Background: The aim of this study was to investigate the clinical characteristics of complex regional pain syndrome (CRPS) in young male patients in South Korea, especially focusing on the association with military service. Methods: From January 2007 to May 2017, we investigated the electronic medical records of 430 consecutive patients, aged 18 to 30 years, who visited Seoul National University Hospital Pain Center, with a suspected diagnosis of CRPS at the initial visit. The following patient details were available for analysis: demographic and disease-related variables, relevance to military service, medications, and the treatment modalities received. Results: Out of 430 patients, 245 (57.0%) were diagnosed with CRPS, of which, 200 were male patients and 45 were female patients. Of the male patients, 95 (47.5%) developed CRPS during military service. CRPS during military service was more likely to result from sprain/strain, and the incidence of CRPS was significantly higher in the lower extremities in patients from the military service group than in those from the non-military service group. During the follow-up period, 37.9% of male CRPS patients (n = 61/161) were treated successfully. Patients with moderate to severe initial pain intensity, and diagnosed during their military service, showed better outcomes. Conclusions: Our results demonstrated that manifestation of CRPS in the young Korean population was more common in male and among those male CRPS patients, about half the cases developed during the military service period.
This study is intended to investigate medication compliance and polypharmacy of the diabetic patients by age group in order to determine the major factors that influence their compliance. 198 ambulatory diabetic patients were interviewed, and the sample was divided into three groups based on the age: Young age group under 55, Borderline age group between 55 - 65, Old age group over 65. According to the study results, medication compliance for the old age group was 72.6% whereas 85.1% for the young age group. Medication compliance significantly decreased as the age of the patients increased. Also the degree of polypharmacy, the rate which patients take more than 6 prescription drugs, was 45.9% for the old group, whereas 31.2% for the young group. As the most important factor of polypharmacy, the number of doctors was statistically significant. With regard to prescription factors related to medication compliance, the amount of prescribed medication is statistically significant between the compliance group and non-compliance group. In addition, the amount of information provided to patients by pharmacists was determined to be a very significant factor. Also the level of ease in understanding the medication instructions varied significantly between the compliance group and the non-compliance group. In light of the empirical data and results for the diabetic patients, it is necessary to develop and implement various programs to improve medication compliance and to decrease the level of polypharmacy among the elderly, or "old", diabetic patients. patients.
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.
Background: The prognosis for young patients generally considered to be poor. The purpose of this study was to determined whether the clinical characteristics and the survival rate in young lung cancer patients after surgical treatment differs from that in older patients. Material and Method: Of 526 patients, 28(5.3%) were 30 to 40 years old. We studied the clinical characteristics and prognosis of 28 patients aged 40 years or less(Group 1), in whom primary lung cancer was diagnosed and operated between 1990 and 1997, and compared them with those 498 patients aged more than 40 years(Group 2). Result: The differences in sex ratio that were higher for women in Group 1, but there was no significant difference (p=0.297). The percentages for smokers and symptoms in Group 1 were significantly less than in Group 2.(p=0.049, p=0.008). Adenocarcinoma was significantly more common (p=0.018) and squamous cell diagnosed was diagnosed as stage IIIb or stage IV in 9 patients(32.1%), while 12.0% of the patients older than 40 years of age had either stage IIIb or stage IV(p=0.002). The 5-year survival rate was 41.3% in Group 1 ; 37.7% in Group 2, and the median survival time was 24.3 months in Group 1 ; 27.0 months is Group 2. There were no significant difference in survival between two age groups(p=0.808). Conclusion: Younger patients have more adenocarcinoma, however have less squamous cell carcinoma, less symptoms and less smoking history. Although younger patients tended to have more advanced disease and less complete resection rate, the recurrence and the long term survival in these patients did not differ that of older patients.
Kwon, Soo Young;Jang, Eun Gyeong;Cho, Young Hwan;Lee, Jang Hoon;Kim, Young Chul;Hong, Jung Woo
The Journal of Korean Medicine
/
v.34
no.2
/
pp.59-65
/
2013
Objectives: This case report was conducted to introduce the effectiveness of herbal decoction on patients with chronic immune thrombocytopenic purpura (ITP). Methods: We closely observed two patients who were admitted to the Department of Internal Medicine 1 of Kyung-Hee Korean Medical Hospital due to ITP. We gave a herbal decoction to these patients and then analyzed the changes in their general conditions as well as blood test results. Results and Conclusions: The treatment with herbal decoctions was helpful for ITP patients.
Purpose: There have been several comparative studies that have focused on elderly groups of patients with gastric cancer. However, new criteria are needed for this elderly group because of the longer life span of Korean people. The diagnosis of gastric cancer has sometimes been missed in the young age group. The perioperative risk is high in the elderly age group because of their combined diseases. This study was designed to determine the differences of the clinicopathologic features and the prognosis between young and elderly patients with gastric cancer. Materials and Methods: Eighty patients were divided in two groups and these patients were selected for making comparison between young and elderly groups of patients with gastric cancer. The young age group consisted of 31 patients who were aged 35 years old or less. The elderly age group was made up of 49 patients who were aged 75 years old or above. Results: For the clinicopathologic features, the young age group was characterized by a high incidence of the poorly differentiated type of adenocarcinoma and the diffuse type too, according to the Lauren classification. On the other hand, the elderly group was characterized by a high incidence of poorly to moderate differentiated adenocarcinoma and also the intestinal type according to the Lauren classification. The other clinical differences were unremarkable. Additionally, there was no survival advantage in the young age group compared to the elderly group. Conclusion: There were no clinicopathologic and prognostic differences between both extreme age groups. So, active surgical treatment is recommended even for the elderly patients group.
Kim, Young-Hae;Koo, Mi-Jee;Kim, So-Hee;Kim, Young-Mi;Lee, Nae-Young;Chang, Koung-Oh
Journal of Korean Academy of Nursing
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v.37
no.6
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pp.924-931
/
2007
Purpose: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. Methods: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). Results: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. Conclusion: The ICU patients had negative experiences in physical mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.
Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.
Samer S. Hasan;Leslie E. Schwindel;Cassie M. Fleckenstein
Clinics in Shoulder and Elbow
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v.25
no.4
/
pp.311-320
/
2022
Background: The outcomes of patients 50-55 years old or younger undergoing prosthetic shoulder arthroplasty (PSA) may not generalize to younger patients. We report outcomes following PSA in a consecutive series of patients 40 years or younger. We hypothesize that total shoulder arthroplasty (TSA) provides better outcome and durability than resurfacing hemiarthroplasty (RHA). Methods: Patients were stratified by diagnosis and surgical procedure performed, RHA or TSA. Active range of motion and self-assessed outcome were evaluated preoperatively and at final follow-up. Results: Twenty-nine consecutive PSAs were identified in 26 patients, comprising 9 TSAs and 20 RHAs, with a minimum of 2-year follow-up. Twelve PSAs were performed for chondrolysis. Mean active forward elevation, abduction, external rotation, and internal rotation improved significantly (p<0.001 for all). Mean pain score improved from 6.3 to 2.1, Simple Shoulder Test from 4.0 to 9.0, and American Shoulder and Elbow Surgeons score from 38 to 75 (p<0.001 for all). Patients undergoing RHA and TSA had similar outcomes; but three RHAs required revision, two of these within 4 years of implantation. Four of five patients undergoing revision during the study period had an original diagnosis of chondrolysis. Conclusions: PSA in young patients provides substantial improvement in active range of motion and patient reported outcomes irrespective of diagnosis and glenoid management. However, patients undergoing RHA, especially for chondrolysis, frequently require subsequent revision surgery, so that RHA should be considered with caution in young patients and only after shared decision-making and counsel on the risk of early revision to TSA.
Purpose:It has been known that the prognosis of a young woman's breast cancer is Poorer than the other woman However, the effect of age on the prognosis is not well-defined We performed this study to investigate age as a prognostic factor of breast cancer. Materials and Methods : A retrospective study was conducted for 3209 breast cancer patients who underwent operations in Department of Surgery, Seoul National University Hospital from January 1981 to December 2000. Patients were divided into two groups, young age(≤35) and old age(>35) groups. And tumor stage, histopathologic characteristics(such as histology, nuclear grade, histologic grade, hormonal receptor, etc), overall survival and disease free survival rates were compared between age groups. Results . The age ranged from 17 to 88 years. 396 patients(12.3%) were included in young age group(median=32) and 2813 Patients(87.7%) in old age group(median=47).There are more advanced stages and poor nuclear grades in young age group(p=0.000, p=0.003), By log-rank test, the young age group had poorer overall survival and disease free survival rates(p<0.05, p=0.0002). Although, the young age group had more advanced TMN stages(p=0.000) and poorer nuclear grade than the old age group(p=0.003) in multi variate analysis, the age was not a significant independent prognostic factor. (P=0.642)Conclusion: Our study showed that the age was not a significant independent prognostic factor.
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