• Title/Summary/Keyword: Multiple Chronic Conditions

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Pelvic Actinomycosis Mimicking Malignancy of the Uterus: a Case Report

  • Shin, Dahye;Hwang, Jiyoung;Hong, Seong Sook;Lee, Eun Ji;Kim, Yon Hee
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.2
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    • pp.136-141
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    • 2019
  • Pelvic actinomycosis is an uncommon infectious disease. It induces a chronic, suppurative illness characterized by an infiltrative and granulomatous response and, thus, the clinical and radiologic findings may mimic other inflammatory and neoplastic conditions. A 56-year-old female with a long-standing intrauterine device was diagnosed with pelvic actinomycosis manifesting as a large uterine mass with locally infiltrative spread into surrounding tissue that mimicked uterine malignancy. Actinomyces israelii infection was confirmed with a surgical specimen, and the patient was treated with antibiotic medication. Pelvic actinomycosis must be included in the differential diagnoses of patients with an infiltrative pelvic mass extending across tissue planes or in patients with findings of multiple microabscesses, particularly in a patient with an intrauterine device, even the lesion primarily involves the uterus.

A Review of Burning Mouth Disorders (구강작열감질환에 관한 고찰 및 의료분쟁 증례보고)

  • Hur, Yun-Kyung;Jung, Jae-Kwang;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.48 no.9
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    • pp.688-695
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    • 2010
  • Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

Differences in the burden of disease of the elderly by socioeconomic status (노인의 사회계층간 질병부담격차)

  • Lee, Chae-Eun;Kwon, Soon-Man
    • Health Policy and Management
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    • v.18 no.4
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    • pp.1-22
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    • 2008
  • Burden of disease analysis provides a unique perspective on health by integrating fatal and non-fatal outcomes, yet allows the outcome of two classes to be examined separately. Although many studies have shown the inequality in health outcomes across socioeconomic status (SES), an analysis and comparison of Disability Adjusted Life Year (DALY) between different socioeconomic groups has been rare. This paper calculates the DALY and analyzes the distribution of DALYs for different SES. This study draws from 3,278 cases from the survey on "The Livelihood and Welfare Needs of the Elderly (2004)". It first provides a comprehensive assessment of the burden of 10 chronic diseases of the elderly based on DALY. Then this paper analyzes inequalities in the burden of disease by the levels of SES such as education, income, family size, occupation, and subjective economic conditions. For the elderly, the burden of disease is the highest for hypertension, arthritis and cancer. DALY rate per 1,000 people for the most socio-economically disadvantaged group is expressed as a multiple of the standardized rate for the least disadvantaged group (Rate Ratios). Family size is strongly related to. the difference in the burden of disease between SES groups, and the elderly Who live alone have higher DALY rate than those who live with their family. Other significant variables related to SES groups include subjective economic conditions, occupation, elderly income, and household income.

Imaging Features of Various Benign and Malignant Tumors and Tumorlike Conditions of the Pleura: A Pictorial Review (흉막의 여러 가지 양성 및 악성 종양 혹은 종양 같은 질환들의 영상 소견: 임상 화보)

  • June Young Bae;Yookyung Kim;Hyun Ji Kang;Hyeyoung Kwon;Sung Shine Shim
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1109-1120
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    • 2020
  • Pleural masses may be caused by various conditions, including benign and malignant neoplasms and non-neoplastic tumorlike conditions. Primary pleural neoplasms include solitary fibrous tumor, malignant mesothelioma, and primary pleural non-Hodgkin's lymphoma. Metastatic disease is the most common neoplasm of the pleura and may uncommonly occur in patients with hematologic malignancy, including lymphoma, leukemia, and multiple myeloma. Pleural effusion is usually associated with pleural malignancy. Rarely, pleural malignancy may arise from chronic empyema, and the most common cell type is non-Hodgkin's lymphoma (pyothorax-associated lymphoma). Non-neoplastic pleural masses may be observed in several benign conditions, including tuberculosis, pleural plaques caused by asbestos exposure, and pleural loose body. Herein, we present a review of benign and malignant pleural neoplasms and tumorlike conditions with illustrations of their computed tomographic images.

Hepatitis C Virus - Proteins, Diagnosis, Treatment and New Approaches for Vaccine Development

  • Keyvani, Hossein;Fazlalipour, Mehdi;Monavari, Seyed Hamid Reza;Mollaie, Hamid Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.5917-5935
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    • 2012
  • Background: Hepatitis C virus (HCV) causes acute and chronic human hepatitis infection and as such is an important global health problem. The virus was discovered in the USA in 1989 and it is now known that three to four million people are infected every year, WHO estimating that 3 percent of the 7 billion people worldwide being chronically infected. Humans are the natural hosts of HCV and this virus can eventually lead to permanent liver damage and carcinoma. HCV is a member of the Flaviviridae family and Hepacivirus genus. The diameter of the virus is about 50-60 nm and the virion contains a single-stranded positive RNA approximately 10,000 nucleotides in length and consisting of one ORF which is encapsulated by an external lipid envelope and icosahedral capsid. HCV is a heterogeneous virus, classified into 6 genotypes and more than 50 subtypes. Because of the genome variability, nucleotide sequences of genotypes differ by approximately 31-34%, and by 20-23% among subtypes. Quasi-species of mixed virus populations provide a survival advantage for the virus to create multiple variant genomes and a high rate of generation of variants to allow rapid selection of mutants for new environmental conditions. Direct contact with infected blood and blood products, sexual relationships and availability of injectable drugs have had remarkable effects on HCV epidemiology. Hundreds of thousands of people die each year from hepatitis and liver cancer caused by HCV virus infection. Approximately 80% of patients with acute hepatitis C progress into a chronic disease state leading to serious hepatic disorders, 10-20% of which develop chronic liver cirrhosis and hepatocellular carcinoma. The incubation period of HCV is 6-8 weeks and the infection is often asymptomatic so it is very hard to detect at early stages, making early treatment very difficult. Therefore, hepatitis C is called a "silent disease". Neutralizing antibodies are produced against several HCV proteins during infection but the virus mutates to escape from antibodies. Some patients with chronic hepatitis C may have some symptoms such as fatigue, muscle aches, nausea and pain. Autoimmune and immunecomplex-mediated diseases have also been reported with chronic HCV infection.

Is Nonstandard Employment Hazardous to Workers' Health Status? A Focus on Special Employment in South Korea

  • Park, Bohyun;Elizabeth, Tarlov;Park, Chang Gi
    • Research in Community and Public Health Nursing
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    • v.31 no.spc
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    • pp.525-533
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    • 2020
  • Purpose: Workers in special employment relationship (WSERs) are workers in nonstandard employment arrangements who lack worker protection accorded in standard employment arrangements. This study aimed to describe self-rated health (SRH) and depressive symptoms (DS) among Korean WSERs in comparison to regular wage workers (RWW) and identify associations between working conditions and those outcomes. Methods: In this study, secondary data analysis using the 5th Korean Working Conditions Survey was used. The sample totaled 29,120, including 1,538 WSERs and 27,564 RWWs. Sociodemographic and work-related characteristics were employed as explanatory variables and SRH and DS as dependent variables. Using multiple logistic regression, the determinants of fair/poor SRH and DS were identified. Results: The prevalence rates for fair/poor SRH and DS in WSERs were 25.2% and 28.3%, respectively, and 20.7% and 25.0% in RWWs, respectively. Compared to RWWs, WSERs had 31% (aOR=1.31, 95% CI=1.14~1.49) and 20% (aOR=1.20, 95% CI=1.06~1.36) higher odds of SRH and DS, respectively. Some factors, such as a lack of rest guarantee and sickness presenteeism, had a larger influence in the WSER than in the RWW group. Conclusion: Compared to RWWs, WSERs reported having poorer working conditions and were more likely to report poor general and mental health. Therefore, in Korea, public health policymakers should consider measures to protect the working conditions and health of WSERs, a growing segment of the working population. The study produced new epidemiological evidence regarding the relationships between employment arrangements and health.

Wearable Intelligent Systems for E-Health

  • Poon, Carmen C.Y.;Liu, Qing;Gao, Hui;Lin, Wan-Hua;Zhang, Yuan-Ting
    • Journal of Computing Science and Engineering
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    • v.5 no.3
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    • pp.246-256
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    • 2011
  • Due to the increasingly aging population, there is a rising demand for assistive living technologies for the elderly to ensure their health and well-being. The elderly are mostly chronic patients who require frequent check-ups of multiple vital signs, some of which (e.g., blood pressure and blood glucose) vary greatly according to the daily activities that the elderly are involved in. Therefore, the development of novel wearable intelligent systems to effectively monitor the vital signs continuously over a 24 hour period is in some cases crucial for understanding the progression of chronic symptoms in the elderly. In this paper, recent development of Wearable Intelligent Systems for e-Health (WISEs) is reviewed, including breakthrough technologies and technical challenges that remain to be solved. A novel application of wearable technologies for transient cardiovascular monitoring during water drinking is also reported. In particular, our latest results found that heart rate increased by 9 bpm (P < 0.001) and pulse transit time was reduced by 5 ms (P < 0.001), indicating a possible rise in blood pressure, during swallowing. In addition to monitoring physiological conditions during daily activities, it is anticipated that WISEs will have a number of other potentially viable applications, including the real-time risk prediction of sudden cardiovascular events and deaths.

C-arm Guided Surgical Excision of Heterotopic Calcification (방사선 영상장치 모니터링하 이소성 석회화 절제술)

  • Choi, Hwan-Jun;Choi, Yim-Don;Park, Nae-Kyeong;Kim, Yong-Bae
    • Archives of Plastic Surgery
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    • v.38 no.2
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    • pp.194-198
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    • 2011
  • Purpose: Heterotopic calcification is the abnormal deposition of calcium salts in tissues other than bone and enamel, and it occurs in the form of dystrophic calcification or metastatic calcification. This deposition can occur under many conditions, but in some rare cases, it may develop in burns and nonhealed scars. It is difficult to treat the combination of heterotopic calcification and ulceration in scar tissues by using conservative therapy and to determine the margin of excision in such cases. Our study proposes the use of intraoperative C-arm-guided mapping of lesions with heterotopic calcification, and adequate excision of ulcers in chronic scars where heterotopic calcification is also observed. Methods: This study included 2 patients and was conducted from January 2010 to July 2010. The first patient was a 63-year-old woman who presented with atypical calcium deposits and chronic ulceration in the lower one-third region of the right leg. The second patient was a 38-year-old man who presented with a nonhealing ulcer that had developed on the right leg 3 months earlier he had a history of 40% scalding burns on the entire body. Surgery is the most reliable method for treating heterotopic calcification therefore, both patients were treated using intraoperative C-arm-guided marginal mapping of heterotopic calcification, followed by release of contracture, and eventually split-thickness skin grafting. Results: Plain radiographs of the leg showed spotty radiopaque areas in the hard part of the scar well superficial to the underlying bones. Histopathological analysis revealed multiple foci of calcified deposits, increased fibrosis, and inflammation in the scar tissue. Surgery-related complications were not observed. Conclusion: C-arm guided excision of calcified scars and the release of contracture can cure nonhealing ulcers and may therefore prevent recalcification.

A Study of Psychological Factors on the Quality of Life in the Elderly with Chronic Pain (만성통증 노인의 삶의 질에 대한 심리적 영향요인에 관한 연구)

  • Lee, Suin;Lee, Eun-ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.10
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    • pp.209-217
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    • 2019
  • This is a descriptive research study undertaken to confirm the relationship between depression, fear-avoidance beliefs, catastrophizing, and the quality of life in the elderly with chronic pain, and how psychological factors affect their quality of life. The subjects were 147 seniors aged 65 years or older, who visited a neuropathy clinic in A city from March 4, 2019 to March 18, 2019. Statistical analysis was achieved by applying t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analyses using the SPSS/WIN 22.0 software. Considering the demographic characteristics of the elderly, quality of life revealed significant differences with respect to age (F=3.464, p<0.001), the presence of the spouse (F=3.464, p<0.001), health condition (t=4.545, p<0.001), and pain degree (F=14.76, p<0.001). Further analysis revealed that factors affecting quality of life in the elderly with chronic pain are depression (${\beta}=-0.25$, p<0.001), pain degree (${\beta}=0.25$, p<0.001), catastrophizing (${\beta}=-0.28,$p<0.001) and health condition $({\beta}=-0.19$, p<0.001), with a total explanation power of 49%. Hence, researches on the negative psychological factors, such as depression and catastrophizing, are required to improve the quality of life for the elderly. In addition, the development of a systematic nursing arbitration program is necessary to positively recognize active pain control and health conditions.

Doctor's Failure to Provide Effective Treatments for Smokers and the Legal Responsibility of Medical Malpractice (의사의 금연 건강지도의무와 의료과오책임)

  • Kim, Un-Mook
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.231-267
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    • 2008
  • Tobacco has become the world's leading cause of deaths and diseases. And !be tobacco use and dependence itself is a kind of diseases, so-called "mental and be-havioural disorders due to use of tobacco" in "International Statistical Classification of Diseases and Related Health Problems(ICD-10)" and "Korean Standard Classification of Diseases". The tobacco use and dependence is a chronic disease that requires repeated clinical interventions and multiple attempts to quit. But effective treatments to the tobacco use and dependence are developed and exist that can significantly increase the rate of long-tenn smoking abstinence. So the physicians should warn smoking patients about the dangers of smoking to the health and the life, and the clinicians ought to provide one of more of the treatments which have been proven effective in helping smokers quit to smoke. It has been concluded that if a doctor failed to provide effective treatment for smokers, and the smokers subsequently died of the smokers-related conditions(tobaccosis) or became incapacitated by the tobaccosis the smokers were considered in the medical malpractice. Thus the smokers could sue the physician for medical malpractice, claiming that the doctor's legal responsibility of appropriate treatments including smoking-cessation which the physician deliberately or negligently breached.

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