• Title/Summary/Keyword: 관절염질환

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

Clinical Characteristics of Elderly Patients with Pulmonary Tuberculosis (고령자 폐결핵에 대한 임상적 관찰)

  • Kim, Chung-Tae;Um, Hye-Suck;Lee, Hyang-Ju;Rhu, Nam-Soo;Cho, Dong-Il
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.432-440
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    • 2000
  • Background : The prevalence of pulmonary tuberculosis among the elderly is increasing in Korea and in the developed countries due to the increased elderly population and their predispositions to chronic disease, poverty and decreased immunity. To define the characteristics of pulmonary tuberculosis in the elderly, we evaluated the clinical spectrum of pulmonary tuberculosis. Method : We analyzed 92 patients retrospectively that were diagnosed as active pulmonary tuberculosis over the age of 65. The analysis involved patient's profiles, clinical manifestations, coexisting diseases, diagnostic methods, anti-TB medications and their side effects, and treatment outcomes. Results : The results were as follows : - 1) The ratio of male to female was 2.1:1(62:30 cases) 2) Chief complaints were a cough (47.8%), dyspnea (40.2%), sputum (38.0%), chest pain (12.0%), anorexia (10.9%), and fever (9.8%). 3) 38 (41.3%) of cases had a past history of pulmonary tuberculosis. 4) The coexisting diseases were : -COPD, 25 cases (27.2%); pneumonia, 17 cases (18.5%); DM. 13 cases (14.1%); and malignancy, 10 cases (10.9%). 5) The positivity of Mantoux test (5 TU, PPD-S) was 82.7%. 6) Pulmonary tuberculosis was diagnosed using the following methods : sputum AFB (Acid Fast Bacillus) smear 42.4%, sputum TB (M. Tuberculosis) culture 15.2%, sputum TB PCR (Polymerase Chain Reaction) 10.9%, bronchial washing AFB smear 2.1%, chest radiology only 25.0%. 7) Locations of radiologic lesions were RULF, 50 cases; RLLF, 50 cases, mostly, then LLLF ; 26 cases were leastly involved. 8) The coexisting tuberculosis were endobronchial TB(8.7%), TB pleurisy(7.6%) miliary TB(5.4%), intestinal TB(2.2%), renal TB(1.1%) 9) The proportion of treatment regimen with 1st line drug and 2nd line drug were 92.3% and 7.6%, respectively. 10) The outcome of treatment were as follows : cured 31.5%, expired 13.0%, no return 47.8%, follow-up now 7.6%. Conclusion : The pulmonary tuberculosis in the elderly has atypical patterns with chronic coexisting diseases. Therefore, the possibility of pulmonary tuberculosis should be considered in elderly patients with pulmonary symptoms.

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Cathepsin S as a Cancer Therapeutic Target (암 치료 표적으로써 cathepsin S)

  • Woo, Seon Min;Kwon, Taeg Kyu
    • Journal of Life Science
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    • v.28 no.6
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    • pp.753-763
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    • 2018
  • Cysteine cathepsins are lysosomal enzymes that belong to the papain family and can induce the degradation of damaged proteins through the endo-lysosomal pathway. It is highly upregulated in many cancers by regulating gene amplification and transcriptional, translational, and post-transcriptional modifications. Cathepsin S is part of the cysteine cathepsin family. Many studies have demonstrated that cathepsin S not only plays a specific role in MHC class II antigen presentation but also plays a crucial role in cancers. Cathepsin S is more stable at a neutral pH compared to other cysteine cathepsins, which supports the importance of cathepsin S in disease microenvironments. Therefore, the dysregulation of cathepsin S has participated in a variety of pathological processes, including cancer, arthritis, and cardiovascular disease. Furthermore, a decrease or depletion in the expression of cathepsin S has been implicated in the processes of tumor growth, invasion, metastasis, and angiogenesis. Taken together, cathepsin S has been suggested as an attractive therapeutic target for cancer therapy. In this review, the known involvement of cathepsin S in diseases, particularly with respect to recent work indicating its role in cancer therapy, is examined. An overview of current literature on the inhibitors of cathepsin S as a therapeutic target for cancer is also provided.

A Drug-Induced Liver Injury by Western Medication (양약으로 유발된 약인성 간손상 환자 임상보고)

  • Son, Chang-gue
    • The Journal of Internal Korean Medicine
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    • v.36 no.1
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    • pp.69-75
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    • 2015
  • Objectives : To investigate the clinical features of drug-induced liver injury (DILI) and traditional Korean medicine (TKM) -based management. Methods : A female patient diagnosed with DILI caused by Western drugs had been treated with Oriental therapies, then the subjective clinical outcome and biochemical parameters were monitored. Results : A 73-year-old female had taken Western drugs (nonsteroidal anti-inflammatory and skeletal muscle relaxants) for about 3 months, and complained of severe abdominal discomfort and tiredness. Her RUCAM score was 9, which met the criteria for DILI (AST 90 IU/L, ALT 100 IU/L, ALP 191 IU/L, and GGT 614 IU/L). She was treated with herbal drugs, moxibustion, and acupuncture, and her symptoms completely resolved, with normalized hepatic enzymes within two weeks. Conclusions : This case report provides a clinical characteristic for a typical DILI caused by Western medicine, and shows an example of a TKM-based application.

Two Cases of Severe Pancytopenia Associated with Low-Dose Methotrexate Therapy in Patients with Chronic Kidney Disease and Rheumatoid Arthritis (류마티스 관절염을 가진 만성신질환 환자에서 저용량 methotrexate 투여 후 발생한 중증 범혈구 감소증 2예)

  • Kim, Hong-Ik;Lee, Woo-Hyun;Oh, Jang-Seok;Hong, Hyo-Rim;Lee, In-Hee
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.60-69
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    • 2011
  • Due to its efficacy and tolerability, low dose oral methotrexate (MTX) therapy has been widely used for treatment of rheumatoid arthritis (RA). However, it can rarely cause serious, life-threatening hematologic toxicities, such as pancytopenia. We report here on two patients with chronic kidney disease (CKD), who developed severe pancytopenia after 5 years (cumulative dose 1,240 mg) and 4 years (cumulative dose 1,320 mg) of low dose MTX therapy for treatment of RA, respectively. Both patients presented with renal insufficiency, hypoalbuminemia, concurrent use of nonsteroidal anti-inflammatory drugs, and elevated mean corpuscular volume of red blood cells (RECs), all of which are known as risk factors of MTX-induced pancytopenia. Despite receiving treatment, which included REC and platelet transfusions, antibiotic therapy, granulocyte colony stimulating factor, and leucovorin rescue, one patient died of sepsis. Based on our case study, prompt investigation of risk factors associated with MTX toxicity is required for all patients receiving MTX therapy. MTX treatment, even at a low dose, should be discontinued in patients with advanced CKD.

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사상체질(四象體質)과 비만(肥滿)의 상관성에 관한 임상적 연구

  • Kim, Dal-Rae;Baek, Tae-Hyeon
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.1
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    • pp.319-335
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    • 1996
  • 연구 목적 : 복지부 발표 '1993년도 대한민국 국민들의 영양상태'보고서를 보면 1인당 섭취열량은 1969보다 257Kcal가 줄어든 것으로 나타났다. 그런데도 불구하고 일부의 사람들은 과도한 열량을 섭취하고 있기 때문에 비만인 사람이 점점 늘어나고 있다. 그렇다보니 신문이나 잡지에서는 거의 매일 살빼는 약이나 신종 다이어트방법에 대한 광고와 기사를 앞다투어 내보내고 있는 실정이다. 비만증은 근래에 발병률이 현저히 증가하면서 중풍, 당뇨병, 고혈압, 암, 간경화증, 당석증 등의 만성질환의 이환율을 증가시키고, 관절에 큰 부담을 주어 골관절염을 보다 빠르게 진전시키며, 사람들의 수명을 단축시키는 등 심각한 건강상의 문제를 일으키고 있다. 또한 비만증은 용모의 손상을 일으켜 정신적인 스트레스의 주요 인자로 등장하고 있기도 하다. 비만인이 증가하는 원인으로는 서구화된 음식습관으로 동물성 지방질과 단백질의 섭취증가, TV 자동차 세탁기 오디오 리모콘 등 생활이기의 사용으로 인한 운동부족, 체질과 질병 등이 재기되고 있다. 이제까지 비만을 치료하기 위한 많은 시도가 있었으나 주된 이론은 섭취음식의 절재와 운동량을 증가시키는 것이었으며, 체질적인 요소를 중심으로 비만증을 해결하려는 시도는 없었다. 이에 저자는 1992년 8월 20일부터 1995년 8월 19일까지 만 3년동안 상지대학교 부속한방병원 체질의학과에서 치료받는 461명의 환자를 대상으로 사상체질과 비만과의 상관성을 임상적으로 연구하고 그 효과를 보고하는 바이다. 연구 결론 : 상지대학교 부속한방병원에 내원치료를 받고 있는 비만증환자들을 대상으로하여 체질과 비만과의 관계를 연구한 결과는 다음과 같다. 1. 비만증 환자의 70.2%가 태음인이었다. 2. 치료결과 4주동안에는 $1.48{\pm}1.64kg$, 5주부터 8주동안에는 $2.05{\pm}2.10kg$, 9주부터 12주동안에는 $2.18{\pm}2.27kg$, 13주부터 16주동안에는 $2.08{\pm}2.88kg$이 감량되었다. 3. 체중감량에 있어 태음인이 가장 많은 감소를 보였다. 연령별로는 10대에서 가장 많은 감소를 보였다. 4. 비만환자의 혈액 가운데 총 콜레스테롤, 저밀도 지방단백이 높온 사람보다 유리지방산과 중성지방이 높은 경우가 대부분을 차지했다. 5. 비만인의 혈청지질에서는 FFA, TG가 높았다. 그 이유는 육식보다는 당질과 지방질의 섭취로 나타난 것이었다.

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Prolotherapy for the Upper Extremity (상지에서의 증식치료)

  • Shin, Keun Man
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.117-121
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    • 2008
  • Prolotherapy can be defined as the injection of growth factors or growth factor production stimulants to grow normal cells or tissue. Even though it has been a controversal procedure for decades, it is currently gaining in popularity among many physicians. The term prolotherapy was coined by Hacket in the 1950s to imply proliferation of normal tissue at ligamentous and tendinous entheses. The procedure has been described by other terms, such as sclerotherapy, regenerative injection therapy, and stimulated ligament repair. Incomplete healing from sprains or strains is common and can lead to chronic pain, joint instability and laxity, and is a risk factor for the development of osteoarthritis. Prolotherapy is commonly used for these musculoskeletal conditions which are refractory to usual care therapies. The proliferant solution and technique varies according to physicial training and preferance. Commonly reported proliferants include 10% to 25% dextrose, P2G and sodium morrhuate. High resolution ultrasound imaging of musculoskeletal tissue is increasing in popularity because of patient tolerability, low cost, ability to visualize tissue in real time motion and superior resolution of highly organized tissue such as a tendon. This procedure can be introduced by ultrasound imaging and tissue growth and repair after this procedure in a tendon or a ligament can be documented with ultrasound.

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Synergistic Effect of Methanol Extract of Salvia Miltiorrhiza and Antibiotics against Dental Caries Pathogens (치아우식증유발세균에 대한 단삼 메탄올추출물과 항생제와의 병용효과)

  • Jang, Keoun-Ae;Kim, Hye-Young
    • Microbiology and Biotechnology Letters
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    • v.38 no.3
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    • pp.289-294
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    • 2010
  • Salvia miltiorrhiza Bunge (S. miltiorrhiza) is a traditional Korean medicine that is commonly used for the treatment of inflammatory diseases such as edema, arthritis, and hepatitis. The present study investigated the antimicrobial activity of methanol (MeOH) extract of S. miltiorrhiza roots against oral bacteria using broth the microdilution method and the checkerboard and time-kill methods evaluated the synergistic effects of treatment with antibiotics. The MeOH extract was demonstrated as a higher antibacterial activity (MICs, 8 to $64\;{\mu}g/mL$; MBCs, 16 to $64\;{\mu}g/mL$) against all tested oral bacteria. Additionally, the extract was observed to have a synergistic effect with ampicillin or gentamicin. A time-kill study evaluating the effects of the extract indicated that the extract treatment in combination with ampicillin or gentamicin showed rapid bactericidal activity. The results suggest that MeOH extract of S. miltiorrhiza could be employed as a natural antibacterial agent against dental caries.

Mechanism of Anti-inflammatory Effect of Peucedanum japonicum Thunb (방풍의 항염 효과 기전)

  • Noh, Sung-Il;Kim, Sang-Don;Park, Sung-Cheul;Seo, Byung-Yun;Yeom, Seung-Ryong;Kwon, Young-Dal;Shin, Byung-Cheul;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.2
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    • pp.31-43
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    • 2005
  • 목적 : 방풍은 임상적으로 관절염을 포함한 다양한 염증성 질환 치료제로 사용되어 왔다. 본 연구에서는 인간 비만세포를 이용하여 세포 독성에 영향을 주지 않는 농도에서 방풍의 항염 효과 및 그 기전을 검토했다. 방법 : 인간의 HMC-1세포를 IMDM에서 페니실린, 스트렙토마이신, 모노티오글리세린을 첨가하여 배양하고 방품추출액을 투여하였다. 그 다음 MTT, CLISA, RT-PCR, 세포내 칼슘측정, 핵단백분석을 이용하여 TNF-${\alpha}$, IL-6, IL-8 각각의 형성과 mRNA발현, 세포내 칼슘 수준, NF-${\kappa}B$ 발현에 대한 방풍추출액의 반응을 측정하고 통계처리 하였다. 결과 : 방풍은 PMA와 calcium ionophore A23187로 활성화된 비민세포에서 세포내 칼슘 수준과 NF-${\kappa}B$, TNF-${\alpha}$와 IL-6의 발현을 억제시켰고 RT-PCR을 이용한 mRNA 발현에서 TNF-${\alpha}$와 IL-6의 발현을 억제하였다. 결론 : 방풍은 비만세포내 칼슘 수준 및 NF-${\kappa}B$의 활성을 억제하고 염증성 세포 활성 물질인 TNF-${\alpha}$와 IL-6의 분비도 억제하여 항염효과를 나타냄을 암시하고 있다.

Arthroscopic Management of Septic Coxitis (화농성 고관절염의 관절경적 처치)

  • Moon, Young-Lae;Lee, Sang-Hang;Cho, Sam-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.144-147
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    • 2000
  • Purpose : The purpose of this study is to evaluate the usefulness of arthroscopy in the management of septic coxitis in adults. Materials and Methods : The subjects were 9 patients ranging from 46 to 61 years of age. All patients were diagnosed to have septic coxitis by arthrocentesis and laboratory tests. Operative arthroscopy of the hip has been performed on the patients under supine position. All patients had a follow-up period of more than 12 months by checking ESR and CRP, and by evaluating the function with Harris hip scoring system. Results : The laboratory abnormalities returned to normal level in average of 11.9 days after the surgery. Twelve months after the surgery, all patients showed normal functional hip without any discomfort. Conclusion : Arthroscopic debridement and irrigation technique seem to have more advantages than open drainage in the management of septic coxitis minimizing the morbidity of the hip joint, while it obtains the same results as open technique.

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