• Title/Summary/Keyword: 아형

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The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.94-101
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    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.

Rapid Detection Method of Avian Influenza Subtype H5N1 using Quick Real-Time PCR (Quick Real-time PCR을 이용한 Avian Influenza Virus Subtype H5N1의 신속검출법)

  • Kim, Eul-Hwan;Lee, Dong-Woo;Han, Sang-Hoon;Kwon, Soon-Hwan;Yoon, Byoung-Su
    • Korean Journal of Microbiology
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    • v.43 no.1
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    • pp.23-30
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    • 2007
  • The most rapid Real-time PCR based detection method for Avian influenza A virus (AIV) subtype H5N1 was developed. The target DNA sequence in this study was deduced from H5N1 subtype-specific 387 bp partial gene of hemagglutinin, and was synthesized by using PCR-based gene synthesis on the ground of safety. Real-Time PCR was performed by $GenSpector^{TM}$ using microchip-based, total $1{\mu}l$ of reaction mixture with extremely short time in each steps in PCR. The detection including PCR-amplication and analysis of melting temperature was totally completed within 13 min. The H5N1-specific 189 bp PCR product was correctly amplified until 2.4 molecules of hemagglutinin gene as minimum of templates. This kind of PCR was designated as Quick Real-Time PCR in this study and it could be applied to detect not only AIV H5N1, but also other pathogens using PCR-based detection.

THERAPEUTIC APPROACHES FOR TREATMENT RESISTANT OBSESSIVE-COMPULSIVE DISORDER IN CHILDREN AND ADOLESCENTS (소아청소년기 치료저항성 강박장애의 치료적 접근)

  • Suh, Hyun-Ju;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.64-80
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    • 2003
  • Although obsessive-compulsive disorder(OCD) affects children, adolescents, and adults whether its juvenile(dhild and adolescent) and adult forms are different subtype of a disorder remains unknown. But there are increasing findings that suggest that juvenile OCD may be unique subtype of the disorder. One proposed subtype is the childhood OCD associated with high comorbidity of tic disorder and increased familial loading for OCD or tic disorder. The other proposed subtype is the childhood OCD and/or tic disorder occuring in association with streptococcal infection(PANDAS). These two subtypes of OCD are unlikely to respond to SSRI due to possible different pathphysiological mechanism. So this paper reviews the characteristics of OCD and therapeutic approaches for treatment resistant OCD in childhood and adolescence. Considering the likely heterogeneity of OCD, the possibility that juvenild OCD may be a variant of the disorder can have important clinical and scientific implications because it may further our understanding of this disorder, its etiology, and perhaps its treatment.

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Combined Small Cell Carcinoma Associated with Microinvasive Squamous Cell Carcinoma of Bronchial Surface Epithelium - A case report - (기관지표면상피의 미세침윤성 편평세포암과 동반된 혼합성 소세포암종 -1례 보고-)

  • 김윤정;심정원
    • Journal of Chest Surgery
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    • v.29 no.9
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    • pp.1031-1035
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    • 1996
  • International Ass ciation for the Study of Lung Cancer(IASLC) recommended the following classification of small cell lung carcinoma(SCLC) : (1) Small cell carcinoma (2) Mixed small cell/large cell carcinoma (3) Combined small cell carcinoma. Combined small cell carcinomas contain a squamous cell carcinoma or adenocarcinoma component. The prognostic significance of these elements is not known, but since the frequency and extent of non-small cell elements are considerably greater in posttherapy and autopsy tissues, it is possible that the non-SCLC elements are more resistant to therapy than the SCLC cells. Metaplasia & dysplasia of the bronchial surface epithelium are frequently observed in the bronchial biopsy specimens that contain small cell carcinoma of the lung. We report a case of combined small cell carcinoma with squamous element associated with microinvasive squamous cell carcinoma of the bronchial surface epithelium in 68 year old male patient, stage was IIIa. The two lesion are not connected n serial sections.

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Improved PCR Amplification of Human DRD4 Polymorphic 48-bp Repeats : PCR of Digested Template for GC-rich Targets (수용체의 다형성 48-hp반복배열의 PCR을 위한 효과적 방법 : 제한효소로 절단된 GC-rich목표배열의 중합효소연쇄반응)

  • Sheen, Joon-Ho;Kim, Young-Tae;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.248-251
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    • 1995
  • 정신분열병의 약물치료에서 중요한 역할을 하는 도파민의 기전은 지금까지 5종류의 수용체들이 발견되고 클론되면서, 새롭고 보다 근본적인 유전학적 접근을 통해 규명될 수 있게 되었다. 특히, 도파민 수용체 D4 (DRD4)는 막단백질의 세포질쪽 세번째굴곡에 48-bp반복 다형성배열을 가지고있다. 이러한 다형성 반복배열이 신호전달에 참여할 가능성이 높은 막단백질의 세포질쪽 굴곡에 있다는것은, 각 개인의 항정신병약물에 대한 민감성의 차이를 포함하여 정신분열병에 대한 개개인의 유전적 차이를 진단할 수 있는 가능성을 제시한다. 이러한 가능성을 검증하기 위하여 주로 손쉽고 빠른 중합효소연쇄반응(PCR)을 사용하여 DRD4의 아형들을 분류하게 되는데, DRD4의 PCR은 그 반복배열과 그 주변배열의 높은 GC함량(78% G+C) 때문에 일반적인 PCR 방법을 변형시켜 사용해야한다. DRD4의 아형을 분류하기 위해 변형된 PCR은 통상적으로 7-deaza dGTP와 10% DMSO를 사용하게된다. 이러한 DRD4 PCR은 대부분의 경우 성공하지만, 항상 모든 시료에서 PCR이 성공되는것은 아니었으며 반복적으로 시도하여 증폭시킬 수 있었다. 이러한 어려움은 대부분이 template DNA에 문제가 있을것으로 의심되며 DNA정제 또는 template DNA를 제한효소로 적절하게 무작위절단하여 성공율을 높일 수 있었다.

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A CASE OF CONDUCT DISORDER CONFINED TO FAMILY CONTEXT (가정에 국한된 품행장애 1례)

  • Chung, Sun-Ju;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.287-297
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    • 1997
  • Conduct disorder has been subclassified by the symptom characteristics of socialization, aggression, or age of onset. In ICD-10, ‘Conduct disorder confined to family context’ has been developed as a distinct subtype. Which delineates the conduct problems which take place only in the family and related situation. These authors experienced a case which presents a child who shows aggressive and violent behavior to his parent and brother, severe tamper tantrum and destructiveness only in family. By through history taking, observation and treatment after admission, we could find that insecure and ambivalent attachment between parent and child due to chronic neglect and abuse, and inconsistent parental behavior contribute to many behavioral and emotional problems of this child. We reviewed the relationship between conduct disorder and family pathology and treatment strategy for conduct disorder with family problems.

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CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME (입시병의 아형과 대처방안)

  • Lee, Young-Sik;Ku, Young-Jin;Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.43-48
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    • 1991
  • The College entrance examination stress syndrome is a kind of anxiety disorder. The underlying cause of this disorder is not a test anxiety itself. One's hidden inner and familial conflicts are more likely attributed to this disorder. Patient's the most common complaints are various psychosomatic symptoms but in severe cases underlying psychopathology may be activated and progress to major psychosis. In a broad sense adolescent's delinguent behavior, drug abuse, school drop-out and sucide are closely related to this syndrome. In clinical management of these patients, considering the special situation of impending examination, the therapist must access to central conflict theme in a short time without severe resistance. The authors classified this syndrome into 5 clinical subtypes ; 'the anxious group', 'the exhaustion group', 'the despair group', 'the emptyness group' and 'the boredome group'. Typical case of each subtype and it's management methods were presented briefly.

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A Morphological Study on the Macrophages During Luteolysis in the Pig (돼지 황체에서 황체용해와 대식세포와의 관계)

  • 김원식;한승로;손성경;박창식;양윤석
    • Journal of Animal Science and Technology
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    • v.48 no.2
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    • pp.191-202
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    • 2006
  • In addition to the removal of dying or dead lutein cells by phagocytosis in many species, macrophages exert both luteotropic effect during maturation period and luteolytic effect during degenerative period via mediating autocrine/paracrine actions of self-producing cytokines in the corpus luteum. In this experiment, immunohistochemical and transmission electron microscopic (TEM) studies were performed to observe the morphologic changes of luteal macrophages during luteolysis. A small number of macrophages and low immunoreactivity were present at the mature stage. The number of macrophages and immunoreactivity gradually increased along the advance of luteolysis. Two subtypes of macrophages could be observed through TEM observation. One type of macrophage located between the large lutein cells contained no lipid droplets in their cytoplasm at mature stage. The other type of macrophage located near the blood vessels contained many lipid droplets in their cytoplasm during luteolysis. Particularly, no phagocytic macrophages were observed, which suggested the macrophages in the porcine corpus luteum did not involve in the phagocytotic elimination of dying lutein cells.

Expression of Superoxide Dismutase Isoforms in Inflamed Gingiva (염증성 치은에서 superoxide dismutase isoform의 발현에 대한 연구)

  • Na, Hei-Jin;Kim, Ok-Su;Park, Byung-Ju
    • Journal of Periodontal and Implant Science
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    • v.36 no.1
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    • pp.97-112
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    • 2006
  • 유리 라디칼과 활성 산소종, 산화방지제 간의 불균형이 염증성 구강내 질환의 발생과 진행에 있어 중요한 역할을 한다는 주장이 제기되었고 최근에는 만성 염증성 치주질환에서도 산화에 의한 소실이 관찰되었다. 다양한 내적인 항산화 방어 기전 중 superoxide dismutase 가 $O_2$$H_2O_2$로 효과적으로 전환시킴으로써 활성산소종에 대한 일차적인 방어를 맡고 있다. 현재까지 인간에서 발견된 superoxide dismutase 는 cytoplasmic copper-zinc SOD와 mitochondrial manganase SOD, extracellular SOD의 3가지 아형이다. 이번 연구는 만성 치주질환을 가전 환자의 치주조직에서 효소 항산화제인 SOD의 발현정도를 알아봄으로써 질환조직 내의 산화자극 정도를 평가해 보고자하였다. 전남대학교 치주과에 내원한 33명의 만성 치주질환자와 20명 의 임상적으로 건강한 대상으로부터 조직을 얻어 Cu/Zn-SOD와 Mn-SOD, EC-SOD를 이용한 면역조직화학 염색을 시행하였다. 임상적 소견과 조직학적 소견이 일치하지 않아 조직학적 소견을 기준으로 건강한 조직, 경도, 중등도, 중도 치주질환 조직으로 그룹을 나누고 완전한 상피와 결합조직을 가진 27개의 표본에 대한 분석을 시행하였다. 치주질환 조직에서 건강한 조직에 비해 Cu/Zn-SOD가 상피의 기저층과 상피에 근접한 결합조직에서 발현되고 Mn-SOD는 염증이 증가함에 따라 크게 상피의 과립증과 각화층, 그리고 상피에 근접한 결합조직에서 발현됨으로써 활성산소종이 치주조직 파괴에 관여한다는 것을 알 수 있었다. 세 아형 모두 혈관주위에서 발현되었고 특히 EC-SOD는 작은 모세혈관주위에서만 발현되었으나 염증에 의해 혈관벽이 두꺼워지고 혈관 수가 증가한 곳에서 뚜렷하게 염색되었다. 이번 연구는 염증성 치주조직내 증가된 SOD의 활성이 치주질환자의 산화자극 정도와 관련되어 있음을 시사하였다.