Limb Differences in the Therapeutic Effects of Complex Decongestive Therapy on Edema, Quality of Life, and Satisfaction in Lymphedema Patients

OBJECTIVE: To investigate the changing patterns of edema, quality of life (QOL), and patient-satisfaction after complex decongestive therapy (CDT) in three trajectories: arm lymphedema (AL), secondary leg lymphedema (LL) and primary leg lymphedema (PL). METHODS: Candidates for AL (n=35), LL (n=35) and PL (n=14) were identified from prospective databases. The patients were treated with CDT for 2 weeks, and lymphedema volume was measured before and immediately following the therapy. Patients then self-administered home therapy for 3 months and presented for a follow-up visit. The Korean version of Short Form-36 (SF-36) was used to assess QOL, and we administered a study-specific satisfaction survey. RESULTS: There was no significant difference in the volume reductions between the 3 groups. There were no significant differences in all of the measures between PL and LL. Overall initial QOL was significantly lower in patients with LL than in patients with AL. SF-36 scores post-CDT did not differ significantly between AL and LL. Clinically significant differences were noted between AL and LL in the mean values of the satisfaction survey. CONCLUSION: AL, LL, and PL may have different longitudinal courses. We suggest that lower extremity lymphedema patients present more favorable outcomes after CDT with respect to QOL and satisfaction than upper extremity lymphedema patients. Clinicians should approach patients with different therapeutic considerations specific to each type or region of lymphedema before using CDT in clinical practice.

Long-Term Effects of Complex Decongestive Therapy in Breast Cancer Patients With Arm Lymphedema After Axillary Dissection

OBJECTIVE: To investigate the long-term effects of complex decongestive therapy (CDT) on edema reduction in breast cancer-related lymphedema patients after axillary dissection, according to the initial volume of edema. METHODS: A retrospective review of 57 patients with unilateral arm after an axillary dissection for breast cancer was performed. The patients, treated with two weeks of CDT and self-administered home therapy, were followed for 24 months. Arm volume was serially measured by using an optoelectronic volumeter prior to and immediately after CDT; and there were follow-up visits at 3, 6, 12, and 24 months. Patients were divided into two groups according to the percent excess volume (PEV) prior to CDT: group 1, PEV or =20%. RESULTS: In group 1, mean PEV before CDT was 11.4+/-5.0% and 14.1+/-10.6% at 24 months after CDT with no significant difference. At the end of CDT, PEV was 28.8+/-15.7% in group 2, which was significantly lower than the baseline (41.9+/-19.6%). The reduction of PEV was maintained for 24 months in group 2. CONCLUSION: The long-term effects of CDT were well-maintained for 24 months, but there was a difference in progression of PEV between the two groups. The patients with more initial PEV showed significant volume-reducing effects of CDT. In patients with less initial PEV, the severity of lymphedema did not progress to higher grades.

Subtypes of hepatitis B surface antigen in Korea in comparison with other Asian nations

No abstract available.

An Observation on the Mortality Rates of Transport Accidents in Korea / 예방의학회지

This paper describes the incidence of transport accident for the period, 1955-1965. Transport accidents were classified into three categories, viz. railway(WHO Classification of Diseases, E-802), watercraft(E850-E858) and motor vehicle accidents(E810-E835, E840-E841, E844-E845). Crude data on the subject were collected from the various sources of Government Statistical Books including Statistical Year Books edited by the Central Office of Economic Planning Board, Annual Police Reports by the Ministry of Home Affairs, and the national and local associations for road traffic safety. From the data incidence and mortality rates by year, month and local province were computed and other variables relevant to the epidemiology of accidents were observed. The following summary could be drawn: 1. Death rates due to transport accidents per 100,000 population were 12.3 for 1955 and 9.7 and 1965. The incidence of injury due to the same cause were 34.0 for 1955 and 35.9 for 1965. 2. Death rates by transportation vehicle showed 9.0 due to motor vehicle accidents, 1.7 due to water-crafts, and 1.6 due to railway trains for 1955. In 1965 death rates were 6.0 due to motor vehicles, 1.2 to water-crafts and 2.4 to railway. 3. Seasonal distribution of transport accidents revealed that car accidents occur more frequently in spring and fall seasons while ship accidents do in winter and train accidents more in summer. 4. Both car and ship accidents slightly decreased during the past decade, 1955-1965, whereas the accidents of railway trains showed a tendency of increase. 5. Although the survey on railway accidents excluded the injuries of passengers or railway employees corresponding to WHO classification of diseases, E801, due to inaccuracy of data, it is roughly estimated that the same number of causalities as the incidence among pedestrians or any other than passengers or employees assumed to be at work(E 802).

An Epidemiological Observation of Fire Accident in Korea / 예방의학회지

Epidemiological and statistical observations were made of fire hazards that occurred during the past 18 years, 1948 to 1965. Injury and mortality rates for all ages were computed chronologically. For the years of 1955, 1961 and 1965, all fire accidents were epidemiologically analysed to draw characteristic pattern in relation to the seasonal and 24 hour distribution, causes and sites of accidents etc.. Fire hazards observed herein are the categorys E 916 of the International Classification of Causes of Death, 1955, and includes all accidents caused by fire and explosion of combustible materials. The following conclusion was made: 1. The average umber of annual deaths due to fire was 183 and the number of the injured due to the same cause was 335. The mortality rate per 100,000 population was 0.8 and the ratio of injures per death was 1.8. 2. The casualty rate including both the dead and injured was 5.0 per 100,000 in Seoul, the highest among the provinces and followed by 3.4 in Cheju-Do, 2.1 in Kangwon-Do, 1.7 in Kyunggi-Do accordingly. The other provinces had a range of 0.6 to 1.2. 3. The monthly distribution of fire accidents showed that the winter months, December through February, had more frequent accidents, while the summer season, June through August had less. The 24 hour distribution of accidents showed more cases from 12:00 to 18:00 and less from 4:00 to 10:00 hours. 4. The per cent distribution of causes of accidents showed; 90.0% for careless, 10.0% for arson. The cause of carelessness was further breakdown into; 15.0% for kitchen fire places, 13.8% for fire playing, 9.4% for electrical heating and wires, 8.3% for fuels, 6.3% for matches, 5.2% for ash dumps and the remaining for others. 5. The accidents as classified by place revealed that 56.8% of the total occurred at the common dwelling houses, 11.3 at various industrial workshops, 9.3% at the street shops and the remaining at the miscellaneous places.

An Observation on the Incidence of Drowning Death in Korea / 예방의학회지

This paper describes the incidence and some epidemiological features of drowning accident out of a series of our study on the epidemiology of various accidents in Korea. By the daily press it is apparent from the frequent reporting of swimming accidents that the incidence would be high. In the rural areas, there are, at present about 1,250 artificial lakes and farm ponds to be utilized for rice production. The reservoirs, irrigation ditches and riversides are also used for recreation. In most places facilities for aquatic activities is meager, and safety measures for the prevention of drowning is not sufficiently enforced. In the survey crude data on drowning were collected from the concerned governmental statistic books for the period 1955 to 1967 which were compiled not in a uniform way. Drowning were classified into two categories, one is accidental drowning, E929 and the other is due to cataclysm, E934, according to the WHO international classification of diseases. Epidemiological variables in relation to drowning accident were obtained through qualitative analysis of informations from the popular newspapers. The following summary may be drawn; 1. The average number of deaths due to accidental drowning totaled 1,088 annually and the mortality rate per 100,000 population was 3.4. The 42.0% of all drowning were rescued and the remaining were not saved. 2. The sex ration(M/F) of the victims for all ages was 5 to 1, which had a wide range of difference among the age groups. The young ages less than 20 years occupied 68.0% of all deaths. 3. The percentage distribution of the causes of accidents revealed 31.9% for careless swimming, 45.5% for unskilled, 16.6% for swimmer's cramp and 6.0% for drunken. The distribution of places where accidents occurred showed 88.0% for rivers, water reservoirs, irrigation ditches and 12.0% for regular swimming pools. The seasonal distribution of cases indicated 85.0% of the total were seen during the summer months, June-August, and 50.0% of them occurred on Sundays. 4. The average annual deaths due to cataclysm were 402 and mortality rate per 100,000 population was 1.6, but the number of victims due to cataclysm varied greatly each year. 5. The accident cases due to cataclysm were classified into 60.0% for injuries, 40.0% for deaths. The 26.8% of all deaths were missing cases. 6. The deaths due to either accidental drowning or cataclysm totaled 1,490, and the death rate per 100,000 for the whole country was 5.0.

The microfilarial density of the host and the infectivity of the mosquito vecter

In filariasis the infectivity of the appropriate mosquito vector is not consistent with the microfilarial density of the host. The reason may be attributed such factors as the time of microfilarial appearance in the peripheral blood of the host, the time of maximum biting activity of the arthropod vector, or the morphological adaptation of the feeding mechanism of the vector. However, it is quite puzzling to see why the number of microfilariae taken up by mosquitoes is subjected such a great variation, even though the same batch of mosquitoes are fed on the same filarial host under same laboratory conditions. The experiment was designed to observe more detail aspect of this relation. Adult Aedes togoi (Theobald, 1907) mosquitoes were reared from egg rafes colonized in an insectary. Animals used were Taiwan monkeys, Macaca cyclopsis which had been artificially infected with Wucheria malayi. The animals showed the microfilarial counts as low as nil to ten per slide of 20 cmm3 of blood, which seem to be rather fortunate for this kind of work. The microfilarial density of each animal was counted by taking each ten smears of 20 cmm(3) of peripheral blood the ear lobes before and after mosquito bite. Feeding were done in two occations, during 1600-1630 and 1900-1930 hours of the same day. The monkeys were immobilized and a rayon cage, housed 100 female mosquitoes for two days starvation, was exposed to the shaved abdomen of each animal. Fully engorged mosquitoes were transferred to a square rearing cage, which was later placed in the insectary, where kept temperature of 23-27degree C and relative humidity of 80-85 per cent. It was found that filarial larvae of the mosquito body usually develop to the third or infective stage in about 10 days after blood meal under these conditions. Daily dissections were made of these mosquitoes, either living or dead, after one week of rearing. Analysing of the result, the following conclusion was made. The rate and intensity of infection in mosquitoes are not directly related to the blood counts of microfilariae of the host animals. This is perhaps due to fluctuations of microbial outflow in the peripheral blood of individual animals. The reason of this would be no doubt due to a patch type of microfilarial distribution in the host blood.