Background: Pulmonary tuberculosis remains a health concern in Korea despite major progress in the development of new strategies for diagnosing and treating tuberculosis. In particular, the diagnosis of newly developed pulmonary tuberculosis is on the rise in elderly persons. The aim of this study was to investigate the clinical, radiographic characteristics, and treatment outcomes of pulmonary tuberculosis in the elderly. Methods: The medical records of 113 young (<65 years old) and 112 elderly (${\geq}65$ years old) pulmonary tuberculosis patients diagnosed at Chungnam National University hospital between January 2007 and December 2008 were reviewed. Results: There was no difference in the prevalence of typical symptoms between the younger and the elderly group. Dypsnea was the only symptom that occurred more frequently in the elderly group (16.8% vs 5.5%, p=0.008). On radiological study, pneumonic infiltration type was more common in the elderly group (28.6% vs 16.8%, p=0.035). Sputum Acid fast bacilli smear positivity rate was similar between the 2 groups. Elderly patients with anti-tuberculosis medication had more frequent adverse drug reactions; however, there was no significant difference between the 2 groups in the number of patients required to stop medication due to an adverse drug reaction. There were more patients lost to follow-up in the elderly group (22/112, 19.6% vs 11/113, 9.7%, p=0.036). Conclusion: The majority of elderly patients did not complete the treatment, resulting in a poorer outcome. Therefore, we need to make an effort to support the continued screening of elderly patients by making this economically feasible.
The purpose of this study were to develop an web-based education program for Lung cancer patients and to test its effects on patients' self-care knowledge, compliance to medical regimen, nutrition status and pain. The program was developed by the following process: first, Lung cancer patients demand on the web-based program was investigated. and second, the program was developed with the help of various reference books and then validation of experts group. last, educations effects on the patients is evaluated and compared the differences in self-care knowledge, compliance to medical regimen, nutrition status and pain between on experimental group and a control group on before discharge 1day and 3weeks after. SPSS/Win 11.0 program was used for data analysis. It was proven with $x^2$ test and t-test, and Pearson Correlation coefficient, and Chronbach's alpha coefficient were done for the reliability of measuring instruments. 1. The summary of the Program development is as follows. The program is based on patients' questionnaire and reference material and is made for users friendly. Not only Bigger font size and bright colors but also illustrations or pictures were adopted to help enhance patients' understanding. 2. The summary of the study results is as follows. 1) Compared with control group, the web-based educated experimental group showed a statistical significant difference on self-care knowledge, Especially disease, radiation treatment, medication & analgesics, chemotherapy side effect, but there was no significant difference in the field of chemotherapy, in the fields of operation, diet & general knowledge. 2) Compared with control group, the web-based educated experimental group showed a statistical significant difference on compliance to medical regimen, especially in the field of follow up care, everyday life, diet, but there was no significant difference in the field of medication, exercise. 3) Compared with control group, web-based educated experimental group showed no significant difference in nutrition status, but partially significant difference in body weight. 4) Compared with control group, the web-based educated experimental group showed no significant difference in pain level. 5) The significantly positive correalation self-care knowledge with the compliance to medical regimen. 6) Users satisfaction with the web-based education program of the contents quality, the level of recommendation to others, content layout, medical information quality, but interesting got a low mark.
Objectives To investigate the pattern of subclinical hypothyroidism (SCH) in patients with bipolar disorders managed by lithium or valproic acid. Methods The study participants were 106 patients with DSM-IV bipolar disorders receiving planned maintenance treatment at the Mood Disorders Clinic of Seoul National University Bundang Hospital (aged between 17 and 64, mean duration of follow-up = 875.65 days). Using the bipolar disorder registry, thyroid function data were analyzed to assess the frequency of and the risk factors for SCH in patients managed by lithium (n = 64) or valproic acid (n = 42) for more than 5 months. Results Overall frequencies of SCH were 20.3% (13/64) in the lithium group, 14.3% (6/42) in the valproic acid group, and between the two groups there is no difference (p = 0.43). No differences were observed in the potential risk factors for SCH between the two groups including age, sex, subtype of bipolar disorder, baseline TSH, and concomitant antipsychotic use. In cases with SCH, thyroid-stimulating hormone (TSH) showed a tendency to increase at 3 month after the initiation of lithium or valproic acid. A gradual increase in the number of patients showing SCH was found within the first 3 years of medication. Conclusions With regular monitoring and careful assessment, there was no difference in the risk of SCH between lithium and valproic acid maintenance. The risk of mood stabilizer-associated SCH may gradually increase within 3 years following the commencement of medication, thereby mandating close monitoring for the first 3 years of treatment. Further studies with large sample size would be needed to confirm these findings.
Journal of the korean academy of Pediatric Dentistry
/
v.38
no.4
/
pp.413-420
/
2011
Garre's osteomyelitis is associated with bacterial infection and bone necrosis resulting from obstruction of blood supply. The most common cause for Garre's osteomyelitis is odontogenic infection that originates from periodontal tissue or dental pulp. Subperiosteal abscess may also cause Garre's osteomyelitis in the progress of the infection. Mandible is more often affected than maxilla, most commonly in the permanent first molar region of mandible. Clinically, it results in a hard swelling over the jaw, producing facial asymmetry. Meanwhile, radiograph shows a characteristic feature of irregular pulpal cavity, showing new periosteal proliferation located in successive layers to the condensed cortical bone on stimulated site. The treatment method for Garre's osteomyelitis are removal of the infection source, root canal treatment, antibiotic medication, and incision and drainage. This report presents a case of Garre's osteomyelitis under 15 years old. The patient was successfully treated by antibiotic medication accompanied with root canal treatment. Since the symptom of pediatric patients is less severe than adult, careful diagnosis with history taking and clinical examination is necessary. Furthermore long-term follow-up examination is needed to prevent recurrence even after the symptom disapears.
Seo, Min-Su;Kim, Hyun-Chul;Choo, Won-Jung;Jeong, Sang-Yun;Kim, Se-Jeong;Choi, Jeong-Uk;Choi, Yo-Seob;Yoo, Yung-Ki
The Journal of Churna Manual Medicine for Spine and Nerves
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v.8
no.2
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pp.67-78
/
2013
Objectives : The present study examines the domestic trend of Osteoporosis studies in Korea. Method : We reviewed oriental medicine papers published in last ten years (2003-2012). Korean literature search was used for domestic Internet search portal. 'Naver specialized information retrieval', 'Korea Traditional Knowledge Portal', 'Korea Medical Information Portal (OASIS)',' Scientific and Technological Information Integration Services (NDSL)',' Academic Research Information Service (RISS)'as the primary destination of the search were. Since 2003 until 2012, the thesis o'f osteoporosis'and found 92 papers with the search term '(golwi)' to the search terms found in 3 papers Korean medical target of on going research trends in osteoporosis about investigated. Results : 1. We researched 95 papers in 15 journals and patterns of study were as follows : experimental studies were 79(83%), clinical studies were 12(13%), reviewed studies were 3(3%) and etc. were 1(1%). 2. The experimental studies(79) were divided into papers on efficiency testing of herbal medications(67) and herbal acupuncture(12). 3. The clinical studies(12) showed that research has been carried out in the fields of follow up surveys for the herbal medication efficiency testing, basic research, case report, the relativity of osteoporosis to age and sex, and the perception about osteoporosis and korean medicine treatment. 4. The reviewed studies showed that research has been carried out in the fields of osteoporosis about acient literature and domestic studies about herbal medication of osteoporosis. Conclusion : Reviewing the domestic trend of Osteoporosis studies and examining the strong and weak points of those treatments are essential for the future studies. It is anticipated that this review benefits the future in-depth study on the treatments for osteoporosis in Korean medicine.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.46
no.3
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pp.191-196
/
2020
Objectives: Beyond the original application approved by the U.S. Food and Drug Administration, recombinant human bone morphogenetic protein-2 (rhBMP-2) is used for medication-related osteonecrosis of the jaw (MRONJ) treatment because of its bone remodeling enhancement properties. The purpose of the study was to investigate the bone formation effect of rhBMP-2/absorbable collagen sponge (ACS) in patients with MRONJ. Materials and Methods: In this retrospective cohort study, 26 female patients diagnosed with MRONJ and who underwent mandibular sequestrectomy at Ajou University Dental Hospital from 2010 to 2018 were included. The experimental group was composed of 18 patients who received rhBMP-2/ACS after sequestrectomy, while the control group was composed of 8 patients who did not receive rhBMP-2/ACS after sequestrectomy. A total dose of 0.5 mg of rhBMP-2 was used in the experimental group at a concentration of 0.5 mg/mL. Follow-up panoramic X-rays were taken immediately after the surgery and more than 6 months after the surgery. Using those X-rays, a radiographic index of bone defect area was calculated using the modified Ihan Hren method, which measures radiographic density of the normal bone and the defect site. Results: This study suggests that rhBMP-2 contributes to new bone formation. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the experimental group was 68.4% and 79.8%, respectively. The mean radiographic index immediately after surgery and more than 6 months after the surgery for the control group was 73.4% and 76.7%, respectively (Wilcoxon signed rank test, P>0.05). The mean radiographic index increased 11.4% in the experimental group and 3.27% in the control group (Mann-Whitney U-test, P<0.05). Conclusion: Based on the results, use of rhBMP-2/ACS on bone defect sites after sequestrectomy could be a successful strategy for treatment of MRONJ patients.
Kim, Hwa-Jung;Lee, Seung-Mi;Choi, Nam-Kyong;Kim, Seon-Ha;Song, Hong-Ji;Cho, Young-Kyun;Park, Byung-Joo
Journal of Preventive Medicine and Public Health
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v.39
no.2
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pp.123-129
/
2006
Objectives : The incidence of colorectal cancer increased greatly among the elderly in Korea, but the relationship between smoking and colon cancer remains controversial. Few studies have targeted Asian elderly people. We analyzed the smoking status, the amount smoked, and the smoking duration as risk factors of colorectal cancer to determine their association and causality. Methods: The cohort members (n=14, 103) consisted of 4,694 males and 9,409 females, and they were derived from the Korea Elderly Phamacepidemilogic Cohort (KEPEC), which was a population-based dynamic cohort. They were aged 65 years or more and they lived in Busan Metropolitan City between from 1993-1998; they were beneficiaries of the Korean Medical Insurance Corporation (KMIC). The baseline information was surveyed by a self-administered mailed questionnaire; after 8.7 person-years of mean follow up period, 100 cases of colorectal cancer occurred. The adjusted relative ratio (aRR) of smoking status, the smoking amount and the smoking duration were calculated from the Cox's proportional hazard model with the never-smokers as a reference group and the Cox model controlled for age, gender, precancerous lesions of CRC, medication history of NSAIDs & antibiotics, the alcohol drinking status and BMI. Results : Compared with the never smokers, the aRRs were 2.03 (95% CI=1.02-4.03) and 1.36 (95% CI=0.80-2.32) for the ex-smokers and current smokers, respectively. Statistical significant trends were not observed for the dose-relationship among the elderly, either for the mean daily amount smoked (p for trend=0.28) or for the total amount (p for trend=0.15). Still, the aRRs were 1.51 (95% CI=0.97-2.34) for the elderly who smoked less than 40 years and 2.35 (95% CI=1.16-4.74) for the elderly who had 40 years or more of smoking (p for trend=0.06). Smokers who started smoking before the age 20 had an increased aRR of 2.15 (95% CI=1.17-3.93) compared to the never smokers. Conclusions : After controlling for age, gender, precancerous lesion of CRC, medication history of NSAIDs & antibiotics, the alcohol drinking status and BMI, smoking increases the risk of colorectal cancer among elderly people. The age when starting smoking is also important.
An, Sung-Hu;Jeong, Yeong-jin;Kim, Jong-gyu;Shin, Hyeryung;Kwon, Young-Dal
Journal of Korean Medicine Rehabilitation
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v.31
no.4
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pp.157-166
/
2021
Objectives This study is designed to evaluate the safety of Bojungikgi-tang soft extract in healthy male volunteers. Methods 12 healthy male volunteers were recruited and this study was carried out by a single center. Laboratory test results, vital signs of the volunteers were collected to evaluate safety. According to registration order, the 12 subjects were allocated by serial number. To evaluate safety, blood samples were taken and vital signs were checked 4 times - screening, pre administration, post administration and follow up-during the whole trial. The difference between pre (before medication [0 hr]) and post-administration (after medication [48 hr]) variables was summarized as mean±standard deviation. The normality test was performed using the Kolmogorov-Smirnov test and Shapiro-Wilk test. When the normality is satisfied, the paired t-test is applied. Otherwise, the non-parametric method, Wilcoxon signed rank test is applied. The significance level was p<0.05. The incidence of all adverse effects are shown in percentage. Results In the case of red blood cell, hemoglobin, hematocrit, lymphocytes, neutrophils, protein, γ-glutamyl transpeptidase values, the normality test result of the variable for the difference value before and after the dosing has a significance level <0.05. But most of values did not deviate from the normal range, and the deviation from the normal range could not be regarded as the significance associated with this clinical trial. And adverse event wasn't observed associated with the clinical trial drug. Conclusions Bojungikgi-tang soft extract were considered to be safe for healthy male volunteers.
Lee, Hwa Young;Kang, Hyeon Hui;Kang, Ji Young;Kim, Sung Kyoung;Lee, Su Hyun;Chung, Yoon Yung;Kang, Hye Seon;Kwon, Hee Sun;Moon, Hwa Sik;Lee, Sang Haak
Tuberculosis and Respiratory Diseases
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v.73
no.5
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pp.278-281
/
2012
A 47-year old man visited our hospital because of purulent sputum for 3 months. Chest X-ray showed destruction of both the upper lungs, and bronchoscopy revealed inflammatory change with whitish plaque on the left main bronchus through upper division of the left upper lobe. Tracheobronchial aspergillosis (TBA) was finally diagnosed as a result of histologic and microbiologic examination. However, he went abroad without medication before the diagnosis was made and visited again 10 months later. Follow-up bronchoscopy showed complete regression of the previously noted endobronchial lesion. We describe this case to consider the role of antifungal treatment in immunocompetent hosts, as well as to discuss a rare condition; TBA resolved spontaneously.
Moon, Sungji;Lee, Hae-Young;Jang, Jieun;Park, Sue K.
Journal of Preventive Medicine and Public Health
/
v.53
no.6
/
pp.476-486
/
2020
Objectives: The objective of this study was to estimate the risk of lung cancer in relation to angiotensin II receptor blocker (ARB) use among patients with hypertension from the Korean National Health Insurance Service-National Health Screening Cohort. Methods: We conducted a retrospective cohort study of patients with hypertension who started to take antihypertensive medications and had a treatment period of at least 6 months. We calculated the weighted hazard ratios (HRs) and their 95% confidence intervals (CIs) of lung cancer associated with ARB use compared with calcium channel blocker (CCB) use using inverse probability treatment weighting. Results: Among a total of 60 469 subjects with a median follow-up time of 7.8 years, 476 cases of lung cancer were identified. ARB use had a protective effect on lung cancer compared with CCB use (HR, 0.75; 95% CI, 0.59 to 0.96). Consistent findings were found in analyses considering patients who changed or discontinued their medication (HR, 0.50; 95% CI, 0.32 to 0.77), as well as for women (HR, 0.56; 95% CI, 0.34 to 0.93), patients without chronic obstructive pulmonary disease (HR, 0.75; 95% CI, 0.56 to 1.00), never-smokers (HR, 0.64; 95% CI, 0.42 to 0.99), and non-drinkers (HR, 0.69; 95% CI, 0.49 to 0.97). In analyses with different comparison antihypertensive medications, the overall protective effects of ARBs on lung cancer risk remained consistent. Conclusions: The results of the present study suggest that ARBs could decrease the risk of lung cancer. More evidence is needed to establish the causal effect of ARBs on the incidence of lung cancer.
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