involvement in HS purpura. Also, the effectiveness of the specific treatment fur antagonizing TNF-$\alpha$ in HS nephritis may need further study.

  • PDF