• Title/Summary/Keyword: indicator chronic disease

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The Prediction of Postoperative Pulmonary Complications in the Elderly Patients (고령환자에 있어서 술후 호흡기 합병증의 예측)

  • Suh, Kyong-Duk;Jeong, Yu-Seong;Kam, Bok-Kyoo;Lee, Jong-Myeong;Huh, Dong;Kim, Jin-Do;Lee, Ju-Hong;Koo, Dae-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.321-328
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    • 1997
  • Background : we have evaluated the association of age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases with postoperative pulmonary complications and identified which parameter of preoperative spirometry was a predictor of postoperative pulmonary complications. Method : In 270 patients older than 60 years, the postoperative pulmonary complications were evaluated according to age, smoking, type of anesthesia, type of operation, duration of surgery, previous history of chronic pulmonary diseases and the parameters of preoperative spirometry were analyzed. Results : The postoperative pulmonary complications rates were significant higher among patients older than 70 years, and among those with previous chronic pulmonary diseases or their smoking history. The pulmonary complications were increased among patients with general anesthesia or duration of surgery more than 2 hours. The pulmonary complications rates did not differ according to sex, type of operation. The patients with hypercarbia($PaCO_2$ > 45mmHg) have more increased postoperative complications. The preoperative FEV1 less than $1\;{\ell}$, FVC, MMEFR & MVV less than 50% of predicted respectively were predictive of complications. Conclusion : Age $\geq$ 70, history of smoking,duration of operation more than 2 hours, general anesthesia, previous chronic pulmonary disease and hypercarbia ($\geq$45mmHg) on preoperative arterial blood gas analysis were predictive of pulmonary complications. Among the parameters of spirometry, FEV1, FVC, MMEFR and MVV were indicator of predicting postoperative pulmonary complications.

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Spirometry and Bronchodilator Test

  • Sim, Yun Su;Lee, Ji-Hyun;Lee, Won-Yeon;Suh, Dong In;Oh, Yeon-Mok;Yoon, Jong-seo;Lee, Jin Hwa;Cho, Jae Hwa;Kwon, Cheol Seok;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.105-112
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    • 2017
  • Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.

A Study on the Angle between the Abdominal Aorta and the Superior Mesenteric Artery by 3D Image Reconstruction (3D 영상 재구성을 통한 복부대동맥과 상장간막동맥과의 각도에 관한 연구)

  • Kim, Young-Keun;Choi, Sung-Kwan
    • Journal of radiological science and technology
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    • v.26 no.1
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    • pp.63-70
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    • 2003
  • SMAS(Superior Mesenteric Artery Syndrome) is a disease caused by a chronic obstruction of the duodenum(transverse portion), which is hardly detectable. However, it is known that when the superior mesenteric artery and abdominal aorta form a narrow angle, that the transverse portion of the duodenum is pressed down between the superior mesenteric artery and the abdominal aorta, and that this can lead to obstruction of the duodenum. Measuring this angle is a complicated job using conventional angiography, and results often turns out to be inaccurate. In addition, no attempt has been made to determine the value of this angle in Koreans. In this study, we conducted abdominal CT angiography using MIP(maximum intensity projection) on patients with no clinical evidence of SMAS in order to determine the angle at which the superior mesenteric artery branches from the abdominal aorta by using PC based software(Rapidia ver. 1.2) for the image reconstruction. Accordingly, we found that the mean angle between the abdominal aorta and the superior mesenteric artery was $50.05{\pm}15.87^{\circ}$ on average, and that the angle in men($53.64{\pm}16.57^{\circ}$) is higher than in women($46.46{\pm}14.98^{\circ}$). We hope that the angles determined by our study will serve as an important indicator for detecting SMAS.

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Health Care Access and Utilization among Korean American Adults in Alameda County, California: 1994 and 2002

  • Kim, Young-Bok;Moskowitz, Joel M.;Lee, Hyun-Ju;Kazinets, Yevgeniy
    • Korean Journal of Health Education and Promotion
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    • v.23 no.5
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    • pp.29-46
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    • 2006
  • Purpose: Since 1994, Asian Health Services, the Korean American Community Advisory Board, and the Center for Family and Community Health (University of California at Berkeley) have conducted periodic, population-based surveys on Korean American community health in Alameda County, California. The present study examines changes in health care access and utilization between 1994 and 2002 among Korean American adults in Alameda County, California. Method: We reanalyzed data from the 1994 and 2002 Korean Health Surveys. The primary variables of interest, health care access and utilization, were operationalized in terms of health insurance coverage, routine check-ups, a usual source of health care and reported barriers to health care. The frequency distribution of each indicator was calculated and its standard error was estimated using SUDAAN. The differences between 1994 and 2002 were examined with chi-square test. Results: Compared to 1994, Korean Americans in Alameda County were more likely to have health insurance coverage in 2002 (74.0% vs. 82.7%). Korean Americans in Alameda County were more likely to have received a recent (prior two years) routine health checkup in 2002 (50.4% vs. 57.2%). Health checkups increased over time for males, for adults with more than 12 years of education, and for employed adults. Also, compared to 1994, employed adults were more likely to have a usual source of health care in 2002 (66.5% vs. 78.4%). In both 1994 and 2002, high cost (58.0% vs. 47.8%) was the most commonly cited barrier to health care, and the next most frequently cited barriers were language (29.2% vs. 27.7%) and no time (29.2% vs. 30.3%). Conclusion: To improve health care utilization and health conditions, it is important to investigate factors related to health care and to monitor changing trends. Ongoing surveillance of health-related factors can contribute to the development of health education programs to reduce morbidity and mortality due to chronic disease, and thereby lead to improvements in health status among Korean Americans.

The Effects of Line Dance on Immune function and Inflammation for Elderly Women (라인댄스가 여성노인의 면역기능 및 염증에 미치는 영향)

  • Beak, Soon-Gi;Chi, Dong-Cheol
    • Journal of Industrial Convergence
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    • v.19 no.6
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    • pp.187-195
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    • 2021
  • This study was conducted to identify the characteristics of immune function and inflammatory changes for elderly women, by having them to participate in line dance program. For this purpose, 18 elderly women in their 60s to 70s, living in Y city were selected, and 9 of the participants were randomly assigned to participate in the line dance program for 12-weeks (line dance exercise group), while the other 9 participants were assigned to carry out their daily lives without participating in certain physical activity (control group) for the same period. The subjects' immune function and inflammation were measured using SPSS 24.0 for datafication, and the average and two-way ANOVA analysis were conducted. The result indicates the immunoglobulin, IgA, has increased, but not dramatically. The level of IgG(p<.05), and IgM(p<.05) increase were detected from the line dance exercise group, but not so much from the control group. Inflammation indicator, the CRP(p<.05), were significantly reduced from the line dance exercise group, but not much for the control group. According to the collected data, line dance for the elderly women can be considered as an effective exercise program, and the result shows that inflammation is reduced and immune function is improved. It also implies the needs of active physical activity arbitration to keep the elderly women's health and to prevent the chronic disease in the future.

Utility of the APACHE II score as a neurological prognostic factor for glufosinate-intoxicated patients with alert mental status (의식이 명료한 글루포시네이트 중독환자의 신경학적 예후인자로서 APACHE II의 유용성)

  • Rok Lee;Tae Yong Shin;Hyung Jun Moon;Hyun Jung Lee;Dongkil Jeong;Dongwook Lee;Sun In Hong;Hyun Joon Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.135-142
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    • 2023
  • Purpose: In patients with glufosinate poisoning, severe neurological symptoms may be closely related to a poor prognosis, but their appearance may be delayed. Therefore, this study aimed to determine whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) score could predict the neurological prognosis in patients with glufosinate poisoning who present to the emergency room with alert mental status. Methods: This study was conducted retrospectively through a chart review for patients over 18 years who presented to a single emergency medical center from January 2018 to December 2022 due to glufosinate poisoning. Patients were divided into groups with a good neurological prognosis (Cerebral Performance Category [CPC] Scale 1 or 2) and a poor prognosis (CPC Scale 3, 4, or 5) to identify whether any variables showed significant differences between the two groups. Results: There were 66 patients (67.3%) with good neurological prognoses and 32 (32.8%) with poor prognoses. In the multivariate logistic analysis, the APACHE II score, serum amylase, and co-ingestion of alcohol showed significant results, with odds ratios of 1.387 (95% confidence interval [CI], 1.027-1.844), 1.017 (95% CI, 1.002-1.032), and 0.196 (95% CI, 0.040-0.948), respectively. With an APACHE II score cutoff of 6.5, the AUC was 0.826 (95% CI, 0.746-0.912). The cutoff of serum amylase was 75.5 U/L, with an AUC was 0.761 (95% CI, 0.652-0.844), and the AUC of no co-ingestion with alcohol was 0.629 (95% CI, 0.527-0.722). Conclusion: The APACHE II score could be a useful indicator for predicting the neurological prognosis of patients with glufosinate poisoning who have alert mental status.

Nuclear Factor-κB(NF-κB) Activity and Levels of IL-6, IL-8 and TNF-α in Induced Sputum in the Exacerbation and Recovery of COPD Patients (만성폐쇄성폐질환의 급성악화와 회복기에서 유도객담 내 Nuclear Factor-κB(NF-κB)의 활성도와 IL-6, IL-8 및 TNF-α의 농도 변화)

  • Song, So Hyang;Kim, Chi Hong;Kwon, Soon Seog;Kim, Young Kyoon;Kim, Kwan Hyoung;Moon, Hwa Sik;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.152-159
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    • 2005
  • Background : Exacerbations of chronic obstructive pulmonary disease (COPD) are thought to be associated with increased airway inflammation, and the $NF-{\kappa}B$ is known to be an indicator of cellular activation and of inflammatory mediator production. This study was undertaken to investigate the change of cytokine characteristics and $NF-{\kappa}B$ activity in induced sputum of COPD patients during exacerbation and recovery of the disease. Methods : Sputum induction was performed in 37 patients with COPD during exacerbation and during recovery and in 15 healthy subjects. Cell counts, levels of IL-6, IL-8 and $TNF-{\alpha}$ in induced sputum and NF-kB activity in macrophage of induced sputum were measured. Results : Patients with COPD showed significantly increased levels of IL-6, IL-8 and $TNF-{\alpha}$(p<0.01) and increased $NF-{\kappa}B$ activity in induced sputum(p<0.05) as compared with control subjects. Level of IL-8 during exacerbation of COPD decreased significantly during recovery(p<0.05). $NF-{\kappa}B$ activity and levels of IL-6 and $TNF-{\alpha}$ tended to be decreased during recovery, but not siginificantly. Conclusion : Activation of $NF-{\kappa}B$ and increased levels of IL-6, IL-8 and $TNF-{\alpha}$ were thought to be associated with pathogenesis and exacerbations of COPD.

Synergistic Inhibition of Aronia melanocarpa and Moringa oleifera Seed Extract on Experimental Atopic Dermatitis (아로니아 및 모링가 종자 복합물의 항아토피 상승효과)

  • Ki, Hyeon-Hui;Lee, Ji-Hyun;Moon, Kwang-Hyun;Lee, Jeong-Ho;Kim, Dae-Geun;Jeong, Kyung-Ok;Im, So-Yeon;Lee, Young-Mi;Kim, Dae-Ki
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.3
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    • pp.298-305
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    • 2017
  • Atopic dermatitis is a chronic, relapsing inflammatory skin disease. This study aimed to investigate the therapeutic benefits of Aronia melanocarpa (AM) and Moringa oleifera seed extract (MO) on experimental atopic dermatitis. We examined the effects of AM or MO and their combination on 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis in BALB/c mice as well as tumor necrosis factor $(TNF)-{\alpha}$ and interferon $(IFN)-{\gamma}-stimulated$ HaCaT keratinocytes. Mice were orally treated with extract during repeated application of DNCB to shaved dorsal skin. Our results show that treatment with AM and MO in combination reduced histological manifestations such as epidermal hyperplasia and inflammatory cell infiltration. Furthermore, it significantly decreased skin thickness and serum immunoglobulin E (IgE) level compared to the AM or MO alone treated group. Combined extract of AM and MO suppressed expression of $TNF-{\alpha}/IFN-{\gamma}-induced$ T helper 2 (Th2) chemokines such as thymus and activation-regulated chemokine and macrophage-derived chemokine. To sum up, combination of AM and MO suppressed the inflammatory response and serum IgE as an indicator of several allergic diseases in DNCB-induced experimental atopic dermatitis and Th2 chemokine expression in HaCaT cells. This result suggests that combination of AM and MO could be a valuable strategy to improve atopic dermatitis.

A Study on the Correlation between Lung Ventilation Scan using Technegas and Pulmonary Function Test in Patients with COPD (Technegas를 이용한 폐환기 검사와 폐기능 검사의 상관관계에 관한 고찰)

  • Kim, Sang-Gyu;Kim, Jin-Gu;Baek, Song-EE;Kang, Chun-Koo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.1
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    • pp.45-49
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    • 2019
  • Purpose Lung Ventilation Scan(LVS) images directly inhaled radiation gas to evaluate lung ventilation ability. Therefore, it is influenced by various factors related to inhalation, including number of breaths, respiratory duration, respiration rate, and breathing method. In actual LVS examinations, it is difficult for objectify the patient's ability to inhale, and there is currently no known index related to inhalation. Therefore, this study confirms the correlation between counts per second(cps) in LVS and the results of pulmonary function test(PFT) and evaluate its usefulness as an objective indicator of inhalation. Materials and Methods From October 2010 to September 2018, 36 Chronic Obstructive Pulmonary Disease(COPD) patients who had both LVS and PFT were classified by severity(Mild, Moderate, Severe). LVS was performed by creating Technegas with Vita Medical's Technegas Generator and inhaling it to the patient. LVS images were acquired with Philips's Forte equipment., and PFT used Carefusion's Vmax Encore 22. The correlation between the cps measured by setting the region of interest(ROI) of both lungs on the LVS and the forced vital capacity(FVC), forced expiratory volume in one second($FEV_1$), $FEV_1/FVC$ of the results of PFT was compared and analyzed. Results We analyzed the correlation between cps of LVS using Technegas and the results of PFT by classifying COPD patients according to severity. Correlation coefficient between $FEV_1/FVC$ and cps was Severe -0.773, Moderate -0.750, and Mild -0.437. The Severe and Modulate result values were statistically significant(P<0.05) and Mild was not significant(P=0.155). On the other hand, the correlation coefficient between FVC and cps was statistically significant only in Mild and it was 0.882(P<0.05). Conclusion According to the study, we were able to analyze correlation between cps of LVS using Technegas and the results of PFT in COPD Patients. Using this result, when performing a LVS, the results of PFT can be used as an index of inhaling capacity. In addition, it is thought that it will be more effective for the operation of the exam rooms.