• Title/Summary/Keyword: Chronic medical condition

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Clinical Characteristics and Prognostic Factors in Patients with Pulmonary Tuberculosis Admitted to Intensive Care Units (중환자실로 입원한 폐결핵 환자의 임상 양상과 예후 인자)

  • Kang, Ji-Young;Kim, Myung-Sook;Kim, Ju-Sang;Kang, Hyeon-Hui;Kim, Seung-Soo;Kim, Yong-Hyun;Kim, Jin-Woo;Lee, Sang-Haak;Kim, Seok-Chan;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.68 no.5
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    • pp.259-266
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    • 2010
  • Background: Pulmonary tuberculosis (TB), requiring the intensive care unit (ICU) care, has been a high-mortality condition until now. In the present study, we aimed to investigate clinical features and parameters associated with TB mortality. Methods: From August 2003 to December 2008, patients with microbiologically or histologically confirmed pulmonary TB then admitted to the ICU, were retrospectively enrolled into the study. Upon enrollment, their medical records were reviewed. Results: Forty three patients (30 males, 13 females) were included and their mean age was 63.8 years (range: 17~87 years). Twelve patients died, an overall in-hospital mortality of 27.8%. The main reason for the ICU care was dyspnea or hypoxemia requiring mechanical ventilation (n=17). Other diagnoses for ICU care were hemoptysis, monitoring after procedures, neurologic dysfunction, shock, and gastrointestinal bleeding. On univariate analysis, the factors affecting the mortality were malnutrition-related parameters including low body mass index, hypoalbuminemia, lymphocytopenia, and hypocholersterolemia, as well as severity-related variables such as high acute physiology and chronic health evaluation (APACHE) score, number of involved lobes, and high C-reactive protein. In addition, respiratory failure requiring mechanical ventilation and acute respiratory distress syndrome contributed to patient fatality. It was shown on multivariate analysis that respiratory failure and hypoalbuminemia were significantly independent variables associated with the mortality. Conclusion: Acute respiratory failure is the most common reason for the ICU care and also the most important factor in predicting poor outcome. In addition, our data suggest that the parameters associated with malnutrition could be possible factors contributing to mortality.

The Psychosocial Adjustment of High-Risk Adolescents in Poverty (고위험 빈곤청소년의 심리사회적 적응)

  • Park, Hyun-Sun
    • Korean Journal of Social Welfare
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    • v.37
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    • pp.195-216
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    • 1999
  • Adolescents whose families receive public assistance are primary interest in the article because they experience disproportionate shares of the burden of poverty and psychosocial stress and are at substantially high risk. To explain the psychosocial stresses of high-risk adolescents in poverty, this study analyzed the inter-relations and interactions of major variables: 1) stress related life condition, 2)individual & environmental resources, 3) emotional, behavioral, and academic adjustment. Data came from the survey of 351 students living in the families receiving public assistance. The major findings were as follows. High-risk adolescents in poverty suffered from chronic stresses related life conditions, including family environmental stress, financial & medical stress and stigmatic stress. As the effects of stress increased, depression/anxiety and delinquency of poor youth increased. The psychosocial adjustment of poor youth at risk was most effected by the stress resulted from family environment. Though they were suffered from stresses related poor environment, adolescents in poverty adjusted well, if they had individual and environmental resources including self-esteem democratic parenting and supportive school climate. In conclusion, this study confirmed that emotional, behavioral, and academic adjustment of adolescents in poverty was affected by various stresses from life conditions and individual and environmental resources. In order to improve adjustment of poor youth at risk, life conditions have to be improved and psychosocial resources to be increased. These findings have provided practical implications for social workers helping high-risk adolescents in poverty.

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Clinical Study on Effect of Carthmi-Flos Herbal acupuncture therapy on Osteoarthritis in Knee Joint (홍화약침(紅花藥鍼)의 퇴행성(退行性) 슬관절염(膝關節炎)에 대한 임상적 연구(硏究))

  • Hur, Tae-Young;Yun, Min-Young;Cho, Eun-hee;Lee, Ok-Ja;Kim, Kyung-sik;Cho, Nam-Geun
    • Journal of Acupuncture Research
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    • v.19 no.2
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    • pp.189-200
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    • 2002
  • Objective : This study is designed to find out the effects of Carthmi-Flos herbal acupuncture theraphy on knee joint with osteoarthritis. Methods : 32 cases of diagnostic patient with the osteoarthritis of knee joints by biochemical method, X-ray analysis and hematologic & serologic tests are divided Carthmi-Flos herbal acupuncture theraphy Group(HAG, 16 peples) and non-Carthmi-Flos herbal acupuncture theraphy Group(NHAG, 16 peoples) at Ik-San Oriental medical hospital in wonkwang university from 1th June 2000 to 31th January 2002. After treatment, we evaluated the effect per each group . Results : 1. In the both HAG and NHAG females were much more than males. Sixty aged patients were the most in the HAG(56.3%) and Seventy aged patients were the most in the NHAG(68.8%). 2. Over 5 years duration of disease in HAG was the most(37.5%). 6 months and over 5 years duration of disease in NHAG was the most(each 31.3%). 3. Two groups were not improved chronic stage(over 5 years). 4. The effect of treatment by condition of patients was follows: After treatment, Grade IV & III were decreased 75.0% in HAG and 56.2% in NHAG 5. In the distribution of treatment progression : 15 cases(93.7%) were recoverd in HAG but 14 cases(87.5%) in NHAG. 6. After comparing the results before and after treatment, we found 93.3% of patients showed recovery at anterior area and 88.9% showed at posterior. Conclusion : These results shows that Carthmi-Flos(CF) herbal acupuncture treatment has good effect on osteoarthritis in knee joint. Futhermore it is possible that CF acupuncture is one of the promising candidates for long-term therapy of osteoarthritis.

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Signal-Averaged P Wave Analysis in Patients with Paroxysmal Atrial Fibrillation (발작성 심방세동 환자의 신호평균 P파 분석)

  • 김인영;이종연;이병채;이용희;이종민;김선일;김준수
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.1-8
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    • 2002
  • Atrial fibrillation(AF). chronic or paroxysmal is the most frequent arrhythmia in human subjects Duration of P wave in signal-averaged electrocardiography(SAECG) reflects intra-atrial conduction time and therefore. could be used as an electrophysiological marker for atrial conduction chance at the earthy stave. So we apply the analysis method using SAECG to diagnose Paroxysmal atrial fibrillation(PAF) . Subjects Participated for the study consisted of two groups: a control group(n=34) of normal healthy volunteers and a group of AF Patients(n=38) with a documented history of PAF but no other history of cardiac disease. We evaluated the effect of several filtering and determination methods to find the starting and ending feints of the P wavy on its duration. To increase the measurement reliability of P wave duration. the automatic detection method was proposed. Also. to increase the detection rate for PAF risk, the decision threshold value was optimized using receiver operation characteristics(ROC) curve. Results showed that the highest statistical difference (p〈0.001) of the P wane duration between controls and subjects was obtained at the Processing condition, using absolute threshold vague(8.75 $\mu N$) , a least mean square(LMS) high pass filter and 30 Hz cutoff frequency. The most outstanding difference(sensitivity 88 % specificity 64.4 %) between controls and subjects was obtained at the decision threshold value of 112 ms.

Two Cases of the Calculi which Are Rare in the E.N.T. Field (이비인후과 영역에 희귀한 결석증 2례)

  • 이석용;양오규;이영효;심상열;김재선
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.11.2-11
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    • 1981
  • Compared with other medical parts, there are relatively rare cases of the calculi in the Otolaryngologic field. The authors have recently experienced cases of the tonsillolith and huge rhinolith. They were removed successfully under the local anesthesia. Small quantities of calcareous or gritty particles are often found in the center of the caseous plugs filling the crypts of the tonsil in chronic follicular tonsillitis. The patients usually give a history of repeated tonsillitis in the earlier years. The patient may be aware of a constant sensation as of a foreign body in the throat. The breath is often fetid. The tonsillar calculi was found to be the accumulated keratohyalin masses in the crypts. The rhinoliths are rare in nasal cavity. They usualy have a foreign body nucleus of bacteria, blood, pus cells, mucus, crusts, or some foreign material from outside the body. They are largely composed of calcium and magnesium salts, principally carbonate with traces of sodium chloride. The condition is commonly found in adults and in female. They are usualy unilateral and are located, in the majority of instances, in the lower portion of the nasal cavity. The first well documented cases of rhinolithiasis, however, were reported by Bartholin in 1654. Since then over 400 cases have been reported.

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A Study on the Factors Affecting Self-Regulation Program for Hypertensives (본태성 고혈압환자를 위한 자기조절 프로그램 관련요인 연구)

  • Park, Young-Im
    • Research in Community and Public Health Nursing
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    • v.6 no.2
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    • pp.234-249
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    • 1995
  • Essential hypertension, one of the leading primary cause of death in Korea, is a typical chronic disease requiring adequate and continuous management. Though these hypertensives need to maintain desirable health practice by themselves for their life time, many previous studies indicated that most of the essential hypertensives have no specific symptoms and thus, reluctant to follow appropriate medical regimens causing the condition further aggravated and complicated. Thus the comprehensive self-regulation program was conducted as a nursing intervention on the promotion self-care 'performance and improvement in physical parameters of hypertensives. For this purpose, a one group quasi -experimental research with pre and post test design was used. And the whole program was carried out from October, 1993 to February, 1994. Self-regulation program was consisted with group education on hypertension and self-care, self-regulation including the blood pressure self-monitoring and recording, recording of daily self-care activities, and encouraging and reinforcing self-efficacy through verbal persuation and enactive attainment. The subjects were asked to measure their own blood pressure by themselves twice per day and to record blood pressure and the daily self-care performance according to the instructions provided during the whole period of 9 weeks. The data was analyzed by experimental stages: the first week, the fifth week, and the ninth week since the experimental imput began. Data were analyzed by the SPSS PC+ program with paired t -test and F-test, and multiple correlation to determine the variables affecting the effect of program. The results were as follows : 1) Subjects in J company were significantly lower diastolic blood pressure than K company after the program (t=2.39, p=.024). Level of cholesterol was significant difference according to position(t=2.23, p=.034), family history (t=-2.66, p=.013), diagnosis duration, and career(t=2.88, p=.055). Perceived self-efficacy was more significantly increased among the group with family history(t=-3.00, p=.013). 2) Before the program, there were significant positive correlation among the variables: internal-LOC and self-efficacy(r=.3952, p=.015), external-LOC and barriers (r=.6515, p=.000), chance-LOC and Barriers(r=.4133, p=.012). However there were significant negative correlation between internal-LOC and barriers (r=-.3236, p=.041, external-LOC and self -efficacy(r=-.3517, p=.028), self-efficacy and barriers(r=-.6654, p=.000). 3) There were significant relationships between changes in self - care performance and self-efficacy at 5th week (r=.5313, p=.001) and changes in self-efficacy at 9th week(r=.4586, p=.005). 4) After the program, internal health locus of control and perceived benefits showed significant correlation(r=.5673, p=.001, but perceived barriers was negative correlation with perceived self-efficacy (t=-4242, p=.01). From the above results, it can be concluded that the self-regulation program is an effective nursing strategy through the change of variables to promote self-care performance of hypertensives and to increase the self-efficacy. Thus this program can be recommended in the management of the hypertensives in workplaces and community settings.

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An Unusual Cause of Acute Maxillary Sinusitis in a 9-year-old Child: Odontogenic Origin of Infected Dentigerous Cyst with Supernumerary Teeth (9세 남자 환아에서 급성 부비동염의 드문 원인 : 과잉치가 동반된 감염된 함기성 낭종)

  • Yun, Hye-Won;Kwon, Hyuck-Jin;Woo, In-Hee;Yang, Byung-eun;Lee, So-Yeon;Lee, Hae-Ran;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.201-205
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    • 2015
  • Acute maxillary sinusitis is a common disorder affecting children. Untreated acute sinusitis can develop into chronic sinusitis, and complications, such as orbital cellulitis or abscess, can occur. Maxillary sinusitis of odontogenic origin is not a well-recognized condition and is frequently missed in children. As an odontogenic source of sinusitis, the dentigerous cyst is one of the most prevalent types of odontogenic cysts, and it is associated with the crown of an unerupted or developing tooth. This report concerns a nine-year-old boy who was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. The boy visited our pediatric clinic presenting with rhinorrhea and nasal obstruction and was initially diagnosed with maxillary sinusitis only. With antibiotic treatment, his symptoms seemed to improve, but after 2 months, he came to our clinic with left facial swelling with persistent rhinorrhea and nasal obstruction. Radiographic examinations of the sinuses were performed, and he was diagnosed with maxillary sinusitis originating from a dentigerous cyst with supernumerary teeth. After a surgical procedure involving the removal of the dentigerous cyst with supernumerary teeth, the symptoms of sinusitis gradually diminished. There are only very few cases in the pediatric medical literature that remind us that odontogenic origin can cause maxillary sinusitis in children. Our patient can act as a reminder to general pediatricians to include dentigerous cysts in the differential diagnosis of maxillary sinusitis.

The Effect of Social Capital on Health-related Quality of Life - Using the Data of the 2019 Community Health Survey - (노인의 사회적 자본이 건강 관련 삶의 질에 미치는 영향 - 2019년 지역사회건강조사를 중심으로 -)

  • Kim, Ji-Hee;Park, Jong
    • Journal of agricultural medicine and community health
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    • v.46 no.4
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    • pp.280-294
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    • 2021
  • Objectives: The purpose of this study is to investigate the effects of social capital characteristics, socio-demographic characteristics, physical condition, and health behavior characteristics on health-related quality of life of the elderly in Korea. Methods: T-test, one-way ANOVA, and regression analysis were performed by applying a complex sample design to 57.787 people aged 65 and over using the 2019 Community Health Survey. Results: First, as a result of complex-sample T-test and ANOVA analysis, it was found that there were differences in health-related quality of life according to social capital characteristics, physical condition & health behavior characteristics, and socio-demographic characteristics. Complex Sample Regression Analysis Results, the explanatory power of the model was 28%. When living in the metropolitan area, living in an apartment building, having a spouse, having a higher household income, economic activity, higher educational attainment, increase sleeping time, walking time, frequent binge drinking, health checkup, networking, trust, and social participation showed higher health-related quality of life. When people were older, their gender was female, higher BMI, number of chronic diseases, and severe stress that showed lower health-related quality of life. Conclusions: It was proved that the factors affecting the health-related quality of life of the elderly are not only physical condition and health behavior factors, but also social capital and socio-demographic characteristics. It was found that the role as a member was important.

The Characteristics of Membranoproliferative Glomerulonephritis I Detected from School Urine Screening (학교 집단 소변 검사로 발견 된 막증식성 사구체신염 I형의 특성)

  • Choi, Jung-Youn;Park, Mi-Young;Lee, Yong-Jik;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong;Park, Young-Seo;Han, Hye-Won;Jin, Dong-Kyu;Chung, Woo-Yeong;Kim, Kee-Hyuck;Yoo, Kee-Hwan;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.10 no.2
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    • pp.152-161
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    • 2006
  • Purpose : In Korea, the school urine screening program is a useful tool for screening urine abnormalities. It is particularly useful in early detection of membranoproliferative glomerulonephritis(MPGN) I, which frequently progresses to chronic renal failure. In this study, we studied the medical history, laboratory findings, and histologic findings of MPGN to gain helpful information on early detection and treatment. Methods : The subjects were 19 children, who were diagnosed with MPGN from kidney biopsies that were performed in ten nationwide university hospitals because of abnormal urine findings from school urine screening programs conducted from July 1999 to April 2004. We divided the patients into 2 groups, a nephrotic range proteinuria group(n=8) and a non-nephrotic proteinuria group(n=11), and retrospectively analyzed the clinical features, laboratory findings, histologic findings, treatment, and clinical course. Results : The mean age at the first abnormal urinalysis was $10.6{\pm}2.2$ years in the nephrotic proteinuria group and $9.6{\pm}3.2$ years in the non-nephrotic proteinuria group. The mean age at the time of kidney biopsy was $11.3{\pm}2.3$ years in the nephrotic range proteinuria group and $10.4{\pm}3.2$ years in the non-nephrotic proteinuria group respectively. There was no significant difference in the mean age and sex between the two groups. In the nephrotic proteinuria group, 6 children had a low plasma C3 level and in the non-nephrotic proteinuria group, 8 children had a low plasma C3 level, but there was no significant difference between the 2 groups. There was no significant difference in the laboratory test results(including WBC count, RBC count, platelet count and other serologic tests) between the 2 groups except for 24 hour urine protein secretion. There was no difference between the 2 groups with regard to the acute and chronic changes in the glomerulus on light microscopic findings, IgG, IgA, Ig M, C1q, C3, C4, fibrogen deposition on immunofluoroscence findings, and mesangial deposits, subendothelial deposits, and subepithelial deposits on electron microscopic findings. The children were treated with corticosteroids, ACE(angiotensin-converting enzyme) inhibitors, dipyridamole and other immunosuppressive agents. During the course of treatment, there were no children whose clinical condition worsened. Among 19 children, 3 children went into remission(2 in the nephrotic proteinuria group, 1 in the non-nephrotic proteinuria group) and 9 children went into a partial remission(4 in the nephrotic proteinuria group, 5 in the non-nephrotic proteinuria group) on urinalysis. There was no significant difference in the treatment results between the two groups. Conclusion : The 73.7% of children who were incidentally diagnosed with MPGN by the school urine screening program had reduced C3. 42.1% of the children had nephrotic range proteinuria. There were no significant differences in clinical features, laboratory test results, light microscopic, immunofluorescence microscopic, and electron microscopic findings between the nephrotic proteinuria group and the non-nephrotic proteinuria group except for the 24 hour urine protein secretion. Therefore, for early detection of MPGN during the school urine screening program, we strongly recommend a kidney biopsy if children have abnormal urine findings such as persistent proteinuria and persistent hematuria, or if the serum C3 is reduced.

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A survey on sex life behavior and factors of low back pain (요통환자들의 성생활 행태와 영향 요인 조사)

  • Nam, Chul-Hyun;Woo, Kwang-Seog
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.31-49
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    • 2002
  • The purpose of this study was to investigate discomforts and sexual life and to identify the relation between the discomforts and sexual life with low back pain. The data were collected from March 2 through July 31, 2001. Four hundred forty-two questionnaires were returned (response rate=88.0%). Analysis of the data was done with SPSS PC+ and use descriptive statistics, $x^2$-test, t-test, ANOVA. regression. The statistics shows that over than 80% of the adults experienced lumbago at least one time in their life, and Back pain is known as one of the most common complaints made by the patients of all ages in the general hospital or local medical clinics throughout. However, in certain case it leads to a chronic condition which can cause a great deal of problems in management and in financial burden to individuals and society. The result of this study was summarized as follows: 1) It appeared that regarding the distribution of gender, male was the higher(63.6%) then that of female, the portion of forties was 28.5%. Sitting for long time was 23.1% in men and 21.7% in women. Unknown reason including sexual behaviour was 12.9% in men and 15.5% in women. Patients treated medicine and physical therapy were 36.4%. In level of educational background, the rate of high school was 31.0%, technical college was 28.5%. The highest proportion by occupation was 18.3% of office workers, occupation posture was 41.9% of sitting. 2) Men(26.0%) and most of women(34.8%) were not satisfied in the explanation satisfaction rate of sex life concerned disease. 23.8% in men and 23.6% in women considered flexibility of waist good. Man(33.3%) and most of woman(35.0%) considered that Health education is necessary. 32.7% in men and 27.3% in women did't mind educator is whoever. Preventing of lower back pain(LBP) and proper Health education of sex life are demanded in daily life. 3) 58.0% of man and 64.0% of woman mostly had a posture which is man over woman. 28.5% in men and 27.8% in women considered that proper information finding of LBP and sex life was very few and few. 37.7% in men and 42.7% in women have acquired information about sex life flung their friends. 4) The number of sex life was decreased from 2.96 0.98 to 2.61 1.63 and also the time of sex life was decreased from 3.65 1.89 to 226 1.64. The satisfaction rate of sex life changed from 3.60 0.86 to 2.77 1.10. In the number of sex life, The non correct group was 2.62 1.91 and the correct group was higher in 2.68 1.65. In the time of sex life, The non correct group was 2.02 1.47 and the correct group was higher in 229 1.65. The satisfaction rate of sex life was 2.76 0.86 in non correct group and 2.88 1.10 in correct group. So there was a difference. 5) In the satisfaction rate of sex life, Men who have a lower back pain were higher than women and no attack group was higher than attack group. As they had many sex life, the satisfaction rate was higher significantly in statistics. As the time of sex life was short, the satisfaction rate was lower significantly in statistics. As the age was low, the demand rate of Health education was high and as means of patient who had a lower back pain was high, the demand rate of Health education was high. As the patient who had a lower back pain had a long married life, the demand rate of Health education was high and as education level was high, the demand rate of Health education was high. It is necessary to provide patients with conservative treatment, educational teaching, and training to prevent further injuries in the future. In general, it is important to educate the public how to prevent back injuries and how to treat themselves in an onset period to prevent further injuries sliding into a chronic state. Sexuality is an integral part of normal and healthy relationships, but patients are unable to enjoy sex because they are riot able to get into a comfortable position due to back pain. Many conditions of the spine can make certain positions uncomfortable. Health educator should make the education program of the discomforts and the sexual pattern for low back pain in workplace and/or hospital. Further study Is needed on how to integrate the educational program on sexuality into the total rehabilitation program.

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