본 연구는 만성질환으로 외래서비스를 이용하는 환자를 대상으로 의 료기관 유형별 의료서비스 이용 경험을 조사하고, 만성질환자의 건강 결과를 실증적으로 비교 분석하여, 만성질환 관리의 효과적인 중재방안 마련에 기초자료를 제공하고자 시도되었다. 본 연구의 자료수집은 2023년 7월 1일부터 7월 31일까지 고혈압과 당뇨병 진단으로 보건소 와 의원, 종합병원의 외래서비스를 이용하고 있는 대상자 167명에게 면담을 통한 구조화된 설문지를 작성하여 자료를 수집하였고, 수집된 자료는 SPSS 통계프로그램을 이용하여 분석하였다. 연구 결과 고령의 취약계층은 의료기관 중 의원을 가장 많이 이용하고 있었고, 의료기관 유형별 이용경험의 결과는 의원이 가장 부정적이었다. 그러나 만성질환 관련 건강 결과는 의료기관 유형별로 유의한 차이가 없었다. 그러므로 보건소는 특히 취약계층 환자들의 보건의료 요구를 중시하고 공공보건 서비스를 효율적으로 제공해야 하며, 의원의 만성질환 관리 역량의 강 화를 위한 다양한 중재 방안 마련과 함께 국가 시범사업의 적극적 참 여를 유도할 수 있는 정책이 수립되어야 할 것이다.

Purpose: This study explored illness experiences and the demands for a health-related program tailored to individuals with chronic disease at one of the Korean Seon Centers. It also utilized this information as foundational data for developing a program tailored to their needs. Methods: The study utilized focus group interviews to collect data from members of one of the Korean Seon centers who have chronic disease, regarding their illness experiences and their expectations for disease management programs. The collected data was then analyzed using the qualitative content analysis method. Results: The analysis yielded five overarching themes and 14 subthemes. These themes included opposing responses to disease diagnosis, reflections on the causes of disease, efforts toward disease recovery, obstacles to disease recovery, and the need for a customized disease management program. Conclusion: The findings highlighted the challenges the participants faced in their disease recovery process. They expressed a strong desire for a comprehensive management program that incorporates in-depth information, experience sharing, and education. Such a program would empower individuals to take control of their physical and mental well-being.

목적: 국민건강영양조사 제7기(2016-2018) 원시자료를 이용하여 황반변성에 영향을 줄 수 있는 만성질환을 파악 하고자 수행되었다. 방법 : 국민건강영양조사 제7기(2016-2018) 자료 중 40세 이상의 성인 중에 황반변성 진단여부에 응답한 4,356명의 대상으로 만성질환과의 관계를 분석하였으며, p<0.05인 경우 유의한 것으로 판단하였다. 결과 : 황반변성은 연령에 따라 유병률이 높아졌는데, 연령과 관계된 만성질환 중 심근경색증에서만 유의한 결 과를 얻을 수 있었다. 또한, 심근경색증의 위험요인인 이상지질혈증과 이상지질혈증을 일으키는 고콜레스테롤혈증 도 황반변성과 관계가 있는 것으로 나타났다. 결론 : 황반변성은 연령과 관련된 만성질환 중 심근경색증, 이상지질혈증, 고콜레스테롤혈증과 관련이 있음을 확인하였다.

A cat who is a 15-year-old and spayed female visited an animal clinic with severe coughing symptoms. Since the cat’s coughing symptoms had worsened from the age of 10 and X-rays showed a bronchial pattern in the lungs, it was diagnosed as Chronic Obstructive Pulmonary Disease (COPD). She received three injections of stem cells isolated from the amniotic membrane on days 0, 7, and 23. Although there was no improvement in the clinical findings on the x-ray, the number of coughing was significantly reduced. In addition, even after long-term follow-up post treatment for a month, she was stable with almost no coughing.

This study compared the lifestyle patterns, dietary patterns, and health care practices of Korean middle-aged people by household type, and ultimately analyzed their relationship with different risk factors for the prevalence and severity of metabolic syndrome. We analyzed the data from 4,755 subjects who were from 40 to 64 years old, and gathered our sample from participants of the Korea National Health and Nutrition Examination Survey from 2013 to 2015. Our results showed that single-person households had lower economic income levels, lower subjective health statuses, and higher levels of food instability than households with two or more individuals. The incidence of metabolic syndrome was 1.64 times higher in single-person households than in households with two or more individuals. After adjusting for potential confounding factors (sex, age, education, household income, smoking status, health status, and dietary factors), single-person households showed 1.75 times higher hypertriglyceridemia ORs than non-single-person households. In the conclusion of our study, we suggest that middle-aged people in single-person households may be at greater risk for metabolic syndrome and hypertriglyceridemia.

The purpose of this study was to investigate the current status of chronic diseases according to obesity in the elderly older than age 65 using data from the 7th Korea National Health and Nutrition Examination Survey (2016~2018). The subjects of the survey were 3,245 elderly older than age 65 who participated in the health survey and nutrition survey, 45.8% of the subjects were males and 54.2% of the subjects were female. 37.5% of all the elderly were obese, and the females (42.4%) were more obese than the males (31.8%) (p<0.001). Diabetes, hypertension, and hypertriglyceridemia had a similar prevalence of 24.6%, 63.0%, and 12.7% in males and females, respectively. Hypercholesterolemia was higher in the elderly females (44.2%) than in the elderly males (24.9%) (p<0.001). Through the logistic regression analysis, it was found that the prevalence of chronic diseases was higher in obesity than normal in elderly males and females (p<0.001). The total food intake increased from ‘under weight’ to ‘obesity’ in males (p<0.01) and females (p<0.001). In the case of the elderly males, the higher the degree of obesity, the higher the energy intake (p<0.05), and ‘pre-obesity’ consumed the most energy in elderly females. As a result of this study, the higher the obesity rate of the elderly, the higher the prevalence of chronic diseases.

The purpose of this study was to examine the association nutrition education experience in regards to metabolic risk and nutrition intake in Korean adult male using the 2016~2017 Korea National Health and Nutrition Examination Survey as the reference. The study involved a total of 1,978 male subjects aged 40~64 who were classified into the 2 groups based on their nutrition education experience: Educated group (n=88) and non-educated group (n=1,890). The household income and education level of educated group were higher than those of the non-educated group. The two groups showed no significant difference in the level of fasting blood sugar, blood lipid profile including total cholesterol and triglyceride, LDL-cholesterol, and hypertension. Vitamin C intake of the educated group (127.5 mg) was higher compared to the non-educated group (88.2 mg) (p<0.05). The percentage of the subjects utilizing nutritional labels was higher in the educated group. The nutrition education experience was inversely proportional to lower Odds Ratio in hyperLDL-cholesterolemia (OR: 0.47, 95% CI: 0.36, 0.84) and HypoHDL-cholesterolemia (OR: 0.57, 95% CI: 0.37, 0.87). This result indicates that nutritional education can be used as an effective tool to avert chronic diseases and develop healthy eating habits.

Angiotensin receptor blockers, such as telmisartan, are considered effective in the treatment of hypertension and proteinuria due to chronic kidney disease (CKD) in cats. It selectively blocks the AT1 receptor and does not affect the AT2 receptor, thus effectively blocking the activity of the renin angiotensin aldosterone system. This study aims to compare over time the changes in various indicators, including systemic hypertension and proteinuria, before and after the administration of telmisartan in cats with CKD. Decrease in blood pressure (BP) (p<0.001) and urine protein to creatinine (UP/C) ratio (p<0.001) were found to be statistically significant over time after the administration of telmisartan. BP and the UP/C ratio were 160 ± 22.2 and 0.50 ± 0.647 before telmisartan administration (Day 0), 150 ± 21.0 and 0.27 ± 0.487 on the 30th day (Day 30), 150 ± 17.0 and 0.25 ± 0.376 on the 60th day (Day 60), and 140 ± 17.8 and 0.15 ± 0.233 on the 90th day (Day 90) after administration, respectively. BP and UP/C were statistically significantly lower in cats with CKD over time at each time point from Day 0 to Day 90 at 30 day intervals. Especially after 90 days of telmisartan administration, the improvement of BP and UP/C were estimated to be about 20 mmHg and 0.35, respectively. In conclusion, the oral administration of telmisartan to cats with CKD is effective in improving BP and proteinuria, which has a positive effect on long-term survival in cats with CKD.

The aim of this study was to examine the association between egg consumption and the risk of chronic disease in Korean adult females using the 2013 Korea National Health and Nutrition Examination Survey. A total of 1,230 subjects aged 40~64 were classified into the 4 groups according to the number of egg consumed per week: <1, 1~2.9, 3~5, ≥5.1 As egg consumption increased, the intake of energy, protein, fiber, cholesterol, calcium, potassium, riboflavin, and vitamin C increased. The percentage of the subjects with lower intake of energy, protein, calcium, iron, vitamin A, riboflavin, niacin, and vitamin C than the estimated average requirement in the <1 group were the highest among the groups. The blood lipid profile including total cholesterol and LDL-cholesterol was not significantly different among the 4 egg groups. The higher egg consumption was inversely related to a lower odds ratio of metabolic syndrome, hypertriglycemia, hyperglycemia, hypoHDL-cholesterolemia, and hypertension. This result indicates that egg consumption does not elevate the plasma cholesterol level and has a beneficial effect of decreasing the risk of chronic disease. (175)

Purpose: The purpose of this study was to understand the lived experience of a main caregiver, in charge of a family member with a severe chronic disease. Methods: The participants of this study were 13 main caregivers, who have a family member with a severe chronic disease. The data were analyzed through the phenomenological research method. Results: This research concluded with: one core theme, five theme clusters and 13 themes. The one core theme was: ‘My Life is Not Mine.’ The five theme clusters include: ‘The Dark Days Ahead, of What We Do,’ ‘Serious Pressure,’ ‘My Body is Broken (caregivers),’ ‘Overcoming,’ and finally ‘Endless, Long and Long tunnel.’ Conclusion: We must emphasize to a main caregiver of a chronic disease patient, to the fact that their life should be theirs, not the patients. In addition, we need to be attentive of their well-being, as well as the chronic disease Patients, and sensitively responsive to their problems.

Prion diseases are a class of transmissible fatal disorders. In order to identify alterations associated with the pathogenesis of prion diseases, several studies have been conducted involving differential gene expression analysis using cDNA libraries, mRNA differential displays, and gene microarrays. These genomic approaches may be useful for identifying genes that are differentially expressed in prion diseases and that may participate directly or indirectly in the pathogenesis of the disease. In this study, we compared the gene expression profiles of normal and CWD-infected TgElk mice using the GeneFishing differentially expressed gene (DEG) screening system and real-time PCR analysis. DEGs were screened using the ACP-based PCR method with GeneFishing synthesis. In order to validate candidate genes, we used quantitative PCR (qPCR), and eleven DEGs were identified. Five of these eleven DEGs were upregulated and two were downregulated in the CWD mice. The DEGs newly identified in this study may be useful for diagnosing and studying the pathogenesis of prion diseases.

This study was conducted to investigate the risk of chronic disease as predicted by abdominal obesity in Korean adult females. Data on 2,738 adult females aged 40~64 yrs was obtained from the 2013~2014 Korean National Health Nutrition Examination Survey. The subjects were divided into normal (n=1,835), abdominal obesity (AO, n=73), and BMI-diagnosed abdominal obesity (BMI-AO, n=505) groups based on the NCEP-ATP III guidelines and by applying the KSSO definition regarding waist circumference. Triglyceride blood levels, fasting blood sugar levels, systolic blood pressure, and diastolic blood pressure were higher in the AO and BMI-AO groups than in the normal group. The HDL-cholesterol levels of subjects in the two abdominal groups were lower as compared to those of subjects in the normal group. The mean adequacy ratio was lower among subjects in the AO and BMI-AO groups than among those in the normal group. Moreover, the NAR and INQ scores of some micro-nutrients in both of the abdominal obesity groups were lower than those in the normal group. Both the AO and BMI-AO groups showed significantly higher risks of hypertriglycemia, hyperglycemia, hypertension, hypoHDL-cholesterolemia, and metabolic syndrome than were shown by the normal group. Notably, as compared to the normal group, the AO group showed higher risk of hypercholesterolemia, hyperLDL-cholesterolemia, hypertriglycemia, and metabolic syndrome than did the BMI-AO group. This finding suggests that it is essential to develop prevention programs including programs for those with abdominal obesity despite their having a BMI within the normal range.

Chronic obstructive pulmonary disease (COPD) is associated with multiple comorbidities, including depression, which carries a higher risk of exacerbation and hospitalization in patients with stable COPD. A newly developed questionnaire, the COPD Assessment Test (CAT), was developed as an alternative to other complex, time-consuming tools for quantifying the symptom burden of COPD in routine practice. It is possible that the correlation between the CAT and depression scales could be useful for early evaluation and management of depression in COPD patients. Thus, we investigated the relationship between the CAT and depression as measured by the Patient Health Questionnaires-9 (PHQ-9). We performed a retrospective observational COPD cohort study. A total of 97 patients were enrolled. The Korean versions of the CAT and PHQ-9 were completed for stable patients. A correlation analysis was performed between the PHQ-9 and CAT scores. Significant depression among the groups based on the 2011 GOLD guidelines occurred only in class Gold B and D patients (40% and 60%, respectively). The frequency of depression was significantly higher in the group with higher CAT scores (20~29 versus ≥30; odds ratio: 5.67 versus 22.66). Significant association was observed between the PHQ-9 and CAT scores (r=0.545 and P<0.001). As a result, the PHQ-9 score was significantly higher in COPD patients with a higher CAT score. The CAT is a simple and valuable predictor of depression in COPD patients, and it should be frequently used to detect COPD patients with depression in clinical practice.

A 7-year-old spayed female English Cocker Spaniel dog presented with polyuria (PU), polydipsia (PD), intermittent vomiting, and weight loss. Physical examination revealed pale, tacky mucous membranes and severe emaciation. Hematological and biochemical examinations revealed moderate normocytic normochromic non-regenerative anemia and moderate azotemia. Abdominal ultrasonography demonstrated bilaterally small lumpy-bumpy kidneys with hyperechoic parenchyma as well as loss of renal corticomedullary junction. Based on clinical history and examinations, the dog was diagnosed with chronic kidney disease (CKD). The dog was treated with supportive care including fluid therapy, phosphate-binding agent, and histamine H2-receptor antagonist. Darbepoetin Alfa was administered to control renal secondary non-regenerative anemia. Prescribed diet with low-protein and low-phosphorus was fed to alleviate CKD signs. Further, dietary probiotics were supplemented. This case demonstrates that oral probiotic supplementation helped reduce blood urea-nitrogen (BUN) levels. This case indicates that dietary probiotics can be a potential alternative therapeutic agent for management of renal failure

By means of the model competition, this research analyzed the factor of patient management, the factor of policy support, and the factor of medical treatment system. Concretely, the factor of policy support forms a positive effects on the factor of medical treatment system. Practically, well-established healthcare policy provide and facilitate the effective medical treatment system. of the hospital. And, in the effective medical treatment system, hospitals try to develop the patient management of the chronic disease. From the empirical research, this paper concluded that the factor of medical treatment system. mediated by the factor of policy support. Also, the factor of medical treatment system promotes the development of patient management in the chronic disease.

The experimental manipulation of protooncogenes and their gene products is a valuable research tool for the study of human neoplasia. In this study, the recently identified human cervical cancer protooncogene (HccR-2) was expressed in transgenic mice under the control of the tetracycline regulatory system. The phenotype observed was similar in many respects to human chronic neutrophilic leukemia (CNL). Thus, the HccR-2 transgenic mouse model is important not only for investigating the biological properties of the HccR-2 protooncogene in vivo, but also for analyzing the mechanisms involved in the progression of CNL.