The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.
The purpose of this study was to assess the nutritional status of cancer patients and non-cancer patients who were admitted to an internal medical department and to determine the degree of malnutrition among these patients. The study was performed from May to July l996 with 151 subjects recruited from the general medical department at D University Hospital. For nutritional assessment the anthropometric and biochemical assessment were performed. Biochemical measurements included serum hemoglobin, albumin, and lymphocytes. For anthropometric assessment, patient's body weight, skinfold thickness in four areas, body mass index, and percent of body fat were measured. The results were as follows : 1) Of the 151 patients who were studied, 47 patients had cancer while 104 patients had non cancer related disease. The mean age of the cancer patients was 57 and 52 for non cancer patients. The percentage of patients who had lost body weight during the last 6 months was 29.8% in cancer patients and 15.4% in non cancer patients. This percentage difference between the 2 groups was statistically significant. However, there was no statistical significance between the 2 groups in gastrointestinal symptoms which lasted more than 2 weeks. 2) There was a statistically significant difference in nutritional status(lympocyte : P=.002 ; skinfold thickness in four areas : p<0.05) between the cancer and the non-cancer patients. The percentage of the patients who had the possibility of malnutrition was 65.5% in cancer patients and 6% in non-cancer patients. 3) There was a correlation between the weight loss during the last 6 months before admission and body mass index and skinfold thickness.
Purpose: To investigate the characteristics of the patients and therapeutic shoes for diabetic patients. Materials and Methods: Forty two diabetic patients who had their own therapeutic shoes which were prescribed somewhere else were studied from March 2003 to December 2003. There were 27 males and 15 females, and the mean age was 62.1 years (range, 49-72 years). Duration of diabetes was average 14 years (range, $6{\sim}30$ years), all had type 2 diabetes. Sensation was examined with 5.07 nylon monofilament. The route of purchasing the shoes, compliance to the prescribed shoes were investigated by interview. The shape of shoe, stiffness of upper, conformity of insole to the shape of the foot were recorded. In-shoe plantar pressure was measured in 15 patients. Results: Eighteen patients were insensate to the monofilament. Seven patients did not wear the therapeutic shoes, and only 18 of 35 patients were wearing the therapeutic shoes more than 6 hours a day. The shoes of 17 patients were prescribed by medical doctor and the rest were purchased by the recommendation of acquaintances or advertisement. Ulcer recurred in four of five patients to whom the shoe was prescribed by medical doctor and the cause of three recurrences were evident by just observing the foot and shoe. The therapeutic shoes were made from 11 different makers. Eight shoes were adequate for diabetic patients with respect to the material, shape of insole, type of shoe. In-shoe plantar pressure was examined in 15 patients and was less than 300 kPa in all patients. Conclusion: The therapeutic shoes for the diabetic patients need to be prescribed by medical doctor for selective patients with neuropathy or previous history of ulcer and follow-up examination is important to monitor the compliance of the patients and adequacy of the shoes.
Kim, Jin-Hwa;Ok, Soo-Min;Heo, Jun-Young;Kim, Kyung-Hee;Jeong, Sung-Hee;Ahn, Yong-Woo;Ko, Myung-Yun
Journal of Oral Medicine and Pain
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제39권1호
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pp.2-9
/
2014
Purpose: The purpose of this study was to compare the clinical and radiographic features of temporomandibular joint (TMJ) osteoarthritis (OA) between adolescents and middle-old aged patients. Methods: The subjects were chosen among the patients who presented to the Department of Oral Medicine of Pusan National University Hospital and were diagnosed with TMJ OA by clinical exam, X-ray and cone-beam computed tomography (CBCT) from 2010 to 2011. We investigated 93 adolescent patients (12-19 years) and 53 middle-old aged (>45 years) patients who observed the erosive bony changes in TMJ. CBCT scans were retaken at intervals at an average of 8 months. Results: The adolescent patients showed unilateral degenerative changes more often, and the middle-old aged patients showed degenerative changes more frequently on both sides. The transition of bone changes to the improved group occurred most commonly in both the adolescent and middle-old aged patients. The adolescent patients were more likely to improve than middle-old aged patients. In the adolescent patients, loss of erosion and subjective symptoms occurred in shorter periods than in the middle-old aged patients. In the adolescent patients, the transition of erosion was distributed into proliferative, normal, and shortening in order. In the middle-old aged patients, the transition of erosion was distributed into shortening, proliferative, and normal in order. Conclusions: The clinical and radiographic features of TMJ OA are a significantly different between the adolescent and middle-old aged patients. Moreover, the difference by age of the adaptive and regenerative capacity of TMJ affects the prognosis of TMJ OA and adolescent patients have a better prognosis after treatment.
The classification of herniated intervertebral lumbar disc type is clinically important, as treatment method may be slightly different according to the type of herniated intervertebral disc. When 450 patients who suffered from herniated intervertebral lumbar disc were tested with Magnetic Resonance Imaging (MRI) to find out the type of herniated disc, the following findings were given : 1. The age of the patients investigated ranged from 15 to 83, and their mean age was 40. 2. The male patients were twice as many as the female patients, since the ratio of males to females was 300 : 150. 3. 118 patients suffered from a single herniated disc, and 332 patients were attacked with multi-herniated disc. 4. The types of single herniated disc were a protrusion for 50 patients (40%) and an extrusion for 40 patients (34%). The part of being herniated was an intervertebral disc between $L_4-L_5$ for 95 patients(80%) and the same disc between $L_5-S_1$ for 22 patients(19%). 5. The types of multi : -herniated disc were an protrusion for 67 patients(20%) and an extrusion for 70 patients(21%). Besides, 90 patients (28%) were the case that protrusion and extrusion coexisted simultaneously. The parts of being herniated were $L_3-L_4,\;L_4-L_5$ and $L_5-S_1$ for 53 patients(16%), $L_3-L_4$ and $L_4-L_5$ for 57 patients(17%), and $L_4-L_5$ and $L_5-S_1$ for 139 patients(42%).
Objective : The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. Methods : A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age : 93 patients below 40 years of age [Group I], 419 patients aged $40{\sim}59$ [Group II], 115 patients aged $60{\sim}64$ [Group III], 82 patients aged $65{\sim}69$ [Group IV], 28 patients aged $70{\sim}74$ [Group V], 12 patients aged $75{\sim}79$ [Group VI] and 5 patients over the age of 80 [Group VII]. We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. Results : Age was not a statistically significant factor among patients below 70 years of age [P $value{\ge}0.05$]. But for those aged 70 and older, the age factor had a statistical value [P $value{\le}0.001$]. In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients [P $value{\le}0.001$]. Conclusion : Advanced age [under the age of 70] dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.
The aim of this study is to present the basic reference data of age and specipic gait parameters for comparisons of the gait characteristics depended on Unilateral Trans-Femoral or Trans-Tibial Prostheses. The basic gait parameters were extracted from 10 Adult, 10 above knee(A/K) patients and 10 below knee(B/K) patients, 50 to 60 years of age using VICON 512 Motion Analyzer. The results were as follows; 1) The mean Cadence of the above knee(A/K) patients and below knee(B/K) patients were $87.77{\pm}8.64$ steps/min, to $99.84{\pm}11.14$ steps/min.(p<0.05) 2) The mean Walking Speed of the above knee(A/K) patients and below knee(B/K) patients were $0.84{\pm}0.15$ m/s, to $0.96{\pm}0.25$ m/s.(p>0.05) 3) The mean Stride Length of the above knee(A/K) patients and below knee(B/K) patients were $1.14{\pm}0.14$ m, to $1.14{\pm}0.22$m.(p>0.05) 4) The mean maximal angles of joint on the hip flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $34.75{\pm}10.18_{\circ}$, to $32.32{\pm}6.34_{\circ}$ .(p>0.05) 5) The mean maximal angles of joint on the knee flexion motion for different above knee(A/K) patients and below knee(B/K) patients were $66.97{\pm}15.08_{\circ}$, to $52.65{\pm}9.21_{\circ}$ .(p<0.05) 6) The mean maximal angles of joint on the ankle dorsiflexion motion for different above knee(A/K) patients and below knee(B/K) patients were $14.41{\pm}4.82_{\circ}$, to $10.04{\pm}3.49_{\circ}$ .(p>0.05) 7) The mean maximal angles of joint on the ankle plantarflexion motion for different above knee(A/K) patients and below knee(B/K) patients were $5.77{\pm}3.17_{\circ}$, to $2.75{\pm}4.49_{\circ}$ .(p>0.05)
Kim, Jae Kyoung;Jeong, Ina;Lee, Ji Yeon;Kim, Jung Hyun;Han, Ah Yeon;Kim, So Yeon;Joh, Joon Sung
Tuberculosis and Respiratory Diseases
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제81권3호
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pp.241-246
/
2018
Background: The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. Methods: We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Results: Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Conclusion: Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations.
According to the Ministry of Health and Welfare, the portion of physical disability was 51.4% which was the highest among the registered disabled in December 2015, followed by visual disability(10.1%), disability of the brain lesions(10.0%), hearing disability(10.0%). The aim of this study is to investigate the types of disability in patients with disabilities visiting the Pediatric Dentistry, Chonbuk National University Dental Hospital in 2016. Of the patients who visited the pediatric dentistry, 196 patients (7.5%) had disabilities, and 19 patients had two or more disabilities. Twelve patients (6.1%) had both disabilities of brain lesion and intellectual disorder. Of the 177 patients with only one disability, 54 patients (30.5%) had physical disorders and 123 patients (69.4%) had psychiatric disorders. In psychiatric disorders, intellectual disorder was the most with 98 patients (55.3%), followed by autistic disorder with 23 patients (12.9%). In physical disorders, disability of brain lesion was the most with 37 patients (20.9%), followed by speech disability with 8 patients (4.5%). In this study, as a result of analyzing the types of disability with the patients who visited the Pediatric Dentistry of Chonbuk National University Dental Hospital, most of them had either intellectual disorder, disability of brain lesion, or autistic disorder. Dentists need to understand their general and dental characteristics to treat children and adolescents with disabilities. Since the most chief complaint of the patients was dental caries, early interventions should be made by dentist to reduce the incidence of the disease.
Objectives : We examined quality of life, psychosocial adjustments to illness, changes in sexual functioning, and prevalence of psychiatric disorders in AIDS patients compared to patients with chronic hepatitis B virus infection (CHB). Methods : Thirty-one men with AIDS and 50 men with CHB were enrolled. The Short-Form 12-Item Health Survey (SF-12), the Psychosocial Adjustment to Illness Scale (PAIS), and the Changes in Sexual Functioning Questionnaire short form (CSFQ-14) were administered. Results on these assessments were compared between the 31 AIDS patients and 50 CHB patients. The Structured Clinical Interview for DSMIV (SCID) was administered to determine the psychiatric diagnosis only for the AIDS patients. Results : The Physical Component Summary score (PCS) was lower in AIDS patients than in CHB patients (p<0.001). In the section examining sexual relationships, AIDS patients exhibited a lower level of adjustment (p<0.05) and had more changes in sexual function (p<0.05) than did CHB patients. Administration of the SCID to AIDS patients indicated that the lifetime prevalence of any psychiatric disorder was 56.7% ; 43.3% for mood disorders, 33.3% for alcohol use disorders, 26.7% for anxiety disorders, and 20% for adjustment disorder. Patients who had experienced any psychiatric disorder had more severe psychosocial distress (p=0.004) and evidenced a lower level of overall psychosocial adjustment (p=0.030) than patients who had not. Conclusion : We showed that AIDS patients have a high prevalence of psychiatric disorders, and that AIDS patients with psychiatric disorders were particularly low in levels of psychosocial adjustment. Thus, careful attention should be given to psychiatric aspects of AIDS patients emphasizing the early diagnosis and treatment of psychiatric disorders.
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