• Title/Summary/Keyword: Chronic Disease Management

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Ki-67/MIB-1 as a Prognostic Marker in Cervical Cancer - a Systematic Review with Meta-Analysis

  • Piri, Reza;Ghaffari, Alireza;Gholami, Nasrin;Azami-Aghdash, Saber;PourAli-Akbar, Yasmin;Saleh, Parviz;Naghavi-Behzad, Mohammad
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6997-7002
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    • 2015
  • Background: In cervical cancer patients it has been reported that there in a significant Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value is still not well understood. Materials and Methods: In the present meta-analysis the prognostic value of Ki-67/MIB-1 with regard to overall survival (OS) and disease-free survival (DFS) in cervical cancer was investigated. The databases of PubMed, ISI Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, Science Direct and Wiley Online Library were used to identify appropriate literature. Results: In order to explore the relationship between Ki-67/MIB-1 and cervical cancer, we have included 13 studies covering 894 patients in the current meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63 (95%confidence interval (CI) 1.09-2.45; P<0.05). The pooled HR for DFS was 1.26 (95%CI 0.58-2.73; P>0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95%CI 2.65-5.09) in Asians. Conclusions: According to this meta-analysis, Ki-67/MIB-1 has prognostic value for OS in patients suffering from cervical cancer. For better evaluation of the prognostic role of Ki-67/MIB-1 on DFS, studies with larger numbers of patients are needed to validate present findings in the future.

A Development of Remote Medical Treatment System for Stroke Recovery using ZigBee-based Wireless Brain Stimulator and Internet (ZigBee 기반의 무선 뇌 자극기와 네트워크를 이용한 원격 뇌졸중 회복 시스템의 개발)

  • Kim, G.H.;Ryu, M.H.;Kim, J.J.;Kim, N.G.;Yang, Y.S.
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.57 no.3
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    • pp.514-517
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    • 2008
  • Ubiquitous healthcare (U-healthcare) system is one of potential applications of embedded system. Conventional U-healthcare systems are used in health monitoring or chronic disease care based on measuring and transmission of various vital signs. However, future U-healthcare system can be of benefit to more people such as stroke patients which have limited activity by providing them proper medical care as well as continuous monitoring. Recently, an electric brain stimulation treatments have been found to be a better way compared to conventional ones and many are interested in using the method toward the treatment of stroke. In this study, we proposed a remote medical treatment system using ZigBee-based wireless electric brain stimulator that can help them to get a treatment without visiting their doctors. The developed remote medical treatment system connects the doctors to the brain stimulator implanted in the patients via the internet and ZigBee communication built in the brain stimulator. Also, the system receive personal information of the connected patients and cumulate the total records of electric stimulation therapy in a database. Doctors can easily access the information for better treatment planning with the help of graphical visualization tools and management software. The developed remote medical treatment system can extend their coverage to outdoors being networked with hand-held devices through ZigBee.

Association between Dietary Habits and Self-rated Health According to Sasang Constitution (사상체질에 따른 식습관과 주관적 건강상태와의 연관성)

  • Jeong, Kyoungsik;Kim, Hoseok;Lee, Siwoo;Baek, Younghwa
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.34 no.1
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    • pp.53-59
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    • 2020
  • Dietary habits are known to be closely related not only to chronic diseases such as cardiovascular disease and diabetes, but also to self-rated health (SRH). Consequently, there is a highly important lifestyle component in maintaining a healthy life. The aim of the present study was to determine the correlation between diverse dietary habits based on the Sasang constitutions (SC) and SRH. The data were collected from 2,984 participants who met the constitution pharmacology criteria and whose SC were clinically confirmed by SC professionals. Dietary habits were observed by assessing the regularity of diet, meal volume, and meal speed; single-answer questions were used for SRH. Fisher's exact/chi-square test and logistic regression were used to analyze the correlation between dietary habits depending on constitutional type and SRH. In association with constitutional SRH, the Taeum type is related to the amount of meal, the Soeum and Soyang types are related to the regularity of meal and meal volume. In the Taeum type, there was a significantly higher risk of lower SRH when meal volumes were irregular less than previous amounts. Irregular diet, as well as increased or decreased meal volume, negatively correlated with SRH in the Soeum type; in the Soyang type, irregular diet and decreased or irregular meal volume negatively affected SRH. This showed the presence of the different effects of dietary habits on health depending on constitution and also confirmed the association of the regularity of diet and meal volume based on constitution and the frequency of bad dietary habits with SRH. We suggest that personalized healthcare with adequate dietary improvement considering constitution is needed for health management or improvement.

A Study on the Operation and Use of Physiotherapy room at Public Health Service Center (보건소내 물리치료실 운영실태와 물리치료사의 배치방안)

  • Song, Myung-Soo;Kim, Seng-Il;Song, Mi-Wha;Park, Seon-A
    • Journal of Korean Physical Therapy Science
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    • v.6 no.4
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    • pp.263-274
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    • 1999
  • The public health service center and its branch are, as one of public institution, responsible for providing non-profitable medical service to local residents, which can't be addressed by private medical institutes. In addition, as a planning coordinator, they need to manage local medical resources effectively to make sure local residents can be offered good-quality health service fairly and impartially. The purpose of this study was to highlight the importance of physical therapy in public health service center's successful role performance, one of treatment to which local residents had a direct access. For attaining the purpose, an investigation was made into the actual facilities of public health service center and its branches in North Cholla province, the extent of use of physicaltherapy room, and the general characteristics of physical therapists. And literatures concerned were referred to. As a result, the dominant opinion was that the current physicaltherapy room shoulder be more reinforced(38.9%) or that it should he kept as it was(46.5%). Besides, the physical therapists investigated still were serving in a poor working condition. To elevate the quality and quantity of medical service, the current way to employ expert personnels temporarily or not to guarantee the position of physiotherapists should be removed immediately. Instead, physicaltherapists should be employed as regular public official. As, in home-visit project, physiotherapist are expected to play a bigger role in rehabilitation care or the management of patients with chronic disease, the physicaltherapy room should be increased and more physicaltherapists should be provided to health service institutions.

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Other Gynecologic Pathology in Endometrial Cancer Patients

  • Khunnarong, Jakkapan;Tangjitgamol, Siriwan;Srijaipracharoen, Sunamchok
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.713-717
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    • 2016
  • Background: To evaluate the prevalence and features of other gynecologic or surgical lesions in endometrial cancer (EMC) patients. Materials and Methods: Clinico-pathological data of EMC patients who were treated in the institution from 1995 to 2012 were collected. Data collected were age, stage of disease according to the FIGO 2009 criteria (FIGO), histopathology, tumor grade, adjuvant therapy, other gynecologic or surgical lesions, follow-up period, and living status. Results: The mean age of 396 patients was $56.7{\pm}10.64years$. Abnormal uterine bleeding was the most common presenting symptom (90.1%). Bleeding was accompanied with pelvic mass in 7.7% and 5.4% had only a pelvic mass. Abnormal cervical cytology was found in 3.8%. Approximately 75% had early stage diseases and 86% had endometrioid histology. We found 55.8% of EMC patients had other gynecologic lesions: 89.6% benign and 9.5% malignant. Some 4.5% had pre-invasive cervical/vulva/vagina lesions. The two most common gynecologic lesions were myoma uteri and ovarian tumors. Focusing on the latter, approximately 14% were benign while 8% were malignant. Among 364 patients with available data, surgical lesions were found in 11.8%, 5.7% benign and 9.2% malignant. The most common benign surgical condition was chronic appendicitis while breast and colon cancers were the two most common malignant lesions found. Conclusions: More than half of EMC patients had other gynecologic lesions including benign and malignant tumors. Surgical lesions were also found in more than one-tenth of patients. Careful pre-operative evaluation and intra-operative inspection are advised for proper management and better prognosis.

Evidence-based estimation of health care cost savings from the use of omega-3 supplementation among the elderly in Korea

  • Hwang, Ji-Yun;Kim, Wu Seon;Jeong, Sewon;Kwon, Oran
    • Nutrition Research and Practice
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    • v.9 no.4
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    • pp.400-403
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    • 2015
  • BACKGROUND/OBJECTIVES: By the year 2050, thirty-eight percent of the Korean population will be over the age of 65. Health care costs for Koreans over age 65 reached 15.4 trillion Korean won in 2011, accounting for a third of the total health care costs for the population. Chronic degenerative diseases, including coronary heart disease (CHD), drive long-term health care costs at an alarming annual rate. In the elderly population, loss of independence is one of the main reasons for this increase in health care costs. Korean heath policies place a high priority on the prevention of CHD because it is a major cause of morbidity and mortality. SUBJECTS/METHODS: This evidence-based study aims to the estimate potential health care cost savings resulting from the daily intake of omega-3 fatty acid supplementation. Potential cost savings associated with a reduced risk of CHD and the medical costs potentially avoided through risk reduction, including hospitalizations and physician services, were estimated using a Congressional Budget Office cost accounting methodology. RESULTS: The estimate of the seven-year (2005-2011) net savings in medical costs resulting from a reduction in the incidence of CHD among the elderly population through the daily use of omega-3 fatty acids was approximately 210 billion Korean won. Approximately 92,997 hospitalizations due to CHD could be avoided over the seven years. CONCLUSIONS: Our findings suggest that omega-3 supplementation in older individuals may yield substantial cost-savings by reducing the risk of CHD. It should be noted that additional health and cost benefits need to be revisited and re-evaluated as more is known about possible data sources or as new data become available.

Analysis of Medical Use and Costs Related to the Management of Liver Cirrhosis Using National Patients Sample Data (환자표본자료를 이용한 간경변증 환자의 의료이용 특성 및 의료비용 분석)

  • Kim, Hye-Lin;Park, Jae-A;Sin, JiYoung;Park, Seung-Hoo;Lee, Eui-Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.4
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    • pp.341-347
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    • 2016
  • Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

Analysis of Anthropometric and Clinical Data in Obese Children in Changwon (창원지역 일부 비만아의 체격지수와 생화학적 지표에 관한 연구)

  • Lee, Kyung-Hea;Yoon, Sang-Yeun;Her, Eun-Sil;Lee, Kap-Yeon;Lee, Ju-Hee;Ju, Jeong;Jang, Dong-Su
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.28 no.5
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    • pp.1164-1171
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    • 1999
  • In this study, we investigated the effects of obesity index on the risk factors of chronic diseases in obese children. The subjects were male and female children aged 9 to 12. The average obesity index was 147.7$\pm$13.8% in boys and 147.6$\pm$16.5% in girls. The average percentages of body fat was significantly higher in boys(33.9$\pm$5.7%) than in girls(30.7$\pm$4.4%). It was found that 26% of subjects had abnormal serum GOT and GPT values. Percentages of subjects at risk of cardiovascular disease(CVD) based on corresponding criteria of TG, T chol, HDL chol, and LDL chol were 28.6%, 28.6%, 45.5% and 42.7%, respectively. The risk of CVD was increased with the degree of obesity, which was not significant. The AI(atherogenic index) was higher in boys(4.6$\pm$2.3) than in girls(3.6$\pm$1.2). The serum T chol and LDL chol levels of subjects whose mother are in thirties were significantly higher than those of subjects whose mother are in fourties. The T chol levels of subjects who had mother with job were significantly higher compaired to those of subjects who had housewife mother. The results indicated the urgent need of nu tritional management for the obese children to prevent further devel opment of childhood obesity and hyperlipidemia. Based upon this study, devising method and media for the mother nutritional education as well as for the children nutritional education is required for better growth and health promotion of primary school children.

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A Case of Cerebral Salt Wasting Syndrome Associated with Tuberculous Meningitis (결핵성 뇌수막염에 동반된 뇌성 염분소실증후군(Cerebral salt wasting syndrome) 1예)

  • Lee, Ja Young;Lee, Eun Sil;Lee, Jae Hyong;Lim, Eun Ju;Kim, Hyoung Su;Jang, Ji Seon;Kim, Hyeon Kyu;Kim, Doo-Man;Park, Yong Bum;Lee, Jae Young;Mo, Eun Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.3
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    • pp.306-310
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    • 2005
  • Hyponatremia which is due to excessive sodium loss in the urine and decrease in extracellular fluid volume following an acute or chronic central nervous system injury, has been conjunctively described as cerebral salt wasting syndrome (CSWS). This syndrome is often confused with dilutional hyponatremia due to inappropriate secretion of antidiuretic hormone. Accurate diagnosis and management are mandatory for improvement of the course of the disease. This report describes a case of a 31-year-old male patient with CSWS associated with tuberculous meningitis. The patient exhibited hyponatremia, polyuria, excessive natriuresis, volume depletion, and hypotension. He was diagnosed to manifest CSWS and was treated by administration of fluids, salt, and fludrocortisone. After the respective treatments, symptoms of polyuria and hypotension were gradually resolved and hyponatremia was corrected.

Surgical Treatment of Patello-Femoral Joint Lesions - Arthroscopic treatment - (슬개-대퇴관절의 수술적 치료 - 관절경적 치료를 중심으로 -)

  • Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.79-85
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    • 2005
  • The symptoms in patello-femoral joint can be occurred from various causes. Most of patients complained chronic discomfort and it is rare to have a characteristic acute pain. Initial management should be started conservatively and if it has no effect to relieve symptoms, surgical treatment would be considered. The selection of operative treatment should be decided in the consideration of patients age, activity and ability of performing rehabilitation. Before surgery, accurate diagnosis is essential and causative factors should be removed or corrected with surgery. Arthroscopic surgery is effective for the most of disease in the patello-femoral joint disorder with low morbidity and early rehabilitation. At arthroscopy, superomedial or superolateral portal can be used for the evaluation and treatment of articular surface in the patella. The structure of normal variants should be saved if it does not have pathological changes for prevention of post operative morbidity. If the arthroscopic surgery has difficulties during the procedure or no effect in removal of lesion, open surgery should be considered.

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