• Title/Summary/Keyword: Disease morbidity

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아이소발레릭산혈증의 신생아선별검사 후 진단 및 치료 전략 (The Strategy for Diagnosis and Treatment of Isovaleric Acidemia)

  • 고정민;이경아
    • 대한유전성대사질환학회지
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    • 제16권2호
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    • pp.57-61
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    • 2016
  • IVA는 상염색체 열성의 유전방식을 보이는 leucine 대사 장애 질환이자 대표적인 유기산 혈증이다. IVD 유전자의 돌연변이에 의한 isovaleryl-CoA dehydrogenase 효소의 결핍이 질환 발생의 원인이다. Isovaleryl-CoA dehydrogenase 효소가 결핍되면 isovaleryl-CoA의 대사물질이 비정상적으로 체내에 축적되어 대사성 산증 및 고암모니아혈증 등의 급성 대사성 위기와 발달지연, 성장지연, 및 경련성질환 등의 만성 합병증을 초래할 수 있기 때문에, 급성 대사성 위기 및 만성합병증의 발생을 예방하기 위해 조기 진단에 따른 적절한 치료의 도입이 중요하다. 현재 IVA은 국내에서 시행되는 탠덤 매스 스크리닝법을 이용한 신생아 대사질환 선별검사 항목에 포함되어 있으며, C5의 상승으로 의심할 수 있다. 그러나 SBCAD 결핍증 혹은 pivalic acid 유래물이 포함된 항생제를 투여한 경우에도 C5의 상승이 동반될 수 있기 때문에, 감별진단 및 확진을 위한 추가적인 생화학적, 유전학적 검사가 필수적이다.

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침구과에 입원한 뇌졸중 환자의 최근 역학적 동향 (Recent Epidemiologic Trends on Stroke Patients Admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital, Kyung Hee University)

  • 홍장무;강미경;김종덕;인창식;강중원;박상민;서병관;정인태;고형균
    • Journal of Acupuncture Research
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    • 제21권4호
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    • pp.19-29
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    • 2004
  • Objective : The purpose of this study is to present the epidemiological data on patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital Kyung Hee University and to investigate the difference between preceding diseases of stroke. Methods : We reviewed medical records of 700 patients with a stroke admitted to Department of Acupuncture & Moxibustion, Oriental Medical Hospital, Kyung Hee University. Results: The incidence of cerebral infarction was 6.7 times that of cerebral hemorrhage. The incidence in males was 1.28 times of that in females. The incidence of stroke increased with aging and more cerebral hemorrhage occured in lower age group than cerebral infarction. There was higher morbidity in October, during the changing of the seasons, than any other months. Hypertension was the most common preceding disease followed by diabetis mellitus, heart disease, hyperlipidemia, and according to Odds's ratio for Male/Female, the probability of having preceding diseases was higher in females than males. In cerebral infarction, MCA territory was the most frequent lesion sites. Of the cerebral hemorrhage, basal ganglia (60%) was the most commonly involved site which was followed by thalamus(33.3%), cortex (3.3%) and subcortex (2.2%). The most common symptom accompanied by stroke was motor dysfunction which was followed by verbal disturbance, urination disorder and dysphagia. Conclusion : This study showed the trends of stroke in Oriental medical center. We expects that Multicenter cooperative and prospective study including Oriental Medicine will be inspired by this study for establishing more accurate chacteristics of stroke in Korea in the future.

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Safety of Laparoscopic Radical Gastrectomy in Gastric Cancer Patients with End-Stage Renal Disease

  • Lee, Hayemin;Park, Cho Hyun;Park, Seung Man;Kim, Wook;Chin, Hyung Min;Kim, Jin Jo;Song, Kyo Young;Kim, Sung Geun;Jun, Kyong Hwa;Kim, Jeong Goo;Lee, Han Hong;Lee, Junhyun;Kim, Dong Jin
    • Journal of Gastric Cancer
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    • 제18권3호
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    • pp.287-295
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    • 2018
  • Purpose: The surgical outcomes of end-stage renal disease (ESRD) patients undergoing radical gastrectomy for gastric cancer were inferior compared with those of non-ESRD patients. This study aimed to evaluate the short- and long-term surgical outcomes of ESRD patients undergoing laparoscopic gastrectomy (LG) and open gastrectomy (OG) for gastric cancer. Materials and Methods: Between 2004 and 2014, 38 patients (OG: 21 patients, LG: 17 patients) with ESRD underwent gastrectomy for gastric cancer. Comparisons were made based on the clinicopathological characteristics, surgical outcomes, and long-term survival rates. Results: No significant differences were noted in the clinicopathological characteristics of either group. LG patients had lower estimated blood loss volumes than OG patients (LG vs. OG: 94 vs. 275 mL, P=0.005). The operation time and postoperative hospital stay were similar in both the groups. The postoperative morbidity for LG and OG patients was 41.1% and 33.3%, respectively (P=0.873). No significant difference was observed in the long-term overall survival rates between the 2 groups (5-year overall survival, LG vs. OG: 82.4% vs. 64.7%, P=0.947). Conclusions: In ESRD patients, LG yielded non-inferior short- and long-term surgical outcomes compared to OG. Laparoscopic procedures might be safely adopted for ESRD patients who can benefit from the advantages of minimally invasive surgery.

시령탕(柴苓湯)이 에탄올 투여로 유발된 흰쥐의 간손상에 미치는 방어효과 (Effects of Shiryung-tang Extract on the Liver Injury induced by Ethanol in Rats)

  • 김범회;최영현
    • 동의생리병리학회지
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    • 제27권5호
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    • pp.611-616
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    • 2013
  • Alcoholic liver disease (ALD) is a major cause of morbidity and mortality around the world. Although much progress has been made in understanding the pathogenesis of ALD, there remains no effective therapy for it. Accumulated evidence indicates that oxidative stress is the main pathological factors in the development of ALD. Ethanol administration causes accumulation of reactive oxygen species (ROS), including superoxide, hydroxyl radical, and hydrogen peroxide. ROS, in turn, cause lipid peroxidation of cellular membranes, and protein and DNA oxidation, which results in hepatocyte injury. In addition to pro-oxidants formation, antioxidants depletion caused by ethanol administration also results in oxidative stress. The objective of this study is to investigate the effects of Shiryung-tang extract on the chronic alcoholic liver injury induced by EtOH. Male Sprague Dawley rats were used in this study. All rats were maintained under standard laboratory conditions ($23{\pm}1^{\circ}C$, 12h light/12h dark cycles). All animals (n=30) were randomly divided into following groups: (1) Normal group, treated with distilled water (n=10); (2) Control group, treated with ethanol (n=10); (3) Sample group, treated with ethanol + pharmacopuncture (n=10). For oral administration of ethanol in Control and Sample group, the ethanol was dissolved in distilled water in concentrations of 25%(v/v). Throughout the experiment of 8 week, the rats were allowed free access to water and standard chow. Sample group were administrated by Shiryung-tang extract daily for 8 weeks. Control group were given normal saline for same weeks. As a results, the oral administration of ethanol for 8 weeks leads to hepatotoxicity. The levels of hepatic marker such as HDL-cholesterol, triglyceride, aspartate aminotransferase and alanine aminotransferase were altered. The ethanol also increased lipid peroxidation and depletion of antioxidant enzyme activities as well as hepatic tissue injury. However, the treatment of Shiryung-tang extract prevented all the alterations induced by ethanol and returned their levels to near normal. These data suggest that Shiryung-tang extract could have a beneficial effect in inhibiting the oxidative damage induced by chronic ethanol administration. Therefore, Shiryung-tang extract can be a candidate to protect against EtOH-induced liver injury.

유헬스케어(U-health Care)에서 양도락의 활용 방안 (The Application of Ryodoraku in the U-health Care System)

  • 송호섭
    • Journal of Acupuncture Research
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    • 제27권6호
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    • pp.115-122
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    • 2010
  • Objectives : The purpose of this study was to propose the utilization plan of Ryodoraku in the U-health care systems. Methods : Computerized literature searches were performed for Ryodoraku related articles using the following databases: KISS, RISS, DBPIA, NDSL from 1990 to Oct 2010. Search terms were '양도락' or 'Ryodoraku' or 'U-health'. Due to Ryodoraku coming from Japan, additional literature review(articles published by 2008) on Japanese journal of Ryodoraku medicine was done for compensation. Results : 1. Introduction of U-health : As rapid progress of population aging and strong interest in health, the demand for the traditional Korean medical service is increasing. Until now healthcare service has provided post treatment by face-to-face manner. But according to related researches, proactive treatment is resulted to be more effective for preventing diseases. Particularly, the existing healthcare services have limitations in preventing and managing chronic geriatric degenrative diseases such as metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis, etc., because the cause of the above is complex and even related to life habit. As the advent of ubiquitous technology, patients with the chronic geriatric degenrative diseases can improve life habit such as poor eating habits and physical inactivity without the constraints of time and space through u-healthcare service. Therefor, lots of researches for u-healthcare service focus on providing the personalized healthcare service for preventing and managing that. To cope with this situations, The concept of u-healthcare service should be adopted in the traditional korean medicine and diagnostic devices suitable for it should be also devised and developed based on traditonal korean medine. 2. Review of existing Ryodoraku related articles for applying to U-health : articles investigating feasibility applying Ryodoraku to meridian diagnosis and raising problems of it, articles providing recent research trends of Ryodoraku, Ryodoraku related articles considering usefulness for U-health, and articles confirming the repeatability and reproducity of Ryodoraku were included. Based on the review of the above Ryodoraku related articles, several application of Ryodoraku in the U-health care system. Conclusions : To make preparations for the increasing need of traditional Korean medicine due to rising morbidity rate of chronic geriatric degenerative diseases, it is necessary to appropriately apply Ryodoraku to the U-health care system. The application of Ryodoraku is as follows. 1. To use Ryodoraku additionally to the established diagnostic device of metabolic syndrome, CVA, coronary heart diseases, parkinson's diseases, degenerative joint disease, spondylosis. 2. To apply Ryodoraku to the symptoms or diseases having a tendency to be diagnosed by correlation between the affected meridian and the lesion such as headache, nuchal pain, shoulder pain, low back pain, sciatica, HNP, etc. 3. To secure the repeatability and reproducity of Ryodoraku. 4. To devise and develop Ryodoraku appliance in order to overcome the known drawbacks and to improve error of measurement.

좌심실기능에 따른 관상동맥우회술의 위험인자 (Risk Factors of Coronary Artery Bypass Grafting According to Ventricular Function)

  • 이헌재;현성렬
    • Journal of Chest Surgery
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    • 제30권9호
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    • pp.885-890
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    • 1997
  • .저자들은 1994년 7월부터 1996년 6월까지 관상동맥우회 술을 시행한 환자 103명을 심실구축력 40%를 기준 으로 심실기능저하군 24명과 심실기능정상군 79명으로 분류하여 환자의 술전,수술변수 18개를 분석하였다. 분석결과 환자의 특성과 수술사망에 영향을 미치는 위험인자에 대해 다음과 같은 결과를 얻었다. 1. 술전 변수중 심비대(p=0.0012), 혈청 크레아티닌 이상(p=0.0166), IABP 실시(p=0.0096)는 기능저하군이 기능 정상군보다 유의하게 높은 빈도를 보였다 2. 수술변수중 기능저하군은 수술적응증에 있어서 심근경색후 협심증의 빈도가 많았고(p=0.00003), 내흉동맥 의 사용은 유의하게 적었다(p=0.00416). 3. 조기사망률은 기능저하군이 기능정상군보다 약간 높았으나 통계적으로 유의한 차이는 없었다(기능저하군 8.3%, 기능정상군 5.1%, p=0.5492). 4. 합병증발생률은 기능저하군 50%(12/24), 기능정상군 33%(79/25)로 두군간에 유의한 차이는 없었다(p=0.1007). 5. 심실기능정상군에서는 연령(고령)(p=0.041)이 수술후 조기사망에 유의한 위험인자로, 심실기능저하군에서 는 연령(p=0.018)외에도 술전 IAaP 실시(p=0.0036), 고콜레스테롤혈증(p=0.00 7), 응급수술(p=0.0036)이 유의 한 위험인자로 작용하였다. 이상의 결과를 통해 심실기능이 저하된 관상동맥질환 환자는 심실기능이 정상인 환자에 비해 많은 술후 조기사망의 위험인자를 갖고있으나.술후 조기사망률과 합병증 발생률은 두 군간에 유의한 차이를 보이지 않 음으로써 심실기능이 저하된 환자에 있어서도 증상의 개선과 장기생존률의 향상을 얻기 위하여 좀더 적극적인 관상동맥우회 술의 실시가 필요할 것으로 생각된다.

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식품알레르기 아동 부모의 양육부담과 영향요인 (Parental burden of food-allergic children's parents and influencing factors)

  • 이은선;김규상
    • Journal of Nutrition and Health
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    • 제51권2호
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    • pp.140-152
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    • 2018
  • 식품알레르기는 알레르기 행진의 시작 단계로 원인 식품의 섭취 제한으로 인하여 성장기 아동의 영양 불균형과 아동을 비롯한 가족구성원의 삶의 질을 저하시키는 원인이 될 수 있다. 이에 본 연구는 2세 이상의 영유아 및 학령기 식품알레르기 아동의 주양육자인 어머니를 대상으로 자녀의 식품알레르기로 인한 양육부담을 정량화하여 자녀의 식품알레르기가 부모의 삶의 질에 미치는 영향을 분석하고자 하였다. 식품알레르기 아동 부모의 양육부담은 정서적 고충, 일상생활 제약에 대한 2개의 하부 요인으로 세분화되며, 자녀의 연령 증가, 섭취 제한 식품의 수, 일부 알레르기질환 진단 여부가 양육부담의 감소 및 증가에 유의한 영향을 미치는 것으로 분석되었다. 이처럼 식품알레르기 아동은 식품알레르기가 다른 알레르기질환으로 이행되지 않도록 전문 의료진에 의한 진단과 증상관리가 필수적이며, 환아를 비롯한 가족 구성원에 대한 주변의 지지와 간호 중재가 동반되어야 한다. 또한 성장기의 식품알레르기 아동은 식품 항원에 대한 식품경구유발시험 등의 정확한 임상 진단을 통해 필수 영양소를 포함한 식품의 과도한 섭취 제한을 방지해야 한다. 지역사회와 의료기관은 식품알레르기의 예방 및 증상완화를 위한 맞춤형 영양교육, 대체 식품에 대한 정보 제공 등의 현실적 지원과 정서적 지지를 병행해야 한다. 이처럼 다양한 형태의 사회적 노력과 제도적 방안을 통해 식품알레르기 아동의 삶의 질을 향상시키고 부모의 양육부담 대처능력을 강화해야 할 것이다.

미니돼지에서 허혈성 신장 손상의 조기진단 (Initial Diagnosis of Acute Renal Failure Induced by Ischemia in Miniature Pig)

  • 김세은;고아라;배춘식;박수현;한호재;심경미;강성수
    • 한국임상수의학회지
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    • 제28권1호
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    • pp.52-56
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    • 2011
  • Acute renal injury induced by ischemia is a major cause of high morbidity and mortality in hospitalized patients and a common complication in hospitalized patients. Thus, the work with acute renal failure and renal ischemia has been studied for many years. Although serum creatinine concentration that is widely used as an index of renal function performs fairly well for estimating kidney function in patients with stable chronic kidney disease, it performs poorly in the setting of acute disease. Thus, an ideal biomarker for acute kidney injury would help clinicians and scientists diagnose the most common form of acute kidney injury in hospitalized patients, acute tubular necrosis, early and accurately, and may aid to risk-stratify patients with acute kidney injury by predicting the need for renal replacement therapy, the duration of acute kidney injury, the length of stay and mortality. In this study, renal ischemia and reperfusion were performed by clapming and un-clamping right renal artery in miniature pigs. Plasma blood urea nitrogen (BUN) and creatinine were examined at pre- clamping, after-clamping at 0, 1 and 3 hours. And we searched initial indicators in these samples. Also, renal tissue was collected and searched the initial indicator by PCR and western blotting. As a result, hypoxia inducible factor $1{\alpha}$ ($HIF1{\alpha}$), nuclear factor kappa-B ($NF{\kappa}B$), $I{\kappa}B$, erythropoietin (EPO), erythropoietin receptor (EPOR), angiopoietin-1 and vascular endothelial growth factor (VEGF) were showed significant changes among the renal protein. $HIF1{\alpha}$, EPO, and EPOR were showed significant changes among the renal gene. Thus, these markers will be used as initial diagnosis of acute renal failure.

보건소 고혈압 영양교육 참여자의 식생활 요인 분석 (Analysis of Dietary Characteristics of Participants Attending the Nutrition Education Program for Hypertensive Patients at a Public Health Center)

  • 임경숙;한문화;강용화;박혜련;김찬호
    • 대한영양사협회학술지
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    • 제6권2호
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    • pp.125-135
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    • 2000
  • Hypertension is a well-known degenerative disease whose prevalence rate increases with age. Management of high blood pressure is a critical concern in preventive strategies to reduce the morbidity and mortality for cardiovascular disease. The purpose of this study was to examine the dietary characteristics of hypertensive program participants, and to establish strategies based on their nutritional needs. Hypertensive patients were enrolled in the program in a public health center or in a local elderly center, at Suwon, in 1999-2000. Trained dietitians interviewed 62 enrollees(24-hour recall) and related variables. Mean body mass index of the subjects was 25.0kg/m². 30.7% of the subjects had a family history of hypertension. The majority of them ate regularly and partook of all available side dishes. They consumed grains and vegetables regularly, but seldom ate dairy products or food prepared with oil. Male enrollees frequently consumed more processed food and animal fat than did female enrollees(p<0.05). An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea 1995) showed that but for ascorbic acid, enrollees consumed nutrients below the RDA. The food group intake pattern was not diverse, thus only 8.1% of enrollees consumed all food groups in a day. An analysis of eating attitude showed that 64.5% of enrollees always added salt to beef soup. Male enrollees showed low food-related self-efficacy compared to female enrollees, especially with reference to reduction of instant food intake(p<0.01), increase in vegetable intake(p<0.01), reduction of monosodium glutamate(MSG) intake(p<0.01). and not overeating(p<0.05). Their perceived barriers for participating in hypertension nutrition programs included lack of time, program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education programs for community hypertensive patients should focus on increasing participant consumption of foods, expecially dairy products, and desirable eating attitudes. It also suggests that the program should consider should consider encouraging self-efficacy in changing eating behavior.

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Presentation and Outcomes of Gastric Cancer at a University Teaching Hospital in Nepal

  • Sah, Jayant Kumar;Singh, Yogendra P;Ghimire, Bikal
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권13호
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    • pp.5385-5388
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    • 2015
  • Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.