This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.
Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
Korean Journal of Culture and Social Issue
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v.11
no.2
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pp.143-181
/
2005
This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.
The purpose of this study was to identify the influence of living factors on TVOC(Total Volatile Organic Compounds) concentrations and personal factors to reduce the Sick House Syndrome for newly-built apartments. The field measurements of TVOC concentrations were made totally 30 times(5 times per one subject house) in six apartment units in which residents recently moved. Those apartments authorized its business approval before May 2004, the Act of Indoor Air Quality Management for multi-use facilities. The Questionnaire surveys of residents' subjective responses on the Sick House Syndrome were carried out in 2nd measurement of each house. Respondents consisted of 20 residents living in the measured houses. The findings were as follows: The TVOC concentrations of the measured subject apartments ranged from about 1/10 of the recommended standard for multi-use facilities($400{\mu}g/m^3$) to up to 90 times as high as the standard. Since then, the Recommended Standard of Indoor Air Quality Management for newly-built apartment house was announced in December 2005. In accordance with this standard($2390{\mu}g/m^3$) it ranged from about 1/100 to up to 15 times as high as the standard. The subject house whose TVOC concentrations reduced below the recommendation standard in the shortest period had the largest amount of ventilation (all the windows were open for ventilation in the past three months) among all measured houses. The reason of another house whose TVOC concentrations were much higher than the rest was fronted with new furniture in the room. There turned out to be no apparent relations between the TVOC concentrations and the residents' individual responses of Sick House Syndrome. The responses were serious in those who stayed in their new houses for a long period or had disease like allergy. It's recommended that they should open all the windows for at least three months for ventilation in newly-built houses, and it would be better to avoid remodeling than needs be.
This study was tried to evaluate the level of completeness and the accordance in electronic medical records by comparing paper-based medical record in doctor's admission records, discharge summary, and nursing information records. Medical records of inpatients of neurology department that the 100 paper-based medical records in 2004 and 100 electronic medical records in 2006 were targeted. Existence of record items and doctor-nurse record accordance were evaluated in doctor's admission record, discharge summary, admission nursing information record, and discharge nursing information record. There were not any differences between electronic medical records and paper-based medical records in doctor's admission record and discharge summary. Electronic medical records had less missing records than paper-based medical records in admission and discharge nursing information records. Electronic medical records showed higher accordance than the paper-based medical record in doctor-nurse record generally, but there were statistically differences in only medication, allergy, smoking, and drinking (p<0.05). In this study, it was verified that the quality of electronic medical records are better than paper-based records in nursing information record and doctor-nurse record agreement.
Koo, So-My;Kim, Song Yee;Choi, Sun Mi;Lee, Hyun-Kyung;Korean Interstitial Lung Diseases Study Group
Tuberculosis and Respiratory Diseases
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v.82
no.4
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pp.285-297
/
2019
Connective tissue disease (CTD) is a collection of disorders characterized by various signs and symptoms such as circulation of autoantibodies in the entire system causing damage to internal organs. Interstitial lung disease (ILD) which is associated with CTD is referred to as CTD-ILD. Patients diagnosed with ILD should be thoroughly examined for the cooccurrence of CTD, since the treatment procedures and prognosis of CTD-ILD are vary from those of idiopathic interstitial pneumonia. The representative types of CTD which may accompany ILD include rheumatoid arthritis, systemic sclerosis (SSc), Sjogren's syndrome, mixed CTD, idiopathic inflammatory myopathies, and systemic lupus erythematous. Of these, ILD most frequently co-exists with SSc. If an ILD is observed in the chest, high resolution computed tomography and specific diagnostic criteria for any type of CTD are met, then a diagnosis of CTD-ILD is made. It is challenging to conduct a properly designed randomized study on CTD-ILD, due to low incidence. Therefore, CTD-ILD treatment approach is yet to been established in absence of randomized controlled clinical trials, with the exception of SSc-ILD. When a patient is presented with acute CTD-ILD or if symptoms occur due to progression of the disease, steroid and immunosuppressive therapy are generally considered.
Byunghoon Lee;Yong Beom Shin;Kwangha Lee;Myung Hun Jang
Physical Therapy Rehabilitation Science
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v.12
no.1
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pp.43-47
/
2023
Objective: To present a case study of a 69-year-old woman with COVID-19 who developed neurological complications due to Extracorporeal Membrane Oxygenation (ECMO) therapy and highlight the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU. Design: A case report Methods: The patient received ECMO therapy, followed by neurological monitoring and rehabilitation in an isolation ICU. Daily neurological examinations were conducted to monitor the patient's neurological symptoms. Computed tomography was performed to confirm the presence of a hematoma in the left hamstring, which was identified as the cause of the neurological complication. Ultrasound-guided aspiration was immediately performed, and sciatic neuropathy predominantly involving the peroneal division was identified after aspiration. Results: Successful recovery was made possible by the early detection of neurological complications and rehabilitation in an isolation ICU. Although electrodiagnostic tests were not performed due to limited access to the isolation ICU, the appropriate intervention time could be determined through daily neurological examinations and rehabilitation, thereby minimizing neurological sequelae. Conclusions: ECMO-related neurological complications are well known, and their recognition in the ICU can be challenging. The presented case highlights the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU, which can minimize neurological sequelae.
Seungchul Han;Soon Ho Yoon;Whal Lee;Young-Hun Choi;Dong Yoon Kang;Hye-Ryun Kang
Korean Journal of Radiology
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v.20
no.1
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pp.148-157
/
2019
Objective: To evaluate the current status of managing adverse reactions to iodinated contrast media (ICM) for computed tomography in referral hospitals in South Korea compared with hospitals in other countries. Materials and Methods: This survey investigation involved 59 Korean and 15 overseas hospitals using guideline-based questionnaires consisting of 24 items in 7 main categories related to managing adverse reactions to ICM. Results: Informed written consent with risk factor evaluation was appropriately performed in most of the Korean hospitals. There was considerable variability in assessing renal function across the hospitals; serum creatinine level was used as a reference in 76.4% of Korean hospitals. The Korean hospitals preferred a more stringent approach to determining normal renal function (p = 0.01), withholding metformin (p = 0.01), and fasting before ICM exposure (p < 0.001) compared with overseas hospitals. All the Korean hospitals had an emergency protocol and in-hospital system for adverse reactions to ICM. The Korean (87.7%) and overseas hospitals (100%) were similarly equipped with epinephrine (p = 0.332), but only 38.6% of Korean hospitals were equipped with a bronchodilator (p = 0.004). For patients with a previous hypersensitivity reaction to ICM, 62.3% of Korean hospitals pre-medicated with anti-histamine and corticosteroid according to the severity of the previous reaction, and changed the culprit ICM in 52.8%, while skin test was performed in 17%. Conclusion: In general, Korean referral hospitals were well-prepared regarding informed consent, protocol, and an in-hospital system for managing adverse reactions to ICM. Nevertheless, there was considerable variability in details and management, thus requiring standardization by reflecting current guidelines.
Seo, Jung-Sook;Yu, Seung-Hum;Oh, Hyohn-Joo;Kim, Yong-Oock
Korea Journal of Hospital Management
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v.13
no.1
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pp.42-64
/
2008
This study was conducted to evaluate the quality in medical records by analyzing its completeness through setting up the level of record on the patient's past history and through examining the actual medial records. Targeting the information on the patient's past history in interns' records, residents' records and nurses' records toward 403 inpatients who were admitted first in 2004 at an university hospital due to stomach cancer. We analyzed whether the charts were recorded or not, recording level, the satisfaction with the expectant level of the records in the hospital targeted for a research and the level of agreement. The results were as follows; first, as for the rate of recording those each items, they were high in the chief complaint & present illness and the past illness history. Depending on the group of recorders, the recording rate showed big difference by items. Second, as a result of measuring the level after dividing the recording level of items for the patient's past history from Level 1 to Level 4 by each item, the admission history, the past illness history, and the family history were about Level 3, and the smoking history, the medication history, the chief complaint & present illness, the drinking history and allergy were about Level 2. In the admission department, it was excellent in the interns' records for the medical department. Third, as a result of its satisfactory level by comparing the expect level of a record and the actual record by item in information on the patient's past history, which was expected by the medical-record committee members of the hospital targeted for a study. And forth, we analyzed the level of agreement with Kappa score in the level of 'Yes' or 'None' related to the corresponding matter in Level 1, in terms of information on the past history in the intern's record, the resident's record, and the nurse's record. The level of agreement in the resident's record & the nurse's record, and in the intern's record & the resident's record was from "excellent" to "a little good". There were differences in the level of completeness and in reliability for the information on the past history by the recorder group or by the admission department. The encounter process that was performed by the admission department or the recorder group, indicated the result that was directly reflected on the quality of medical records, thus it was required further study about the medical record documentation process and quality of care. The items that showed the high recording rate quantitatively were rather low, consequently we'd should develop the tool for the qualitative inspection and evaluate the medical records further. And the items were needed to be detailed in the record level were rather low, and hence there needed to be a documentation guideline and education by the clinical departments.
The naturalized plants in the Byeonsanbando National Park were listed 88 taxa composed of 24 families, 65 genus, 83 species and 3 varieties and 2 forms by field survey. The naturalized plants divided into pattern by survey of annual plants ratio is 38 taxa (43.2%) by life form spectrum and perennials is 28 taxa (31.8%), biennials is 19 taxa (21.6%), two trees (Robinia pseudoacacia, Ailanthus altissima) and one shrub (Amorpha furticosa) were founded. According to analysis results form place of origin, Europe covered 26 taxa (37.1%), North America covered 23 taxa (32.8%). Naturalized degree 3 plants, as common but not abundant, founded as 28 taxa (31.8%) were hold most highly ratio, naturalized degree 1 plants founded as 8 taxa (9.1%) were hold lowest. Introduction period 1 covered 39 taxa (44.3%) have had highest score and period 2 covered 16 taxa (18.2%) have had lowest scores. In addition, the urbanization index based on 271 taxa was 32.5% and Ambrosia artemisiaefolia is growing by ecosystem disturbing wild plants. Meanwhile, Ambrosia artemisiaefolia have confirmed into district of introduction in the Byeonsanbando National Park were damage the human body of plants develop an allergy to pollen. Therefore, management counterplan of the sequel of monitoring them might be required, introduction into naturalized plants are grasp of ecological characteristics and systematical management plan from this point of time by require.
The purpose of this study was to investigate the anti-allergy activities of persimmon leaf extract (PLE) on a phthalic anhydride (PA)-induced allergic mouse model. A human leukemic mast cell line (HMC-1) was used to examine the inhibitory activity of PLE on the histamine release by human leukemic mast cells. PLE inhibited histamine release from HMC-1 cells in response to cross-linkage of high-affinity IgE receptor-${\alpha}$ ($Fc{\varepsilon}RI{\alpha}$). Additionally, a PA-induced allergic mouse model was used to investigate the effects of PLE in vivo. Mice were orally administrated with or without PLE of single dose (250 mg/kg/day) for 31 days. Oral intake of PLE significantly inhibited passive cutaneous reactions. Oral administration of PLE to PA-induced allergic mice also led to a striking suppression of the development of contact dermatitis, ear swelling and lymph node weight. In addition, PA-specific IL-4 production of draining lymph node cells was markedly diminished by PLE oral administration, but not IFN-${\gamma}$. Furthermore, PLE treatment suppressed PA-induced thymus and activation-regulated chemokine (CCL17) and cutaneous T cell-attracting chemokine (CCL27) expressions in ear tissues. Based on these results, we suggest that PLE may have therapeutic potential as an effective material for management of irritant contact dermatitis or related inflammatory diseases.
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