• Title/Summary/Keyword: Chronic medical condition

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Colonic cryptococcosis presenting with chronic diarrhea in a person with advanced human immunodeficiency virus disease: a case report

  • Oh, Hyunjoo;Kim, Misun;Yoo, Jeong Rae;Boo, Sun-Jin;Heo, Sang Taek
    • Journal of Medicine and Life Science
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    • v.19 no.1
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    • pp.26-29
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    • 2022
  • Cryptococcus neoformans infection usually occurs in patients with advanced human immunodeficiency virus (HIV) infection or with a CD4 T lymphocyte count of <100 cells/µL. Pulmonary and central nervous system infections are the most frequently encountered forms of cryptococcosis; however, colonic cryptococcosis is uncommon. We describe the case of a 41-year-old antiretroviral-naïve man with HIV infection diagnosed eight years prior and intermittent diarrhea for 4 months who presented to the emergency department with a 1-day history of low-grade fever and confusion. Brain magnetic resonance imaging and cerebrospinal fluid analysis revealed normal results; however, he was diagnosed with Pneumocystis jirovecii pneumonia based on chest computed tomography and bronchoalveolar lavage analysis. Trimethoprim-sulfamethoxazole administration was initiated followed by antiretroviral treatment. Although his condition gradually improved, he developed fever and abdominal discomfort, and the diarrhea worsened. Endoscopy revealed a small ulcer in the distal transverse colon. Histopathological examination of a colon tissue sample revealed cryptococcal infection. He improved substantially during liposomal amphotericin B and fluconazole treatment. We encountered a rare case of colonic cryptococcosis that caused chronic diarrhea in a patient with advanced HIV infection. Colonic cryptococcosis should be considered when patients with acquired immune deficiency syndrome present with gastrointestinal symptoms.

Long-term prenatal stress increases susceptibility of N-methyl-D-aspartic acid-induced spasms in infant rats

  • Kwon, Hyeok Hee;Lee, Taekwan;Hong, Jinpyo;Kim, Dong Woon;Kang, Joon Won
    • Clinical and Experimental Pediatrics
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    • v.61 no.5
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    • pp.150-155
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    • 2018
  • Purpose: Infantile spasms, also known as West syndrome, is an age-specific epileptic seizure. Most patients with this condition also exhibit delayed development. This study aimed to determine the effect of long-term prenatal stress on susceptibility to infantile spasms. Methods: We subjected pregnant rats to acute or chronic immobilization stress. Resulting offspring received N-methyl-D-aspartic acid (15 mg/kg, intraperitoneally) on postnatal day 15, and their behaviors were observed 75 minutes after injection. The expression of KCC2 and GAD67 was also determined using immunohistochemistry. Results: Exposure to long-term prenatal stress increased the frequency of spasms and decreased the latency to onset of spasms compared with offspring exposed to short-term prenatal stress. Expression of KCC2 and GAD67 also decreased in the group exposed to long-term prenatal stress compared with the group exposed to short-term prenatal stress. Conclusion: Our study suggests that exposure to long-term prenatal stress results in increased susceptibility to seizures.

Tumoral calcinosis of the prepatellar bursa -a case report- (슬개골전 점액낭에 발생한 Tumoral Calcinosis - 증례보고 -)

  • Kim, Hee-Chun;Song, Kwang-Jin;Cho, Duck-Yun
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.127-130
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    • 1997
  • Tumoral calcinosis is a rare disorder of unknown etiology, which is characterized by the developement of large calcified masses overlying the large joints in otherwise healthy subjects. If histologic tests are not confirmed, the condition may be treated erroneously as bursitis. This report describes the case of a 10-year-old man with tumoral calcinosis of the knee, a joint very rarely affected by this unusual disorder. Microscopically the tumor consists of a stroma of chronic inflammatory tissue surrounding cystic spaces containing calcium-rich material. We made excision alone, and the patient made an uneventful recovery with no evidence of recurrence up to 13 months postoperatively.

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Factors Influencing Falls in Inpatients (입원환자의 낙상 경험에 영향을 미치는 요인)

  • Sung, Young-Hee;Kwon, In-Gak;Kim, Kyung-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.200-207
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    • 2006
  • Purpose: This study was done to identify factors influencing falls in inpatients. A comprehensive analysis of individual, disease, and environment related factors and an assessment of being in a risk factor group were included in the data. Method: The medical records of 325 inpatients were reviewed. Data were collected from January to July 2003. Frequencies, 1-test and $X^2-test$ were used to analyze the data and the SPSS program was used. Results: Individual-related factors for inpatients falls were age, drinking and weakness. Disease-related factors for inpatients falls were diagnostic department, admission from ER or OPD, admission by wheelchair or orther method and activity status. Environment-related factors for inpatient falls were re-education and side-rails. Assessment of the risk factor group related factors were age, history of falls, body balance, depression, communication, medication, chronic disease, urinary condition and total score for risk factors. Conclusion: Experienceing a fall among Korean inpatients was associated not only with individual factors, but also with disease and environmental factors. The findings of this study suggest that broad intervention programs should be provided to prevent inpatient falls.

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Long lasting mesalazine-induced pancytopenia in a patient with ulcerative colitis

  • Ko, Juyeon;Song, Hyun Joo;Han, Sanghoon;Moon, Chiyoon
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.46-51
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    • 2019
  • Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

Pulmonary Thromboendarterectomy for Pulmonary Hypertension Caused by Chronic Pulmonary Thromboembolism (만성폐색전중으로 인한 폐동맥고혈압 환자에서 시행한 폐동맥내막절제술)

  • Song Seung-Hwan;Jun Tae-Gook;Lee Young-Tak;Sung Ki-Ick;Yang Ji-Hyuk;Choi Jin-Ho;Kim Jin-Sun;Kim Ho-Joong;Park Pyo-Won
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.626-632
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    • 2006
  • Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.

A Study on the Health Care of Ewha Womans University Staff, Faculty and Families (대학교 교직원 및 그가족의 의료에 관한 연구 -이화 여자 대학교를 중심으로-)

  • Kang, Ji-Yong
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.163-173
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    • 1974
  • A study on the health care of Ewha Womans University staff, faculty and families was conducted during the period from March 1973 to August 1974 using designed questionaire. A total of 196 persons who were randomly sampled as 27.3% of the total staff and faculty 789 were studied. The response rates were 96.0%. The results and findings obtained from the study are summerized as follow. 1. The sex ratio of the members the faculty and the staff shows 83.2% and the singles are 37.2% of the total. Their mean family size being 4.6 persons per capita, each family has mean number of 2.3 childeren. 2. The median monthly income of a member of faculty amounts \114,000 and that of a staff \43,077. It amounts \79,333 when the median monthly income of both the members of the faculty and the staff are taken. Consequently, it amounts \91,727\ per family (Assumed mean). 3. 71.4% of the total hold the house of their own. A spouses of 59.4% of them are working for the additional income of the family. 4. Their health condition is rated fair, i. e. 92.3% of them enjoy good health. Out of total members faculty and the staff, 20.6% are cared by family physician. 36.2% of them feel that they are burdened by heavy medical expense. 5. 76.7% of them have affirmatively responded that they would purchase medical insurance policy when they were offered. It reaches 84.0% of the total who consider buying the policy for their dependents. 74.0% of them desire to purchase the policy for their spouse's parents. 6. The monthly prevalence rate reaches 17.0% and the hospital admission rate 4.7%.12.3% of them affirmatively responded that they had chronic diseas. The number of sick call per capita counts 0.2 per month and the hospital admission rate 0.05. 7. To examine the nature of their disease, the respiratory disease is rated to be the top and the gastro-intestinal disease comes to the next. As far as chronic disease is concerned, the gastro-intestinal disease is predominent. 8. As to their treatment, 65.4% of them get the physician's treatment and 17.0% treatment of drug purchasing and 7.7% prefer Chinesedrug. 6.6% of them gets no medical treatment at all. 9. The treatment ratio, including drug purchasing and other means, reaches 93.4%. 60.7% of them affirmatively responded that they did not or could not get physician's treatment at least once even though they thought they had to. It is disclosed that 25.4% of them are caused by economical reason. 10. Average medical expense per case amounts \7,116 and monthly medical expense per capita \1,345. Consequently, average monthly medical expense per family amounts \6,185. 11. The medical expense of a family is rated 7.7% of total earnings of the same period.

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A Study on Nursing Service of Chronic Diseases by the First Step and Third Step Medical Treatment (1차 및 3차 진료기관 이용 만성질환자의 간호서비스에 관한 연구)

  • Cho Chong Sook
    • Journal of Korean Public Health Nursing
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    • v.10 no.2
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    • pp.103-118
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    • 1996
  • It is to be growing up the interest of community health affairs through visiting nursing care. The health medical treatment of Korea has been changed largely on the period. The juvenile population has decreased. This means that is has took the population consensus of advanced national organization to be increased by the old age. The transition of disease has changed from the contagious disease importance to the chronicity disease omportance because the domestic district population has experienced the sudden urbanization circumstance district population has experienced the sudden urbanization circumstance to be growing up $70\%$ of the whole population. When the nursing service has common function to be delivering from all direction to home, this study is getting the great important phase velocity in order to manage the kernel questional adult chronicity disease of health medical institution at the present age. (1) community over system or with people particularity (2) the first of third step medical treatments. The variety of medical treatments organization has quantity of the delivery manpower and specially between consumers and rdlated person. A qualitative difference is showed at the purpose to be seizing. That research related person is use at district health center in Seoul, by foundation on nurse registration book of H collage hospital and public health registration book. According the chronicity disease. age. and sex. nature agree-able standard 54 people took the content analysis on nurse registration book of total 108 people. The results of the study were as follows: 1. General background factors are houses or kind of medical facilities and number of patients in family. The first medical treatment is more patients than third medical treatment organization. The first medical treatment of economic environment os appering to be worse. 2. The chronicity disease frequency have been different speciality according to medical treatment organization. On case of the first medical treatment. Diabetes and High Blood Pressure were good but Cerebrum Vascular Accident(CVA) showed many for bed case. In addition. the number of family is comparative large exception of CVA on according for moving condition and health more than the first medical treatment. However. family condition. whole family percentage is decreasing preferably through the potential resource is increasing by the number of and the construction of family. The ability of real resource is considered to be low. 3. The average percentage of nurse service has appered to be differed two groups by the first step medical treatment(33.72 times) and third step medical treatment(45.70 times). However, the difference (the first step medical treatment and third step medical treatment) is to be limited to issue the medicine at the service. The condition of nurse care was the indirect nursing care. Supportiong area was to be related to volunteer service and administration support. 4. The various nursing care average percentage of the chronicity disease was increased by orders of Diabetes. High Blood Pressure. and CVA in examination result and the medical treatment. The indirect nursing care was also same. At third step medical treatment, orders of chronicity disease were same. The case of other area on service conditions were increased by order of Diabetes. High Blood Pressure, and CVA. However. it is never appearing the difference at bottleneck affairs nursing care. 5. When the visiting nursing care demand particularly. the average percentage of nursing care from the first step medical treatment that the time under a person is many more than the time over two people. However, there was no difference in statistic. Third step medical treatment is $49.81\%$ at the time under a person. The average nursing care service is appeared by more many when the visiting nursing care demand is a few by 12.83 at the time over two people. 6. By visiting nursing care percentage to be frequency that nursing care averaghe percentage and inter-relation are large. The related factor of the first medical treatment is 0.96. However, the related factor of third medical treatment has shown the decreased 0.49 for the condition of relation more than that. Therefore. the nursing care average percentage is related to the visiting times of a nurse. This result is be showing the obvious fact that the first step medical treatment is few more than third step medical treatment.

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A Study on the Application of the Korean Valuation Weights for EuroQoL-5 Dimension (EuroQoL-5 Dimension 한국 가중치 모형의 적용 연구)

  • Lee, Young-Hoon;Choi, Jin-Su;Rhee, Jung-Ae;Ryu, So-Yeon;Shin, Min-Ho;Kim, Jin-Hee
    • Korean Journal of Health Education and Promotion
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    • v.26 no.1
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    • pp.1-13
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    • 2009
  • Objectives: This study was conducted to estimate the health-related quality of life (HRQOL) using EuroQoL-5 Dimension (EQ-5D) and to identify its related factors among urban-dwelling adults. Methods: The data for this study were obtained from 1,134 subjects aged $20\sim91$, who participated in 'Survey on the health status and demand for health' in two cities of Korea (Dong-gu, Gwangju and Suncheon-si, Jeollanamdo). The HRQOL was measured using the EQ-5D instrument and EQ-5D index scores were calculated by two Korean valuation study model using time trade-off method. Results: The mean EQ-5D index scores for all subjects were $0.865{\pm}0.218$ (model A), and $0.921{\pm}0.170$ (model B). The EQ-5D index score was significantly different according to demographic and socioeconomic characteristics (gender, age, marital status, education, occupation, income, and health security system), self-rated health condition, health-related psychological assessments (enough sleep, fatigue rate, stress rate, and degree of satisfaction on the residence). The results of multiple linear regression showed that age, marital status, income, coverage of medical insurance, self-rated health condition, and fatigue rate were significantly related common statistical factors of HRQOL in two Korean valuation study model. Conclusion: Among the adults residing in urban environment, the HRQOL was significantly lower on the subjects with following conditions: higher age, being alone without a spouse as a result of death, divorce or separation, low income, medical aid program, poor self-rated health condition, and chronic fatigue. In order to improve the urban adults' quality of life, healthcare policy and health promotion program must be developed with considerations to factors related to the HRQOL.

Mobile Healthcare System for Personalized Emergency Management (사용자 맞춤형 응급 관리를 위한 모바일 헬스케어 시스템)

  • Chun, Seung-Man;Choi, Joo-Yeon;Park, Jong-Tae
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.6
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    • pp.50-59
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    • 2014
  • In mobile healthcare service, the accurate detection and the notification of the emergency situation are important to chronic patients' life. In the existing healthcare service, the medical staff or medical service provider always judges patients' health status by monitoring from the measured from bio-data. However, it is difficult to monitor many patients in real-time simultaneously, because the medical staff should monitor the health status continuously. Furthermore, an emergency condition diagnosis based solely on the statistical level of the bio-data may be difficult, since the emergency judgment of the bio-data might differ depending on the health characteristics of each person such as age, history of disease, gender, etc. In order to solve this problem, this article presents an mobile healthcare system for emergency bio-data management using a personalized emergency policy. The salient feature of the proposed mobile healthcare system is that the characteristics of the health status of an unique patient is defined to the policy, which is used to judge the emergency condition of the bio-data measured from the patient. The prototype of proposed mobile healthcare system has been built to demonstrate the design concept.