• Title/Summary/Keyword: Symptom management

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Clinical Finding of MDR Tuberculosis and Frequency of MOTT (다제내성결핵의 임상적 특성과 비결핵항산균증의 빈도)

  • Bae, Mi-Hee;Kim, Hwa-Jung;Kwon, Eun-Soo;Kim, Cheol-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1123-1142
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    • 1998
  • Background : The frequency of MOTT has risen as the prevalence of tuberculosis has been declining. Our country has been also. The most of MOTT was resistant to the major anti-tuberculous drugs. Method : To compare clinical characteristics and frequencies of MDR tuberculosis with MOTT, the author studied 65 patients showing AFB culture positive with sputum. The data were collected from 176 patients who had been admitted at the National Masan Tuberculosis Hospital from May to June, 1997 to April, 1998. Result : The frequency of MDR tuberculosis was 43.1% and that of MOTT was 9.2%. Among 65 isolated mycobacteria, 3 cases were M. intracellulare. 2 cases were M. fortuitum, and 1 case was unidentified MOTT. The most frequent age group in 65 culture positive patients was 4th decade and the mean age was 44. The mean age was 61 in MOTT and 42 in M. tuberculosis and had significant difference(p<0.01). The numbers with past history of treatment were 2.3 in MDR tuberculosis and 1.7 in non-MDR tuberculosis and had significant difference(p<0.05). At the time of admission, the most frequent regimen for the treatment of MDR tuberculosis was 24 months regimen(85.7%) with the 2nd line anti-tuberculosis drugs. For non-MDR tuberculosis, 9 or 12 months regimen (72.9%) with the 1st line anti-tuberculosis drugs and had significant difference (p<0.01). At the time of admission, the symptom of weight loss was shown in 84.7% of M. tuberculosis and 50.0% in MOTT and there was significant difference(p<0.05) between them. All of the MOTT were identified to be resistant against INH and PAS. Drug resistance rates to INH, OFX(p<0.01) and PAS(p<0.05) in MOTT were higher than in MDR. All of three M. intracellulare strains were resistant to INH, RFP, PAS and OFX. All of two M. fortuitum strains were resistant to most anti-tuberculosis drugs. And the other MOTT was resistant to INH, EMB and PAS. Conclusion : MOTT was more common in elderly patients than M. tuberculosis. MOTT cases should be considered to be the probability of multiple drug resistance and treatment failure during the 1st treatment because they showed more resistance to anti-tuberculosis drugs than M. tuberculosis cases. Therefore, there should be more careful investigations for clinical characteristics, natural history of disease, and efficient management for MOTT.

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A Case of Tracheal Hamartoma (기관내 과오종 1예)

  • Yoon, Ho-Il;Lee, Sang-Min;Choi, Seung-Ho;HwangBo, Bin;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Sung, Sook-Hwan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.3
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    • pp.383-388
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    • 1999
  • Background: Tracheal hamartoma is a very rare cause of upper airway obstruction. Its clinical features can mimic medical conditions, such as bronchial asthma, chronic bronchitis, and so on. Case; This report presents the case of a 65 year old man whose major symptom was dyspnea. We found a tumor in his distal tracheal lumen, and the tumor was removed with success using rigid bronchoscope. The tumor was histologically proven to be a hamartoma, and his symptoms were much improved. Conclusion: It is important to distinguish it from other conditions because medical management is often not helpful. Surgical correction-with or without thoracotomy-is inevitable.

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A Case of Primary Pulmonary Hypertension in Pregnancy Presented as Massive Hemoptysis (임신 중 대량객혈로 발현된 원발성 폐고혈압 1예)

  • Kim, Myung Sook;Kim, Hyoung Doo;Kim, Seok Chan;Kwan, Soon Suk;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.66-71
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    • 2004
  • Primary pulmonary hypertension (PPH) is a rare, progressive and incurable disease, which is characterized by an increase in the pulmonary artery pressure without a demonstrable cause. The most common presenting symptom is dyspnea on exertion, with other symptoms comprising of chest pain, syncope and hemoptysis. The diagnosis is one of exclusion of any of the known causes of pulmonary hypertension. When associated with pregnancy, the maternal mortality ranges from 30 to 50%. Because pregnancy and labor are very serious problems for patients with PPH, the available evidence suggests that pregnancy when afflicted with PPH should be avoided. In account the case of a 33-year old patient, reporting with massive hemoptysis, and diagnosed with PPH during her twenty seventh week of gestation, is presented. She was treated with conservative management, including oxygen and a vasodilator, and underwent a pregnancy termination. However, due to aggravation of right heart failure, she presented with severe systemic hypotension and hypoxemia, and eventually died. This case is reported, with brief review of the literature.

NON-SURGICAL TREATMENT WITH TYING OF MUCOCELE (봉합사를 이용한 점액종의 비외과적 처치)

  • Lee, Yong-Seok;Choi, Byung-Jai;Choi, Hyung-Jun;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.29 no.3
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    • pp.413-417
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    • 2002
  • Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.

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Postoperative malocclusion after maxillofacial fracture management: a retrospective case study

  • Kim, Sang-Yun;Choi, Yong-Hoon;Kim, Young-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.27.1-27.8
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    • 2018
  • Purpose: Various complications occur when a maxillofacial fracture is malunionized or improperly resolved. Malocclusion is the most common complication, followed by facial deformity, temporomandibular joint disorder (TMD), and neurological symptoms. The purpose of this study was to evaluate the dental treatment of postoperative complications after maxillofacial fracture. Materials and methods: In this study, nine patients with a postoperative complication after maxillofacial fracture who had been performed the initial operation from other units and were referred to the authors' department had been included. Of the nine patients, six had mandibular fractures, one had maxillary fractures, one had maxillary and mandibular complex fractures, and one had multiple facial fractures. All the patients had tooth fractures, dislocations, displacements, and alveolar bone fractures at the time of trauma, but complications occurred because none of the patients underwent preoperative and postoperative dental treatment. Malocclusion and TMD are the most common complications, followed by dental problems (pulp necrosis, tooth extrusion, osteomyelitis, etc.) due to improper treatment of teeth and alveolar bone injuries. The patients were referred to the department of dentistry to undergo treatment for the complications. One of the nine patients underwent orthognathic surgery for a severe open bite. Another patient underwent bone reconstruction using an iliac bone graft and vestibuloplasty with extensive bone loss. The other patients, who complained of moderate occlusal abnormalities and TMDs such as mouth-opening limitation, underwent occlusal treatment by prosthodontic repair and temporomandibular joint treatment instead of surgery. Results: One patient who underwent orthognathic surgery had complete loss of open bite and TMD after surgery. One patient who underwent reconstruction using an iliac bone graft had a good healing process. Other patients were treated with splint, injection, and physical therapy for mouth-opening limitation and temporomandibular joint pain. After treatment, the TMDs were resolved, but the remaining occlusal abnormalities were resolved with prosthetic restoration. Conclusions: Considering the severity of malocclusion and TMJ symptom and the feasibillity of reoperation, nonsurgical methods such as orthodontic and prosthodontic treatments and splint therapy can be used to manage the dental and TMD complication after the trauma surgery. However, reoperation needs to be strongly considered for severe malocclusion and TMD problem.

A Survey on the voice symptoms and vocal-health service related experience of occupational voice users (직업적 음성사용자의 음성증상 및 '음성건강' 관련 서비스 인지도 조사)

  • Lee, Eun-Jeong
    • Journal of Digital Convergence
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    • v.13 no.1
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    • pp.397-405
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    • 2015
  • This survey was to identify voice symptoms and vocal-health service related experiences of occupational voice users(teachers, telemarketers, speech therapists). The 91.8% of teachers, 97.9% of telemarketers, 86% of speech therapists surveyed reported more than one voice symptom. The symptoms were classified as 9 categories(running a temperature, getting dry, dry and cough, pain, phlegm, tingled, hoarseness, cracks, swollen) and the most frequently reported from 3 groups was 'getting dry'. The 85.7% of teachers, 87.8% of telemarketers, 66% of therapists surveyed had no experience of vocal-health related services. The 19.6%, 19.9%, and 72% of each group reported they have heard both of 'voice/speech therapist'. The 36.8% of teachers and 43.6% of telemarketers answered they don't know how to use their voice efficiently and 45.3% of the teachers, 43.6% of the telemarketers, 28% of the therapists surveyed asked professional help for their voice. The result showed that most of the occupational voice users surveyed experienced voice symptoms but rarely knew professional vocal-health related services.

Analysis of Occurrence Type of Physiological Disorder to Soil Chemical Components in Ginseng Cultivated Field (인삼 재배지의 토양 화학성에 따른 생리장해 유형 분석)

  • Hyun, Dong-Yun;Yeon, Byeong-Yeol;Lee, Seong-Woo;Kang, Seung-Weon;Hyeon, Geun-Soo;Kim, Young-Cheol;Lee, Kwang-Won;Kim, Seong-Min
    • Korean Journal of Medicinal Crop Science
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    • v.17 no.6
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    • pp.439-444
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    • 2009
  • This study was to set the guidelines of soil chemical components in order to assure the safety and quality of the panax ginseng from physiological disorder. The disorder symptoms appeared on the leaf with yellow spot, atrophy, yellow-brown spot, also showed red skin and rough skin of the root. Occurrence type of physiological disorder in cultivated field divided into two types : type I 'such as, yellow spot' consist of single disorder symptom; type II 'such as, yellow spot and yellow-brown spot' consist of two or more different disorder symptoms. The individual contribution of soil properties to the occurrence type was as follows ; The yellow spot was affected by Na > $NO_3$-N > salinity (EC) in soil. The same results was observed in red skin. Atrophy was affected by $NO_3$-N > salinity (EC) > Ca > Mg. Rough skin was affected by $P_2O_5$>pH>Organic material > K. It showed positive associated to $P_2O_5$, pH and K, but negative associated to organic matter. Simultaneous occurrence of two different disorder, including cases which yellow spot and yellow-brown spot, those were affected by $NO_3$-N > salinity (EC) > Na > Mg. In the case of atrophy plus yellow-brown spot, those also were affected by in the order : $NO_3$-N > salinity (EC) > Ca > Mg > Na. Red-rough skin was affected in the order : salinity (EC) > $NO_3$-N > K > Na. Soil chemical components appear to be related to occurrence of physiological disorder, particularly in salinity (EC) and $NO_3$-N. The salinity (EC) and $NO_3$-N were negative related to plant growth. In addition, exchangeable cation capacity play critical roles in attributing to complex occurrence of physiological disorder.

Oxaliplatin-induced Peripheral Neuropathy in Patients with Advanced or Metastatic Gastric Cancer (진행성 또는 전이성 위암 환자에 있어서 Oxaliplatin 투여로 인한 말초신경통증 분석)

  • Park, Ae-Ryoung;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.18-22
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    • 2009
  • Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

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Human Health Factors and Traffic Accidents among Taxi Drivers in the Seoul Area (서울지역에 있어서 직업운전자의 건강상태가 교통사고에 미치는 영향)

  • Kim, Ihm-Soon;Lee, Kyung-Jong;Roh, Jae-Hoon;Moon, Young-Hahn
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.3 s.27
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    • pp.313-322
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    • 1989
  • The present status of the traffic accident rate in Korea shows that it is the highest in the world with a continuously increasing trend. Human factors account for 90% of the causes of traffic accidents. Therefore, the purpose of this study was to determine some human factors related to traffic accidents by studying the relationship between health status and traffic accidents. To accomplish this purpose, all taxi companies located in the Seoul area were divided in three groups according to the number of taxi possessed, then some companies in each ?roup were randomly selected for study, and a total of 222 drivers in those selected companies were questioned and examined from April 15 to April 22, 1989. Seventy drivers among 222 had experienced a traffic accident. A $x^2$-test was performed on the data, then, factor analysis and discrminant analysis were executed with the following results: 1. The drivers complaining of gastroenteric symptoms numbered 110(49.5%), which was the major symptom among all drivers complaining of poor health. 2. In the primary analysis, variables related to traffic accidents were divided into general, occupational, and health characteristics. Drivers having no traffic accident experience and drivers having that experience were subjected to question about age, educational level, residential status, monthly average income, working hours and days, degree of satisfaction with their profession and homelife, degree of worry about health. degree of fatigue, medication, drunken driving, and illness, but there were no statistical significances. 3. In the factor analysis, the 8 health variables which cause traffic accidents were classified into 3 common factors which were perceived health factor, sleeping and drunken driving, and visual acuity and smoking factor. Perceived health was the factor which contributed most to explaining accidents. 4. In the discriminant analysis, a correct prediction rate of 68.0% was obtained in the factors of all the characteristics. 5. Degree of sttisfaction with their homelife and educational and economic factor in the general characteristics, degree of satisfaction with their profession in the occupational characteristics, and sleeping and drunken driving in the health characteristics were selected as statistically significant factors to discriminant the traffic accident. 6. Among the factors of the general, occupational, and health characteristics, degree of satisfaction with their homelife, driving experience, family factor, perceived factor were selected as the statistically significant factors.

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Health Education Needs of Students, Parents and Teachers and the Status of Health Education in Elementary, Middle, and High Schools (초․중․고등학교 학생․학부모․일반교사의 보건교육 영역별 요구도와 보건교육)

  • Yun, Soon-Nyoung;Kim, Young-Im;Choi, Jeong-Myung;Cho, Hee-Soon;Kim, Young-Hee;Park, Young-Nam;Oh, Gyoung-Soon;Lee, Boon-Ok;Cho, Sun-Nyu;Cho, So-Young;Han, Sun-Hee;Ha, Yeong-Mi
    • Journal of the Korean Society of School Health
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    • v.18 no.1
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    • pp.1-14
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    • 2005
  • Purpose: The purpose of this study was to identify the needs of health education in students, their parents and teachers in the elementary, middle and high schools and the current situation of health education class. Method: The subjects of this study were a total of 9450 persons including students, their parents and teachers from 279 schools throughout the country. They were selected through convenient sampling. Data were analyzed through $\chi^2$-test and ANOVA. Result: Students, their parents and teachers replied that 18 dimensions of health education class (DHEC) are necessary. The four DHEC - healthier life style, sex education, mental health and safety education - showed high educational needs in students, their parents, and teachers. High school students had higher educational need of 'symptom management for daily living' than elementary and middle school students. Students, their parents and teachers in elementary school had higher educational needs of 17 DHEC than those in middle and high school. The percentages of schools with health education class taught by health teachers were 99.2%, 75.5% and 66.0% respectively in elementary, middle and high schools. Health education was given mainly using physical education classes at elementary schools, and creative class hours at middle and high schools. In general, health education took 1-3 hours per week at elementary schools, and less than an hour at middle and high schools. Conclusion: Therefore, based on the results, systematic health education class should begin from elementary school to meet the need of health education in students, their parents and teachers, and further study should be made on the number of hours required and the amount of contents of 18 DHEC.