• Title/Summary/Keyword: older patient

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A Case of Huge Liposarcoma in Thigh (사지에 발생한 거대 지방육종)

  • Kang, Shin-Taek;Hwang, Tae-Hyok;Park, Boem-Soek;Kim, Tae-Jung;Shin, Hwang-Mi
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.192-197
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    • 2008
  • It is well understood that liposarcoma is most common in soft tissue sarcomas. It usually develop proximally in the extremities and most patients are older than 50 years. We report a case of huge liposarcoma which develop on left thigh of 67-year-old man. There was no evidence of metastasis and the tumor was successfully removed by marginal resection. Patient's height is 153 cm and weight is 43 kg, but the tumor's size is $34{\times}20{\times}9\;cm$ and weight is 2.82 kg. The Mass is severely huge in compare with patient's height and weight. But, There are few reports regarding the correlation between tumor-size and pathologic differentiation. Pathological examination reveals a well differentiated liposarcoma. The patient is still asymptomatic at 6-months follow up.

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Association Between Alterations in the Serum 25-Hydroxyvitamin D Status During Follow-Up and Breast Cancer Patient Prognosis

  • Lim, Seung Taek;Jeon, Ye Won;Suh, Young Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2507-2513
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    • 2015
  • Background: Serum vitamin D status can affect the prognosis of breast cancer patients. Our aim was to determine the association between alterations in the 25-hydroxyvitamin D [25(OH)D] status during follow-up and the prognosis of breast cancer patients. Additionally, we evaluated the association between the 25(OH)D status at the time of diagnosis and the prognosis using a detailed age and stage categorization. Materials and Methods: Four hundred and sixty-nine Korean breast cancer patients were included. We collected patient clinicopathological data, including their serum 25(OH)D concentration at diagnosis and at the annual follow-up until 4 years after diagnosis. The patients were divided according to their 25(OH)D status at diagnosis into a deficient (<20 ng/ml) and a non-deficient (${\geq}20ng/ml$) group. At follow-up, patients were categorized into the four following groups according to 25(OH)D status alterations: persistently deficient, improved, deteriorated and persistently non-deficient. Results: At diagnosis, 118 patients were classified into the deficient group and 351 into the non-deficient group. After a median follow-up period of $85.8{\pm}31.0$ months, the patients with advanced-stage disease or an older age in the non-deficient group showed a significantly better survival compared with the deficient group. Furthermore, at the 1-year follow-up of 25(OH)D status, the persistently non-deficient group and the improved group had better survival compared with the other two groups. Conclusions: Our results suggest that maintaining an optimal 25(OH)D status at diagnosis and during the 1-year follow-up period is important for improving breast cancer patient survival.

Risk indicators related to periimplant disease: an observational retrospective cohort study

  • Poli, Pier Paolo;Beretta, Mario;Grossi, Giovanni Battista;Maiorana, Carlo
    • Journal of Periodontal and Implant Science
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    • v.46 no.4
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    • pp.266-276
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    • 2016
  • Purpose: The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods: Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to preestablished clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results: The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (${\geq}65$ years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions: Within the limitations of this study, patients aged ${\geq}65$ years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients.

The Relationship between Perceived Family Functioning and Depression in Patients with Chronic Low-Back Pain (만성요통환자가 지각하는 가족기능과 우울의 관계)

  • Son Jung-Tae;Park Hyun-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.316-331
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    • 2000
  • This study was conducted using a descriptive correlational survey design to identify how patients with chronic low-back pain perceived family function and to examine the relationship between family function and depression. The participants of the study were 116 patients with chronic low-back pain patient who were having follow-up treatment in a local pain clinic, located in Daegu. A structured questionnaire was filled out participants themselves and the structured interview was given during January and February, 2000. The data collection instrument were FACE II-Korean version and Beck's Depression Inventory(1983). The data collected were analysed using mean, standard deviation(SD), t-test, F-test, Duncan test and Pearson correlation coefficient, done with SAS. The results are as follows; 1. The mean of the respondents' perceived family function was 3.47, with emotional bonding at 3.61, acceptability and sharing at 3.61, participation at 3.23, negotiation and satisfaction at 3.24 and responsibility and expectation at 3.76. 2. The mean of the respondents' perceived depression was $17.53{\pm}8.76$. 3. There was significantly negative correlation between family function and depression(r=-0.4817, p=.0001). 4. Research variables included demographic characteristics and showed that subjects who were aged 65 years or older showed significantly lower scores in patient's perceived family function than those who were aged 45 years or below(p=.0502). Perceived family function of females respondents were significantly lower than males(p=.0026). The illiterate showed significantly lower scores than other groups(p=.0001). Respondents with spouse and extended family tended to show significantly higher scores than those who were living with spouse only or by themselves alone(p=.0091). Those who had higher income showed significantly higher scores than in the lower income group(p=.0001). 5. For family function regarding pain characteristics, those who reported severe pain-related daily activity impediments showed significantly lower scores in family function than others with less pain(p=.0357).

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Design and Implementation of CDA Based PACS for Optimized Metadata Extraction (최적화된 메타데이터 추출물 위한 CDA 기반의 의료영상전달시스템 설계 및 구현)

  • Kim Sun-Chil;Cho Hune;Kwak Yun-Sik;Kim Il-Kon;Kim Hwa-Sun
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.54 no.5
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    • pp.315-323
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    • 2005
  • The recent development of embodiment technology of the medical images makes most medical institutions introduce PACS in haste. However, while many older HIS and PACS systems are not yet capable of some of the integration, several new systems are moving rapidly in that direction. Typical PACS system architecture begins with the HIS since this is where the correct patient demographic information and in many cases the orders originate. So, PACS developed convenience of users and to satisfy user's demand because of financial limitations and administrator-oriented considerations in the process of development. Therefore, we have developed a CDA (Clinical Document Architecture) based PACS with HIS, by which we can search and refer to the patient's medical images and information with few restrictions of time and space for diagnosis and treatment. Target model of this research limited to 135 of hospital have 200 beds. We'll make more effort to develop the application which insures the better quality and information of medical images. Medical Image History manages the patient's image files and various medical informations like film chart in connection with time. This trial will contribute to the reduction of the financial loss caused by unnecessary devices and improve the quality in the medical services. The demand on the development of the program which refers to the medical data quickly and keeps them stable will be continued by the medical institute. This will satisfy the client's demand and improve the service to the patients in that the program will be modified from the standpoint of the users.

Could Crepitus Be an Indication for Early Temporomandibular Joint Osteoarthritis?

  • Ju, Hye-Min;Lee, Sun-Hee;Jeon, Hye-Mi;Kim, Kyung-Hee;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.44 no.2
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    • pp.45-53
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    • 2019
  • Purpose: To determine whether crepitus may be a clinical indication for early temporomandibular joint (TMJ) osteoarthritis (OA) and to investigate the correlation between crepitus and the occurrence of TMJ OA with respect to factors, such as patient sex, age, chewing habits, and diagnosis. Methods: This is retrospective analysis of clinical data for 162 TMJs. The criteria for a joint to be included in this study was a minimum of two cone-beam computed tomography (CBCT) scans performed with no OA observed during the initial scan. The Diagnostic Criteria for Temporomandibular Disorders was used for OA diagnosis. Crepitus was recorded when it was objectively palpated during the follow-up period. Correlations between various patient factors and progression to TMJ OA were calculated using the Pearson's chi-square test. A linear-by-linear association was used to analyze trends of OA progression with increasing age. Results: Among the 162 joints, 101 progressed to OA and 61 did not. In the joints where crepitus had been present before OA was confirmed at next or last CBCT, OA progressed at a high rate, and especially higher in female and older patients (p<0.01). Patients in the pain-related disorder group with crepitus were observed to have higher rates of OA progression compared to patients in the intra-articular disorder group (p<0.01). Conclusions: If a patient experiences pain in the TMJs and crepitus, close monitoring through regular CBCT scans is necessary even if there is no evidence of radiologically confirmed OA after the first CBCT.

Analysis of Status and Success Factor of Referral and Return of Patients to Clinics: Focusing on Patients with Endocrinology and Cardiology at a General Hospital in Goyang (진료회송 사업 현황 및 성공요인 분석: 고양시 소재 종합병원급 내분비내과와 심장내과 환자를 중심으로)

  • Park, Hee Sun;Choi, Jung Kyu;Tae, Eun Sook;Choi, Sang Gil;Kim, Eui Hyeok
    • Health Policy and Management
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    • v.32 no.3
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    • pp.323-329
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    • 2022
  • Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

Foreign body aspiration and ingestion in dental clinic: a seven-year retrospective study

  • Huh, Jisun;Lee, Namkwon;Kim, Ki-Yeol;Jung, Seoyeon;Cha, Jungyul;Kim, Kee-Deog;Park, Wonse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.3
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    • pp.187-195
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    • 2022
  • Background: This retrospective study investigated the incidence rate of accidental foreign body aspiration and ingestion according to patient sex, age, and dental department. This study aimed to verify whether the incidence rate is higher in geriatric than in younger patients and whether it is different among dental departments. Methods: Accidental foreign body aspiration and ingestion cases were collected from electronic health records and the safety report system of Yonsei University Dental Hospital from January 2011 to December 2017. The collected data included patients' age, sex, medical conditions, treatment procedures, and foreign objects that were accidentally aspirated or ingested. The incidence rate was calculated as the number of accidental foreign body aspirations and ingestions relative to the total number of patient visits. Differences depending on the patients' sex, age, and dental department were statistically identified. Results: There were 2 aspiration and 37 ingestion cases during the 7-year analysis period. The male to female incidence ratio was 2.8:1. The incidence rate increased with age and increased rapidly among those aged 80 years or older. Seven of the 37 patients with accidental foreign body ingestion had intellectual disability, Lou Gehrig's disease, dystonia, or oral and maxillofacial cancer. The incidence rate was highest in the Predoctoral Student Clinic and the Department of Prosthodontics. The most frequently swallowed objects were fixed dental prostheses and dental implant components. Conclusion: The incidence rate of accidental foreign body aspiration and ingestion differed according to patient sex, age, and dental department. Dental practitioners must identify high-risk patients and apply various methods to prevent accidental foreign body aspiration and ingestion in dental clinics. Inexperienced practitioners should be particularly careful.

Impact of Periodontal Treatment and Demographic and Socioeconomic Factors on Tooth Loss in Persons with Disabilities: An Analysis of Korean National Health Insurance Claims Data

  • Bo-Ra Kim
    • Journal of dental hygiene science
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    • v.23 no.3
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    • pp.225-235
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    • 2023
  • Background: This study aimed to analyze the effects of periodontal treatment and individual- and tooth-related factors on tooth extraction in people with disabilities. Methods: The Korea National Health Insurance claims data of individuals with disabilities aged 40~64 years with chronic periodontitis in 2008 were obtained. Of these, data on the disabled who underwent scaling/root plaining, subgingival curettage/periodontal surgery, or non-periodontal treatments, and data on their teeth were selected. The extraction of 716,688 teeth from 39,097 patients was tracked until 2018, and the patient- and tooth-level factors related to tooth loss were identified using a mixed-effect logistic regression analysis. Results: Data from approximately 17% of the teeth were extracted during a follow-up period of approximately 11 years. Among the tooth-level variables, scaling/root planing treatment at baseline and periodontal treatment during the follow-up period were associated with a lower risk of tooth loss (odds ratio=0.692 and 0.769, respectively, p<0.001). Non-vital teeth increased the risk of tooth loss by 3.159 times (p<0.001). Among the patient-level variables, females were less likely to have lost their teeth than males, and those with orthopedic impairment or brain lesions/mental disabilities, a higher age group, lower income level, or residents in medium/small cities or rural areas were more likely to have lost their teeth (p<0.001). Conclusion: Through approximately 11 years of follow-up, scaling or root planing, experience with periodontal treatment at least once, female sex, older age, lower income, smaller residential areas, type of disability, and pulp vitality were found to be associated with tooth loss in individuals with disabilities aged 40~64 years with chronic periodontitis. To prevent tooth loss in individuals with disabilities, it is necessary to establish a dental treatment plan that considers the timing of periodontal treatment and the characteristics of the patient and teeth.

A Case Study on Hwabyung Patient with Flush face (면적(面赤)을 주소(住所)로 하는 화병(火病) 환자(患者) 1례(一例)에 대(對)한 임상고찰(臨床考察))

  • Kim, Hyun-Soo;Jung, In-Chul;Lee, Sang-Ryong
    • Journal of Haehwa Medicine
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    • v.15 no.1
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    • pp.105-110
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    • 2006
  • Generally, Hwabyung is more common in older women, in low educational group. Many psychiatrists explain it as the illness originated from a series of psychological stresses. And they think that Hwabyung patients have somatization disorder, anxiety disorder, and major depression. But, many of oriental medical doctors explain it as symptoms having the character of fire. In this case, we described a 67-years old woman who diagnosed as Hwabyung. She complained flush face with surging feeling, headache, dizziness and depression, and her condition was improved through oriental medical treatment such as acupuncture and herbal medicine about 5 weeks.

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