• 제목/요약/키워드: Total Symptom Score

검색결과 308건 처리시간 0.029초

만성폐쇄성폐질환자에서 질병 중증도 및 삶의 질을 비롯한 사회적 요인과 호흡곤란과의 관계 (Relationship between Dyspnea and Disease Severity, Quality of Life, and Social Factor in Patients with Chronic Obstructive Pulmonary Disease)

  • 김은진;박재형;윤석진;이승준;차승익;박재용;정태훈;김창호
    • Tuberculosis and Respiratory Diseases
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    • 제60권4호
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    • pp.397-403
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    • 2006
  • 연구배경: 만성폐쇄성폐질환은 질병의 중증도를 추정 정상치에 대한 $FEV_1$의 백분율을 기준으로 분류해 왔다. 그러나, 같은 폐기능 검사소견을 보이는 환자들 사이에서도 환자가 느끼는 주관적 호흡곤란에는 차이가 있다. 본 연구에서는 호흡곤란이 $FEV_1$를 비롯하여, 건강관련 삶의 질, 주변으로부터 받는 도움의 정도, 직업 등에 영향을 받는지에 대해 알아보고자 하였다. 방법: 2002년 6월부터 2004년 5월까지 경북대학교병원 호흡기 내과에서 만성폐쇄성폐질환으로 추적관찰 중이며, 임상적으로 안정되어 있고 비가역적인 폐쇄성 폐기능 장애를 가진 환자 36명을 대상으로 하였다. 만성 폐쇄성 폐질환의 병기는, GOLD 병기를 따랐으며, 호흡곤란 척도는 MRC 호흡곤란 척도를 사용하였다. 건강 관련 삶의 질은 한국어 St. Goerge's respiratory questionnaire(SGRQ)를 사용하였다. 결과: 환자들의 평균 $FEV_1$은 추정 정상치의 32.0%였다. GOLD 병기와 호흡곤란 정도사이에 유의한 상관관계는 없었다(p=0.114). 호흡곤란이 심할수록 SGRQ 값의 증상(symptom)(p=0.041), 활동력(activity)(p=0.004), 영향력(impact)(p=0.001), 총점(total)(p<0.001) 수치 모두에서 의미있게 높은 수치를 보였다. 호흡곤란 정도와 직업간에 의미있는 상관관계는 없었으며(p=0.259), 호흡곤란이 심할수록 환자가 주변으로부터 받는 도움 정도는 적다고 느끼는 상관관계가 뚜렷하였다(p=0.011). 결론: 만성폐쇄성폐질환자의 진료에서 환자가 느끼는 주관적인 호흡곤란은 $FEV_1$에 따른 병기 외에도 건강관련 삶의 질 및 주변의 지지 정도와 더 연관성을 가질 수 있다는 점이 고려되어야 할 것으로 사료된다.

기능성 소화불량 한의 변증 표준화를 위한 이중탕, 평위산 및 시호소간탕 투여 : 무작위 배정, 평가자 눈가림, 3군 비교, 평행 설계, 공개, 다기관 임상시험 프로토콜 (Administration of Yijung-tang, Pyeongwi-san, and Shihosogan-tang for Standardization of Korean Medicine Pattern Identification for Functional Dyspepsia: A Study Protocol of a Randomized, Assessor-blind, 3-Arm, Parallel, Open-label, Multicenter Clinical Trial)

  • 이보람;조민진;최영은;권오진;임미영;고석재;김소연;김용주;남동현;최동준;이준환;박재우;김호준
    • 대한한방내과학회지
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    • 제43권6호
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    • pp.1105-1121
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    • 2022
  • Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

일부 제조업 남성근로자들의 직무스트레스 및 사회적 지지와 우울과의 관련성 (The Association of Job Stress and Social Support with Depressive Symptoms among Manufacturing Male Workers)

  • 박승경;이후연;조영채
    • 한국산학기술학회논문지
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    • 제19권5호
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    • pp.216-224
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    • 2018
  • 본 연구는 제조업 사업장 남성 근로자들의 우울수준을 알아보고 직무스트레스 내용(직무의 요구도, 직무의 자율성) 및 직장의 사회적지지(상사의 지지도, 동료의 지지도)와 우울과의 관련성을 검토하는 것을 목적으로 하였다. 조사대상은 제조업 사업장 남성 근로자 428명으로 하였으며, 2017년 7월 1일부터 8월 31일까지의 기간 동안에 구조화된 무기명 자기기입식 설문지를 사용하여 설문조사하였다. 연구결과, 전체 조사대상자 중 우울경향이 있는 자(CES-D 점수 16점 이상)는 21.5% 이었다. 조사대상자의 직무스트레스 내용별 CES-D 점수는 업무의 요구도가 낮은 군보다 높은 군에서, 업무의 자율성이 높은 군보다 낮은 군에서 유의하게 높았으며, 직장의 사회적지지도별 CES-D 점수는 상사의 지지도가 높은 군보다 낮은 군에서, 동료의 지지도가 높은 군보다 낮은 군에서 유의하게 높았다. CES-D 점수는 업무의 요구도와 유의한 양의 상관관계를 보인 반면, 업무의 자율성, 상사의 지지도, 동료의 지지도와는 유의한 음의 상관관계를 보였다. 위계적 다중회귀분석 결과, 업무 요구도가 높을수록, 업무의 자율성이 낮을수록, 상사와 동료의 지지도가 낮을수록 CES-D 점수가 높은 것으로 나타났으며, CES-D 점수에 대한 설명력은 업무 요구도와 업무의 자율성이 추가됨에 따라 18.4% 유의하게 증가되었고, 상사의 지지도와 동료의 지지도가 추기됨에 따라 14.1%의 설명력이 증가되었다. 위와 같은 결과는 업무의 요구도와 업무의 자율성 및 상사와 동료의 지지도가 우울수준과 높은 관련성이 있음을 시사한다.

Single Centre Experience on Decision Making for Mechanical Thrombectomy Based on Single-Phase CT Angiography by Including NCCT and Maximum Intensity Projection Images - A Comparison with Magnetic Resonance Imaging after Non-Contrast CT

  • Kim, Myeong Soo;Kim, Gi Sung
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.188-201
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    • 2020
  • Objective : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including noncontrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; <0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

A Randomized Comparative Study of Blind versus Ultrasound Guided Glenohumeral Joint Injection of Corticosteroids for Treatment of Shoulder Stiffness

  • Lee, Hyo-Jin;Ok, Ji-Hoon;Park, In;Bae, Sung-Ho;Kim, Sung-Eun;Shin, Dong-Jin;Kim, Yang-Soo
    • Clinics in Shoulder and Elbow
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    • 제18권3호
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    • pp.120-127
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    • 2015
  • Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

천연소재 MS-10의 에스트로겐 수용체 조절을 통한 여성건강 증진 (Natural Substance MS-10 Improves Women's Health via Regulation of Estrogen Receptor)

  • 노유헌;이지원;박지애;이상형;이준영;김성수;박광균;김태진;명순철;정윤화
    • 한국식품영양과학회지
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    • 제45권6호
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    • pp.903-910
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    • 2016
  • 엉겅퀴와 타임의 복합추출물인 MS-10이 여성호르몬 수용체를 가역적으로 활성화해 여성갱년기에 감소하는 에스트로겐이 효율적으로 사용될 수 있도록 작용한다는 것이 확인되었다. 12주간의 인체적용시험에서 MS-10은 안면홍조 및 야한증, 감각마비, 수면장애, 신경과민, 우울, 현기증, 피로, 관절 및 근육통, 두통, 가슴 두근거림(심계항진), 그리고 질건조 등의 여성갱년기 증상이 개선되었음이 확인되었다. 이러한 MS-10의 여성갱년기 증상 개선은 MS-10에 의한 insulin-like growth factor-1의 개선에 기인한 것으로 판단된다. MS-10은 여성갱년기 증상을 개선하는 천연소재 건강 기능식품으로 사용될 수 있다.

양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석 (Analysis of High-Resolution Manometry Results in LPRD Patients Who Do Not Response to PPI Medication)

  • 이창희;이현섭;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제23권1호
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    • pp.43-47
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    • 2012
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Materials and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석 (Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication)

  • 이창희;이현섭;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제22권2호
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    • pp.151-155
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    • 2011
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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중극(中極), 신궐(神厥) 뜸요법이 여성의 요실금과 삶의 질에 미치는 효과 (Effect of Moxibustion at Junggeuk(CV3), Singwol(CV8) on Women's Urinary Incontinence and Quality of Life)

  • 이은숙;김이순;이정원;오미정;김경철
    • Korean Journal of Acupuncture
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    • 제30권3호
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    • pp.193-200
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    • 2013
  • Objectives : This study is to examine the effects of moxibustion at Junggeuk(CV3), Singwol(CV8) on women's urinary incontinence and quality of life. The study is a research based on the non-equivalent control group pretest-posttest design. Methods : The subjects of the study were 45 women who were using either of 2 health clinics located in Ulsan. They were sampled in accordance with predetermined standards and then divided into the experimental and control groups, respectively consisting of 22 and 23 members. In treating those women through moxibustion, this researcher applied 2 sheets of 'shingigu' to each of the women on 40 min, per time basis. This experiment was conducted 6 times in total for 2 weeks on every two day basis. Data from all of the measurements were statistically processed and analyzed using SPSS/WIN 12.0. Demographic characteristics of the subjects were examined and indicated in frequency and percentage. The homogeneity test of the two groups was conducted using $x^2$-test, Fisher's exact test, t-test and Mann-Whitney U Test. Hypotheses set for the study were verified through t-test and Mann-Whitney U Test. Results : The experimental group who take moxibustion will be lower in the severeness of urinary incontinence than the control group who do not was supported(p<0.001). 2. The experimental group who take moxibustion will be higher in score for life quality than the control group who do not was supported(U=42.00, p<0.001). Conclusions : These findings suggest that moxibustion can be an effective intervention for women having urinary incontinence because it treats the symptom with no adverse effect and it is non-invasive and easily applicable.

표준화환자가 스마트폰 동영상으로 증상을 보여준 진료문항에 대한 의과대학생들의 반응 (Responses of Medical Students to Using Smartphone Video at Clinical Performance Examination)

  • 조영혜;김민지;염정숙;배화옥;김재범;이근미;고석봉;서지현
    • 의료커뮤니케이션
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    • 제13권2호
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    • pp.217-221
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    • 2018
  • Background: There are practical difficulties to show exact clinical symptoms such as seizure to medical students at Clinical Performance Examination (CPX). We developed a new CPX case of child's seizure on video using smartphone. Methods: A total of 356 $4^{th}-year$ students of five universities in Daegue-Gyeongbuk and Gyeongnam area took the clinical skill examination from June $13^{th}$ to $17^{th}$ in 2016. Among them, 72 students took the new CPX case in June $15^{th}$ and 71 students filled out the questionnaire on whether the new CPX with smartphone video is helpful, authentic, difficult, and necessary for other CPX. All the questions were measured on 5-Likert scale. Results: Mean score of the new CPX was 57.1, lower than the mean scores of the other 11 CPX cases, 62.8. For the question "Smartphone videos helped to solve the problem", 45 students (63.4%) answered 'Very much'. For the question "Is it realistic compared to other questions?" 30 students (42.3%) and 25 students (35.2%) answered 'Very much' and 'Much'. For the question "Is it difficult compared with other questions?" 18 students (25.4%) and 26 students (36.6%) answered 'Very much' and 'Much'. As for the question "I would like to have more tests using smartphone video", 26 students (36.6%) answered 'So and so'. Conclusion: A majority of students responded that video presentation was helpful and authentic to figure out the CPX, whereas they assessed smartphone video was more difficult compared with other CPXs. Further, students were negative toward using smartphone video for the other CPXs.