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Relationship of Level of Stress, Life Style, Subjective Symptoms and Clinical Diagnosis in Clients taken Multiphasic Screening Program (종합검진 수검자의 스트레스 수준과 생활습관, 자각증상 및 임상적 진단의 관련성)

  • Park, Jun-Han;Chun, Jin-Ho;Kang, Jang-Mi;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Jeong, Kui-Won;Urm, Sang-Hwa
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.728-739
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    • 1998
  • To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

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Clinical Observation on C.V.A. (뇌졸중(腦卒中)에 관(關)한 임상통계적(臨床統計的) 연구(硏究))

  • Yun, Jin-Goo;Cho, Ki-Ho;Kim, Young-Suk;Lee, Kyung-Sup
    • The Journal of Internal Korean Medicine
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    • v.10 no.1
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    • pp.25-38
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    • 1989
  • Clinical observation was done on 1092 cases of cerebrovascular disease which were confirmed by Brain CT scan in Oriental Medical Hospital in Kyung Hee Univ. from May 1987 to May 1988. Specially, clinical prognosis of 250 patients who had been hospitalized for over 4 weeks, were obserbed. The results were obtained as follows; 1. In this study, Occlusive CVD was 77.9%, Cerebral hemorrhage was 18.8%, Subarachnoid hemonhage was 0.8%. 2. The ratio of male to female was 1.4:1. In the age distribution, 60th decade, 50th decade, 40th decade, 30th's, 20th's were in order of frequency and specially 60th decade was 35.53% over 70th decade was 17.1% in ratio. 3. The most common preceding disease of CVD was hypertension (54.21%) and diabetes mellitus (19.96%) was second. 4. Almost, the duration of hospitalization was 2-4 weeks in 34.8%, within 4 weeks in 78.02%. 5. Primary attack was 75.7%, 2nd attack was 17.9%, over 3rd attack was 3.1% in ratio of recurrence. 6. The level of consciousness was Grade I in 96.4%, Grade II in 3.2%, Grade III in 1% at attack. 7. A few complications of C.V.A. were observed in the studies: pneumonia was noted frequently in 3.2%, bed sore, urinary tract infection, gastro intestinal bleeding in order of frequency. 8. The ratio of neurologic deficiency in occlusive CVD decreased from 51.9% to 29.3% in upper limb, 52.6% to 24.4% in lower limb, and that in cerebral hemorrhage decreased from 69.5% to 25% in upper limb, 50% to 20% in lower limb. 9. The ratio of left side hemiplegia to right was 1.04:1 in male, 1:1.18 in female. 10. The herb medications for C.V.A. were various Chungg-Paesagantang, Sunghanggeonggisan were used most frequently to Chungyeold, Geopung, Soongi, Haldam and Chungsimtang, the drugs for Bogiheol were used as discharge. In these oriental medical therapy of C.V.A. objective diagnosis and more various therapeutic method must be obtained through east-west medical co-operation.

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A Case of Massive Empyema Caused by Streptococcus constellatus and Anaerobic Bacteria for Mental Retardation (정신지체환자에서 발생한 Streptococcus constellatus와 혐기성 균에 의한 거대 농흉 1예)

  • Kim, Kyeong-Hyun;Kim, Se-Hyun;Heo, Jeong-Won;Lee, Sang-Hoon;Han, Seon-Sook;Lee, Seoung-Joon;Kim, Woo-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.476-479
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    • 2011
  • The Streptococcus milleri group, which also includes S. anginosus, S. intermedius and S. constellatus, is found in the oropharynx, upper respiratory tract, gastrointestinal tract, and urogenital tract mucosa. Bacteria in the Streptococcus milleri group are associated with bacteremia and abscess formation. Most of the reports of of Streptococcus milleri group (SMG) infection occur in patients with underlying medical conditions. Predisposing factors that have been associated with S. milleri group empyema include mucosal disturbances (sinusitis, periodontal disease, enteric disease), preceding to pneumonia, thoracic surgery, malignancy, neurological disease, alcohol abuse, and also diabetes mellitus. We report on a 42-year-old man with mental retardation. He who suffered from dyspnea and a fever that he had developed for over 14 days. S. constellatus and anaerobic bacterias (Prevotella buccae and Micromonas micros) were cultured. The patient was treated with the drainage of pleural effusion and clindamycin and levofloxacin.

The study for recent changes of disease-mix in health insurance data (의료보험 통계자료를 이용한 최근 우리나라 질병구조 변화관찰 - 의료보험관리공단 자료를 중심으로 -)

  • Yu, Seung-Hum;Jung, Sang-Hyuk
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.3 s.31
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    • pp.345-357
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    • 1990
  • Accumulated data on medical care utilization among the insured in Korea Medical Insurance Corporation can explain the health status of the population. The purpose of this study was to analyze a change of the disease-mix and utilization pattern by controlling the size of the population enrollment. Major findings of the study are as follows : 1. The changes of inpatient disease-mix a. Utilization rate was 139.2% in 1988 against 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. Meanwhile, disease groups seen less often were infections and parasistic diseases, diseases of blood and bloodforming, diseases of the digestive system etc. c. Utilization rate was up 106.3% in 1988 compared to 1985, and diseases above that average level were ill-defined intestinal infections, chronic liver disease and cirrhosis, diabetes mellitus, essential hypertension, etc. d. The disease-mix by institution in 1988 compared to 1985 shows that chronic disorders rank high in general hospitals whereas opthalmologic, obstetric, and orthopedic diseases rank high in private clinics. 2. The changes of outpatient disease-mix a. Utilization rate was up 175.2% in 1988 compared to 1980. b. Disease groups higher than the average utilization rate included neoplasms, endocrine, nutritional and metabolic diseases and immunity disorders, mental disorders etc. And disease groups seen less often were infections and parasistic diseases, diseases of the respiratory system, diseases of the genitourinary system. etc. c. Utilization rate was up 104.0% in 1988 compared to 1985, and diseases above that average level were gastric ulcer, diseases of hard tissues of teeth, etc. And diseases seen below that average level were acute nasopharyngitis(common cold). acute upper respiratory infections of multiple or unspecified sites, etc. It was concluded that medical care utilization level was increased, and that, from 1980 to 1988, disease-mix shifted to the chronic disorders. Chronic disorders accounted for more medical care utilization in general hospitals.

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Obstructive Sleep Apnea in Interstitial Lung Disease (폐쇄성 수면 무호흡증과 간질성 폐질환)

  • Kim, Shin Bum;Lee, Sang Haak;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.19-23
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    • 2017
  • Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.

A Case Study of Prosthetic Ambulation Training for Upper and Both Lower Extremity Amputated Patient (상지 및 하지절단 환자의 의지보행훈련 증례연구)

  • Hong, Do-Sun;Park, Chang-Ju
    • Journal of Korean Physical Therapy Science
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    • v.7 no.1
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    • pp.367-375
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    • 2000
  • The purpose of this study is to announce the present condition, walking training, and adaptable training of a limb amputated patient. The study is a successful report of the limb amputated patient through the medical treatment of the physical therapy. A cause of the limb amputated patient, a truck driver, was that the patient was hit by a train when the driver alight from the truck. Then, the driver was surgical operated on left AK (Above Knee) amputation and left AE (Above Elbow) amputation by orthopedics at the Young Dong Severance Hospital on Dec.7, 1996. Two weeks after the operation (Dec., 22, 1996), the patient was trained at the Yonsei Medical Center Physical Therapy Hospital for the walking and temper adjust training. It was possible to do a flat surface walking and a slope surface walking without helping due to the patients optimistic personal character and motivation. However, the patient struggled to a dull surface walking and his weak endurance. the patient has several problems when the patient wears artificial legs and hands, fears on fall down, and mentally worries on noise when he walks. It is necessary to approach for this problems by many fields of the helpers, such as Rehabilitation medical doctor, physical therapist, occupational therpist, artificial limbs makers, psychologists, and etc. Therefore, in order for recovering from the amputated parts function after the surgical operation, more approved reports have to be for the amputated patients due to increasing traffic accidents, industrial disaster, cancer, diabetes, obstacles of the peripheral nervous system, and etc.

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Body Fat Distribution and Blood Pressure according to Anthropometric Change in Korean Patients with Non-Insulin Dependent Diabetes Mellitus(NIDDM) (한국 인슐린 비의존형 당뇨병 환자의 체형 변화 유형에 따른 체지방 분포와 혈압)

  • Park Hye-Ja;Kim Se-Hyun;Kim Eun-Jeong
    • Journal of Korean Academy of Nursing
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    • v.36 no.5
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    • pp.837-844
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    • 2006
  • Purpose: This study was done to identify fat distribution and blood pressure according to anthropometric change patterns between NIDDM patients and control subjects. Methods: Cross-sectionally 167 NIDDM patients and 87 controls were studied. Previous maximal body weight and acute weight loss was obtained. Current height, body weight, BMI, waist-hip ratio(WHR), skinfold thicknesses(abdomen, subscapular & triceps), and blood pressure was measured. Three anthropometric change patterns were categorized by BMI changes from the maximum lifetim's BMI to the current time (obese-obese, obese-nonobese and nonobese-nonobese: obese: BMI$\geq$25kg/m$^2$, nonobese: BMI<25kg/m$^2$). The data was analyzed by $X^2$, t-test, age adjusted ANCOVA and Least Squares Means(LSM) for multiple comparison. Result: Acute body weight loss(p=0.01), anthropometric change types (p=0.001), WHR (p=0.05), and skinfold thickness (p=0.002) of NIDDM were significantly higher than those of the controls. The mean arterial pressure, WHR and skinfold thicknesses were greater in both obese-obese and obese-nonobese NIDDM and control subjects compared with both nonobese-nonobese NIDDM and control subjects. (all p's<0.05). Conclusion: NIDDM patients had more central and upper body adiposicity. Also both obese-obese and obese-nonobese NIDDM and control subjects had higher mean arterial pressures and central body obesity.

A Case of Secondary Organizing Pneumonia Occurring in Therapy for Lung Abscess (폐 농양 치료 중 발생한 이차적 기질화 폐렴 1예)

  • Yoon, Hyeon Young;Oh, Suk Ui;Park, Jong Gyu;Sin, Tae Rim;Park, Sang Myeon
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.540-544
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    • 2007
  • The patient is a 62-year-old man with known diabetes mellitus who presented with a two-weeks-history of dyspnea, cough, and fever. He was diagnosed with a lung abscess in the right upper lobe and was treated with intravenous antibiotics. The patient's clinical and radiological findings improved within seven days after medical treatment. However, newly developed ground-glass opacity and infiltrations were observed in the right lower lung. Fourteen days after admission, the patient's symptoms and imaging finding became aggravated despite trestment with susceptible antibiotics for lung abscess. Trans-bronchial lung biopsy (TBLB) was performed in the lateral basal segment of the right lower lobe of the lung. A histologic photomicrograph showed organizing pneumonia, also called bronchiolitis obliterans with organizing pneumonia(BOOP), that became more definite as the terminal bronchioles and alveoli became occluded with masses of inflammatory cells and fibrotic tissue. The clinical symptoms and radiograph findings resolved quickly with prednisone treatment. We report a case of secondary organizing pneumonia diagnosed after TBLB following lung abscess treatment and provide a review of the literature.

A Study on the Pressure Ulcers in Neurological Patients in Intensive Care Units (신경계 중환자의 욕창발생에 관한 연구)

  • Im, Mi-Ja;Park, Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.190-199
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    • 2006
  • Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

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Relationship between Chronic Rhinosinusitis and Blood Pressure (비부비동염과 혈압의 상관관계)

  • Seo, Youn Tae;Kim, Deok Su;Kil, Bu Kwan;Shin, SeungHeon;Ye, Mi Kyung
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.182-189
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    • 2018
  • Background and Objectives : There were few literatures about the relationship between upper airway disorders and cardiovascular risk factors such as hypertension, although an association between impaired lower respiratory function and cardiovascular alterations was often reported. Our purpose was to assess the relationships between chronic sinusitis and hypertension. Materials and Methods : Three hundred subjects with bilateral chronic sinusitis who underwent functional endoscopic sinus surgery between 2015and 2017 were evaluated. Six hundred forty subjects without any nasal diseases were enrolled as a control group. Blood pressure and body mass index (BMI) were measured using a standardized method, and subjects were asked about current use of any antihypertensive medication, history of diabetes, smoking and alcohol drinking habits.Sinusitis group was assessed by nasal endoscopic examination, paranasal sinus CT scan and allergy test. Results : Average systolic and diastolic blood pressures were statistically significantly higher in subjects with sinusitis than control group. Chronic rhinosinusitis was associated with a 1.415-fold (95% confidence interval 1.053-1.930) increased hazard of hypertension after multivariate adjustment. Conclusions : These results suggest that sinusitis is associated with high blood pressure. Therefore patients with sinusitis may need special attention for blood pressure control. Further studies need to be performed to elucidate the pathogenesis behind such associations.