Purpose: To examine the prevalence and clinical manifestations of eosinophilic esophagitis (EoE) in Korea children. Methods: The study was designed as a 1:2 matching case-control study. Using information from the endoscopic database of a tertiary center, we retrospectively reviewed the medical records of patients aged 18 years or younger who underwent upper gastrointestinal endoscopy between January 2014 and December 2017. A total of 21 patients were diagnosed with EoE based on current diagnostic criteria. In addition, 42 controls with normal esophageal biopsy findings matched to each EoE case by sex, age (±1 months), and season were randomly selected during the study period. Results: The mean age of EoE diagnosis was 12.1±4.0 years and the male-to-female ratio was 2:1. The proportion of allergic diseases in patients with EoE (28.6%) was higher than that in the controls (6.8%) (p=0.04). Most EoE patients tested for allergy were positive for at least one antigen, which was significantly different to the controls (88.2% vs. 47.4%, p=0.01). Characteristic endoscopic findings of EoE were noted in 19 patients (90.5%), but 2 patients (9.5%) showed normal esophageal mucosa. The clinical symptoms of EoE were improved by a proton-pump inhibitor in 10 patients (50.0%), and by an H2 blocker in 9 patients (45.0%). Only one patient (5.0%) required inhaled steroids. Conclusion: While EoE is rare in the Korean pediatric population, the results of this study will improve our understanding of the clinical manifestations of the disease.
Journal of The Korean Society of Integrative Medicine
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v.8
no.2
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pp.169-185
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2020
Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.
Background: Endovascular aortic aneurysm repair (EVAR) has come into use and been widely extended because of the low complication rate and less-invasiveness. This article aimed to describe our experience in the treatment of abdominal aortic aneurysm with EVAR. Materials and Methods: A retrospective review was conducted for the 22 patients who underwent EVAR in a single hospital December 2001 to June 2009. Results: The mean age of the patients was $68.5{\pm}7.6$ years. There were several risk factors and comorbidities in 20 patients (90.9%). The mean diameter of the aortic aneurysms was $61.2{\pm}12.9$ mm. The mean length, diameter, and angle of the aneurysmal neck were $30.5{\pm}15.5$ mm, $24.0{\pm}4.5$ mm, and $43.9{\pm}16.0^{\circ}$, respectively. The mean follow-up period of the patients was $28.8{\pm}29.5$ months. The 30-day postoperative mortality was none. Seven patients (31.8%) had endoleaks during the hospital stay and three patients (13.6%) had endoleaks during the follow-up period. One patient (4.5%) died due to a ruptured aortic aneurysm. The cumulative patient survival rates were 88.2%, 88.2%, and 70.6% at 1, 3, and 5 years of follow-up, respectively. Conclusion: EVAR is currently a safe, feasible procedure for high risk patients with abdominal aortic aneurysm because of low postoperative complication and mortality if patients are selected properly and followed up carefully.
Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.
This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of aerobic walking exercise program on the physical & psychological functions of home stayed stroke patients. The data were collected during the period of May 20th to August 15th, 2001. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b)suffering from stroke for 6 months to 5 years, (c)without recognition disorder with the MMSE-K score above 25, (d)below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease (f)able to walk beyond 15 minutes for themselves. The aerobic walking exercise program for the experimental group was aerobic exercise and education and supportive care. The aerobic exercise was 8 weeks' period, three times a week, 35 to 50 minutes a day. And the education and supportive care was consisted of one home visiting and 2 times telephoning a week. The data were analysed by $X^2$-test, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. There was insignificant difference in the gait length experimental and control group. There was significant difference in the gait speed between the two groups. 2. There was significant difference in the dynamic valance between the two groups. 3. There was significant difference in ADL score between the two groups. 4. There was no significant difference in the depression between the two groups. As shown above, the results of 8 weeks' the aerobic walking exercise program for home stayed stroke patients produced positive effects on gait speed, dynamic valance, ADL score. And this program was expected that it was more effective in different intervention period, verified program. Also it was needed follow study.
Objective : This study aimed to compare the patients' satisfactions with local Korean Medicine(KM) clinics and networked KM clinics, and to find out which factors had an effect on it. Method : Six local KM clinics and six networked KM clinics were selected, and patients' questionnaires on the satisfaction with KM clinic use were administered using exit poll method. The questionnaires were developed to measure satisfactions with facility, doctor and staffs, and services. 240 patients completed the questionnaires, and the data were statistically analyzed. Results : There was more diversity in patients' diseases among networked KM clinics users, however, treatments provided were not differentiated clinically between two types of KM clinics. Patients' satisfaction scores for local KM clinics were significantly higher than those for networked KM clinics in the aspects of doctors/staffs (9.35 vs 8.92, p<.01) and services (8.76 vs 8.42, p<.05). 90.0% of local KM clinic users expressed their willingness to recommend the clinics they used to others, while 75.0% of networked KM clinics users did. For both the local and networked clinics, 'KM doctors' kindness', and 'process and waiting time' were statistical factors affecting patients' satisfaction. Conclusion : The patients' satisfactions with general KM clinics were higher than those with networked KM clinics. Networked KM clinics need to develop services to meet the diverse medical demands which were created by them selves.
Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki Hong;Kim, Hun Joo
Journal of Korean Neurosurgical Society
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v.29
no.3
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pp.353-359
/
2000
Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.
The Journal of Korean Society for School & Community Health Education
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v.21
no.1
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pp.61-74
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2020
Objectives: This study aims to examine hypertension patients' quality of life by using the data of the 7th Korea National Health and Nutrition Examination Survey (1st year, 2016), identify the factors related to this, and utilize the results as basic data for intervention that can improve hypertension patients' quality of life. Methods: For the research subjects, this study extracted 1,531 patients who were diagnosed with hypertension by a doctor from the total sample of 8,150 participants of the 7th Korea National Health and Nutrition Examination Survey, and selected 1,072 patients with no missing value in the variables to be analyzed as the final research subjects. The SPSS(version25.0) program was used for the analysis of the collected data. Then, this study used a backward elimination multiple regression analysis method that applied complex sample, to examine the factors related with the finally estimated quality of life. Results: The results of this study revealed that hypertension patients' quality of life was related with age, occupation, spouse, household income, weight gain, restriction of activity, subjected health status, perceived stress, and presence of comorbidity. The final model explained 37.0% of the variance (Wald F=30.012 p<.001). Conclusions: When an intervention program is implemented for the improvement of hypertension patients' quality of life in the future, it will be effective to construct the program according to age group, employment, marital status and household income. As for the program operation, patients should get help therefrom to control weight, facilitate activities and relieve their stress, and they should be also motivated to feel healthy. Furthermore, education should be offered so that they appropriately manage their underlying disease at an early stage.
Kim, Seunghyun;Ryu, Jiseon;Lee, Kyungmin;Kwon, Byungjo;Lim, Byungmook
Journal of Society of Preventive Korean Medicine
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v.23
no.2
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pp.1-10
/
2019
Backgrounds : In 2017, National Health Insurance implemented the pilot coverage program for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the program to monitor the effectiveness and patients' satisfaction of insured CMT. Objectives : This study aimed to evaluate patients' satisfaction of CMT in the pilot coverage program of National Health Insurance. Methods : Survey participants were recruited among the patients who used CMT at the designated organizations. On-line questionnaire link was sent to the smart phones of patients who agreed to participate in the survey and provide personal contact information. The questionnaire consisted of the basic charactersitics of respondents, imformation on using CMT satisfaction with CMT and willingness to recommend CMT to others. The answers that were automatically coded and saved were statistically analyzed. Results : Of 386 participants who completed the questionnaire, 92.8% satisfied or strongly satisfied with the CMT. Most frequent reason of satisfaction was 'Good effectiveness', and there was no difference in satisfaction between patients of hospital and those of clinics. Patients with the highest and the lowest level of pain satisfied more than those with other pain levels(p=0.003), but the level of copayment and reasons of CMT use did not affect the satisfaction results(p=0.405). The proportions of respondents who had willingness to recommend CMT to others and to revisit for CMT use were 97.8% and 98.8%, respectively. Conclusions : Most patients were satisfied with CMT in the pilot coverage program, and it can provide the rationale for expanding the insurance coverage of CMT to all KM hospitals and clinics.
Objectives: This study aims to contribute to devising systems for family caregivers of dementia patients by examining the state of oral care of dementia patients, and depression and social support among family caregivers of dementia patients. Methods: Family caregivers of dementia patients in the metropolitan area were selected in this study. The inclusion criteria were individuals who have provided care for a dementia patient at home for at least six months and those who come in contact (including phone calls) with the patient at least twice a week. Results: Oral health knowledge of the elderly, caregiving burden, depression, and social support were examined. The mean scores for oral health knowledge of the elderly and caregiving burden were $57.11{\pm}16.94$ out of 100 and $17.33{\pm}8.61$ out of 48, respectively. Further, the mean caregiving behavior score, depression score, and social support score were $8.49{\pm}13.71$ out of 100, $5.11{\pm}3.05$ out of 10, and $72.75{\pm}17.03$ out of 100, respectively. Factors affecting oral health knowledge of the elderly were examined. The results showed that the level of oral health knowledge of the elderly increased with an increasing perception of a need for oral health education (p<0.05), caregiving burden (p<0.01), and social support (p<0.01). Conclusions: These findings suggest that developing and popularizing oral care intervention programs for family caregivers of dementia patients are necessary to ensure systematic oral care for dementia patients.
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