Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.23
no.1
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pp.199-214
/
2010
Objective : Atopic dermatitis (AD) may profoundly affect patient's quality of life (QOL), and also cause economic impact. The aim of our study was to evaluate the quality of life and the economic impact of adult atopic dermatitis patient in Seoul. We also evaluate the relationship of QOL and economic impact with severity of AD. Methods : 30 adult atopic dermatitis patient were included and evaluated by using the SCORAD Index and EASI. Patients were asked to fill in the questionnaires about their quality of life and financial costs during the past year by AD. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation were used for statistical analysis. Results : 1. Among 30 patients, women were 19(63.3%), men were 11(36.7%). The mean age of the patients were 27.3 years old, patients between the ages of 17 and 30 years were 23, over 30 were seven. 2. The mean score of Objective SCORAD was $32.89{\pm}7.30$, Subjective SCORAD was $8.13{\pm}3.53$ and EASI was $9.15{\pm}6.90$이었다. 3. The mean score of Skindex-29 was $28.26{\pm}7.58$, DLQI was $10.17{\pm}5.55$. 4. By analyzing the questionnaire, a monthly average cost of 583,200 won for each patient was determined. Direct cost was 236,800 won and indirect cost was 346,300 won. 5. By analyzing the correlation between the severity of AD and QOL, Objective SCORAD and EASI were positively correlated with QOL(Skindex-29, DLQI) but not significant, meanwhile subjective SCORAD were significantly and positively correlated with QOL(Skindex-29, DLQI). 6. By analyzing the correlation between the severity of AD and economic impact, Objective SCORAD were significantly and positively correlated with direct cost and indirect cost. Also, EASI were significantly and positively correlated with direct cost and oriental medical hospital visits. Conclusions : The above results show that the QOL of the patients with atopic dermatitis is significantly related to their disease severity. Atopic dermatitis patients pay 583,200 won a month, and the economic impact of the patients is significantly related to their disease severity.
Kim, Soo-Hyun;Lee, Ji-In;Gu, Ja-Hwan;Chung, Dae-Kyoo
Journal of Physiology & Pathology in Korean Medicine
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v.24
no.5
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pp.892-897
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2010
Insomnia is common disease generating about 30% incidence in Korea. It describes not only a state of a lack of sleep but also a causative factor for both psychological and physical disorders. According to Oriental Medicine theory, there are many causes of insomnia, and Wibulhwa(胃不和) is one of causes. In this study, we diagnosed as Wibulhwa(胃不和) for three patients and mainly treated with Modified Yukgunja-tang. We compared with before and after Insomnia Severity Index(ISI) treatment. As a result, ISI score falled, and it showed an improvement in insomnia. So we suggest that Modified Yukgunja-tang might be usefully applied to the treatment of insomnia caused by Wibulhwa(胃不和).
Objective The object of this case report is to evaluate the possibility of utilizing Osuyu-tang as a new therapy of psoriasis.Method Diagnosis and Psoriasis' progress was evaluated based on the patient's chart and picture. Diagnosis based on Sanghanlun was organized by graph. The severity of psoriasis' progress was evaluated by Psoriasis Area Severity Index(PASI) and visually analyzed through picture.Results On PASI and picture, we could confirm psoriasis’s area was decreased from hairline to middle of forehead and redness, thickness, scale of psoriasis also got better.Conclusion Osuyu-tang is efficient to patient of this case report as a treatment.
Purpose: The purpose of this study was to evaluate the effects of reminiscence therapy on depressive symptoms in older adults with dementia using a systematic review and meta-analysis. Methods: Randomized controlled trials (RCTs) published from January 2000 to January 2018 were searched through Research Information Sharing Service (RISS), Korean Studies Information Service System (KISS), Korean Medical Database (KMbase), KoreaMed, PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Ovid MEDLINE. Two researchers independently performed the search, selection, and coding. Comprehensive Meta-Analysis 3.0 was used for meta-analysis, and Review Manager program 5.3 was used for quality assessment. Results: Out of the 1,250 retrieved articles, 22 RCTs were selected for analysis. The overall effect size of reminiscence therapy for mitigating depressive symptoms in older adults with dementia was -0.62 (95% Cl: -0.92 to -0.31). The effect size was greater in older adults under 80, those with less disease severity, and those for whom the therapy session lasted less than 40 minutes. Conclusion: Reminiscence therapy is an effective non-pharmacological therapy to improve depressive symptoms in older adults with dementia. Because its effectiveness is also influenced by age, disease severity, and application method, it is necessary to consider treatment designs based on individual characteristics as well as methodological approaches.
Objectives : This study aimed to suggest distinct signs of Greater yin disease (tàiyīnbìng, 太陰病) by researching the etymology of three terms: zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), which are exclusive found only in Greater yin disease (太陰病) in Gangpyeong-shanghanlun, but not in other categories. Methods : We studied the etymologies of the three terms that are unique in Greater yin disease, then found some pathological signs that are related with them through the four mental illness cases, which include somatization, obsessive-compulsive behavior, delusion, and panic disorder. Results : Based on the definitions of each term, we diagnosed the four patients who had mental illnesses as having Greater yin disease, and we observed meaningful improvements after administering herbal medication. After Gyejigajakyak-tang administration, the Insomnia Severity Index (ISI) score decreased from 18 to 7 and the Beck's Anxiety Index (BAI) score decreased from 36 to 18 in the first case, the ISI score decreased from 27 to 16 and the BAI score decreased from 50 to 33 in the second case, and the ISI score decreased from 23 to 4 and the BAI score decreased from 34 to 5 in the third case. In the last case, the ISI and BAI scores were 16 and 22, respectively, at the first visit, and it was found that the scores had changed to 6 and 22, respectively, at the last visit. Conclusions : We found that the unique terms in Greater yin disease, including zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), can be interpreted as groundless arbitrary assumption, resting strong tension, and psychological projection based on the etymological hypothesis. Therefore, we suggest these as specific signs of Greater yin disease.
Bt-cotton germplasm, consisting of 75 genotypes was evaluated against cotton leaf curl disease (CLCuD) under high inoculum pressure in the field and using graft inoculation in glasshouse by visual symptom scoring assessments. None of the tested genotype was found disease free under both evaluation tests. Under field conditions in 2011, 3 genotypes were found resistant, 4 moderately resistant, 3 tolerant, 2 moderately susceptible and one susceptible; in 2012, 3 genotypes were tolerant, 7 moderately susceptible, 5 susceptible and 38 highly susceptible; in 2013, one was moderately susceptible and 51 were highly susceptible with varying degree of percent disease index (PDI) and severity index (SI). However, through graft evaluation in glasshouse, none of the graft inoculated plant was symptomless. All tested genotypes showed disease symptoms with SI values ranging between 5.0 and 6.0, and latent period between 12 and 14 days. Of the 75 genotypes evaluated using graft inoculation, 11 were found susceptible with SI values of 5.0 to 5.4 while remaining 64 were highly susceptible with SI values of 5.5 to 6.0. Inoculated plants of all tested genotypes exhibited severe disease symptoms within 10 days after the appearance of initial symptoms. No reduction in SI value was observed until the end of the experiment i.e., 90 days after grafting. Information generated under the present study clearly demonstrates that no sources of resistance to CLCuD are available among the tested Bt-cotton genotypes. So, a breeding programme is needed to introgress the CLCuD-resistance from other resistant sources to agronomically suitable Bt-cotton genotypes.
Journal of the Korean Society of Physical Medicine
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v.14
no.4
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pp.45-53
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2019
PURPOSE: This study examined the differences in the trunk impairment scores according to the levels of the gross motor classification system by evaluating trunk control in children with spastic cerebral palsy using the index of trunk impairment. In addition, the characteristics of trunk control disabilities were investigated according to the cerebral palsy type. METHODS: The subjects were 49 children (mean age 8.57±1.83 years, 11 with hemiplegia, 26 with diplegia, and 12 with quadriplegia) with spastic cerebral palsy levels I to IV under the gross motor function classification system (GMFCS). The coordination and balance of the children with cerebral palsy were evaluated using the index for trunk impairment. Statistical analyses were performed using a Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. RESULTS: The median of the total scores of trunk impairment was 13 (range, 9-17), which was 56% of the maximum score. The total score of trunk impairment and subscales differed significantly according to the disease severity and type of motor disability. The scores for children with quadriplegia were the lowest compared to children with hemiplegia and diplegia. CONCLUSION: Trunk control function in children with spastic cerebral palsy was reduced, and varied according to the disease severity and types of motor disabilities. The degree of trunk impairment differed from the trunk control ability according to the degree of motor disability of children with cerebral palsy.
Background: A chronic obstructive pulmonary disease (COPD) assessment test (CAT) has recently been developed as a short and simple method for assessing the quality of life in COPD patients. The object of this study was to assess the usefulness of the Korean version of the CAT for assessing COPD patients in an outpatient clinic. Methods: The study included 60 COPD patients in a stable state from an outpatient clinic. The authors investigated the frequency of acute exacerbation during aprevious year through reviewing medical records. We evaluated the spirometry test, a 6-min walk distance test, and obtained the MMRC dyspnea scale, the Korean version of the CAT, and the BODE index at the time of visit. To assess the usefulness of the CAT, correlations between the CAT and other methods were evaluated. Results: The mean age of patients was $68.3{\pm}8.6$ years and 95% of patients were male. There was a significant correlation between the CAT score and $FEV_1%$ (r=-0.323, p=0.012), the frequency of acute exacerbation (r=0.292, p=0.024), the MMRC dyspnea scale (r=0.554, p<0.001), the BODE index (r=0.380, p=0.003), and 6 MWD (r=-0.372, p=0.004). The mean CAT score increased according to the GOLD stage (stage 1, $10.7{\pm}4.5$; stage 2, $13.1{\pm}7.9$; stage 3, $16.3{\pm}6.2$; stage 4, $16.5{\pm}14.8$; p=0.746). Conclusion: The CAT was shown to be useful for the assessment of COPD severity. Therefore, the CAT is an easily applied and simple method for assessing COPD severity in an outpatient clinic.
A total of 200 patients, ranging in age from 20 to 60 years, were selected for the study. Each had at least one tooth which was restored with complete cast gold crown and a nonrestored contralateral tooth with no clinical evidence of caries and periodontal disease. The gingival tissues adjacent to the crowned and nonrestored teeth were examined to determine the evaluation of the severity of inflammation and probed to determine individual pocket depth. The findings are listed here. 1. The average sulcus bleeding index of the gingival tissues adjacent to crowned teeth was 1.99. The average sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth was 0.67. 2. The average gingival sulcus depth adjacent to crowned teeth was 2.19mm. The average gingival sulcus depth adjacent to non restored teeth was 1.68mm. 3. No difference could be found between the average gingival sulcus bleeding index and average gingival sulcus depth of male and those of female. 4. The difference between sulcus bleeding index of the gingival tissues adjacent to crowned teeth and sulcus bleeding index of the gingival tissues adjacent to nonrestored teeth increased with increased age of the cast crown.
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