• Title/Summary/Keyword: 임상적 연관성

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Attitude and Belief About Menopause and Menopausal Symptoms in Depressive or Anxiety Disorder Patients (우울, 불안장애 환자에서 폐경에 대한 태도 및 인식과 폐경기 증상)

  • Choi, In Kwang;Lee, Moon-Soo;Ham, Byung-Joo;Lee, Hwa-Young;Ko, Young-Hoon;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.82-93
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    • 2010
  • Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

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Clinical Analysis of MALT Lymphoma in the Stomach (위장의 점막 연관성 림프조직 림프종(MALT Lymphoma)의 임상적 고찰)

  • Paik Kwang Yeol;Noh Jae Hyung;Heo Jin Seok;Sohn Tae Sung;Choi Seong Ho;Joh Jae Won;Kim Yong-Il
    • Journal of Gastric Cancer
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    • v.1 no.1
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    • pp.60-63
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    • 2001
  • Purpose: The aim of this study was to analyze the clinical and the histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphomas in the stomach. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who had been treated at Samsung Medical Center from Jan. 1995 to Sep. 2000 and who had been pathologically proven to have a MALT lymphoma. The factors we analyzed were operative procedure, tumor stage, and histopathological characteristics. Results: Of 3658 patients with a gastric malignancy, 22 patients proved to have a MALT lymphoma ($0.6\%$). There were 7 men and 15 women whose ages ranged from 25 years to 70 years (mean, 48.8 years). Forteen cases were located in the antrum, 4 ($18\%$) in the body and 4 ($18\%$) in the fundus or the high body. Nineteen of these patients were managed with total gastrectomy and splenectomy and 3 with radical subtotal gastrectomy. Histopathologically the tumor was limited to the mucosa in 3 patients ($1.36\%$), to the submucosa in 13 ($59.1\%$) and extended to the muscularis propria in 6 ($27.3\%$). Lymph node involvement was seen in 12 patients ($54.6\%$). There was no splenic or hepatic involvement. Bone marrow involvement was not seen in any patients. H. pylori was identified in 11 patients (50$\%$). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death. Conclusion: MALT lymphomas rarely disseminate by the time of diagnosis and rarely involve the bone marrow. Lymph node involvement is relatively high and a total gastrectomy is effective in managing patients with a MALT lymphoma.

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Correlation of Behavioral and Psychological Symptoms and Homocysteine in Patients with Dementia of Alzheimer's Type (알쯔하이머형 치매 환자에서 행동심리증상과 호모시스테인과의 연관)

  • Lee, Ji Min;Im, Woo-Young;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.23-30
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    • 2014
  • Objectives : Homocysteine has been associated with cognitive impairment and various psychiatric symptoms. This study was designed to examine the relationship exists between plasma homocysteine concentration and behavioral and psychological symptoms of dementia(BPSD). Methods : 41 subjects with dementia of Alzheimer's type were included in this study. We carried out history taking, physical examination, and cognitive assessment for the diagnosis of dementia of Alzheimer's type based on DSM-IV. We scored the Mini Mental State Examination(MMSE), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), and the Korean Neuropsychiatric Inventory(K-NPI). We also measured levels of homocysteine, folate, and vitamin $B_{12}$ in the plasma. Results : We found statistically significant positive correlations between homocysteine concentration with NPI total score, and with scores of several sub-domains such as delusion, agitation/aggression, depression/dysphoria, and elation/euphoria. No significant correlation existed between homocysteine levels and scores of MMSE, GDS, and CDR. Conclusions : This study shows that plasma homocysteine levels are associated with BPSD. Further research is necessary to identify pathophysiologic mechanisms underlying these relationships.

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The Relationship between Modified Mallampati Grade, Tonsillar Grade and Apnea-Hypopnea Index (변형 Mallampati 지수 및 편도 지수와 무호흡-저호흡지수의 지수의 상관관계)

  • Ahn, Byung-Hoon;Choi, Jong-Won;Park, Youn-Ho;Song, In-Hyuk;Nam, Young-Jin;Song, Dal-Won
    • Sleep Medicine and Psychophysiology
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    • v.11 no.2
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    • pp.84-88
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    • 2004
  • Objectives: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. Methods: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI):control (n=24), and patients with sleep apnea (n=70). Results: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p<0.05) Conclusion: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.

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Genetic Diversity of Hepatitis C Virus in Korea (한국내 C형 간염바이러스의 유전적 다양성)

  • Kim, Hyun-Sung;Choe, Joon-Ho;Lee, Hyo-Suk
    • The Journal of Korean Society of Virology
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    • v.26 no.1
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    • pp.31-45
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    • 1996
  • C형 간염바이러스 (HCV)는 각 개체간에 뉴클레오티드 서열상의 다양성을 나타내고, 이러한 유전적 다양성이 임상병리적 증상과 밀접한 연관이 있을 것으로 고려되어 왔다. 본 연구에서는 HCV E1과 NS5B 부위의 염기서열 분석을 통해 한국의 C형 간염바이러스의 분포와 다양성에 관해 분석하고, 발생계통도를 그려 HCV간의 진화적 거리를 확인하였다. 염기서열분석은 서울대학교 병원과 충남대학교 병원으로부터 얻은 56개의 HCV-양성 혈청을 대상으로 RT-PCR과 PCR 과정을 통해 얻은 유전자 산물을 클로닝하여 수행되었다. 56개의 혈청중 53개의 샘플에서 HCV RNA가 검출되었다. 이들 53개 샘플에 대한 분석 곁과, 유전형 1a, 1b, 2a, 2b, 7a가 각각 5.7, 45.3, 45.3, 1.9, 1.9%로 분포하고 있고, 1b형과 2a형이 한국에서의 주요한 HCV 유전형으로 밝혀졌다. 본 연구는 염기서열 분석을 통해 한국에서 1b형과 마찬가지로 2a형도 높은 빈도로 분포하고 있고, 비록 분포 빈도는 낮지만 1a 형과 7a 형도 존재하고 있음을 밝힌 최초의 보고이다.

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작업환경을 위한 TLV의 근거 - PARATHION(1)

  • Kim, Chi-Nyeon
    • 월간산업보건
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    • s.247
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    • pp.16-19
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    • 2008
  • 파라티온(Parathion)은 폭넓고 다방면으로 사용되는 유기 인계 해충 진드기의 살충제이다. 파라티온의 첫 번째 생물학적 반응은 콜린에스테라아제 효소의 활성도 저감이다. 파라티온의 다양한 수준의 동물 노출 실험 결과, 경구 투여량 0.5-6 mg/kg 수준에서 악영향이 관찰되었다. 인간의 경우 파라티온 0.1 mg/kg 이하 수준에서는 RBC 콜린에스테라아제 효소의 활성도 감소가 나타나지 않았다. $0.2-0.8\;mg/m^3$의 작업장 노출 수준에서는 RBC 콜린에스테라아제 효소의 감소가 관찰되었다. 본 연구 결과에 근거하여 흡입 노출농도 $0.35\;mg/m^3$에 해당되는 0.05 mg/kg 이하 용량에서는 파라티온과 관련한 건강상의 생물학적 장애 증상이 유발되지 않았다. 따라서 흡입성 에어로졸과 증기상 형태로 $0.05\;mg/m^3$의 TLV-TWA가 파라티온의 작업장 노출기준으로 권고되었다. 이 노출기준은 부교감 신경의 이상과 다른 생물학적 장애 증상을 예방하는 목적에서 설정되었다. 이 수치는 인간을 대상으로 한 연구에서 얻어진 NOAEL로부터 근거를 둔 것이고, 작업자들의 RBC 콜린에스테라아제 효소의 활성도 저하를 방지하는 용량에 해당되는 것으로 예상된다. 이러한 접근은 RBC 콜린에스테라아제 효소의 억제가 단독 사용자에게서는 나타나지 않는다는 것을 확인하는데 이용되는 Biological Exposure Index의 활용과 일치된다. 인간에게 있어 파라티온 피부노출이 죽음까지도 이를 수 있다는 임상적 증세와 연관되어 있기 때문에 피부경고주석이 권고되었다. 쥐들을 대상으로 한 사료 공급 연구들에서 파라티온의 노출을 통한 명확한 종양의 발생 증가가 관찰되지 않아 비발암성 물질(A4)로 설정하였다. 파라티온의 TLV-STEL과 SEN notation을 설정하기에는 아직 충분한 데이터가 확보되어 있지 않고 있으며 파라티온의 작업 노출 모니터링에 대한 자세한 정보를 얻으려면 아세털콜린에스터라제 억제 농약의 BEI 문서들을 참고하는 것이 필요하다.

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Immunohistochemical Study of C-erbB-2 and VEGF Expression in Non-Small Cell Lung Cancer (비소세포 폐암에서 C-erbB-2와 VEGF 발현에 대한 면역조직화학적 연구)

  • Shin, Jong Wook;Ha, Kyung Won;Choi, Jae Cheol;Kim, Jae Yeol;Park, In Whon;Choi, Byoung Whui;Yoo, Jae Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.1
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    • pp.43-50
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    • 2007
  • Background: Mutated or deregulated expression of C-erbB-2 causes this gene to function as a potent oncogene. Vascular endothelial growth factor (VEGF) is a crucial angiogenic molecule in lung cancer. Both C-erbB-2 and VEGF can promote growth, proliferation and metastasis in non-small cell lung cancer (NSCLC). The purpose of this study was to investigate evaluate the relationship between the expressions of the C-erbB-2 and VEGF genes using immunohistochemistry. Materials and Methods: Ninety-five patients with NSCLC were involved (60 squamous cell carcinoma and 35 adenocarcinoma). The formalin-fixed paraffin embedded specimens were immunohistochemically stained for C-erbB-2 and VEGF using the avidin-biotin complex method. Results: Positive C-erbB-2 expression was observed more often in adenocarcinomas than squamous cell carcinomas (p<0.05). Although the immunohistochemical expressions of C-erbB-2 and VEGF in non-small-cell lung cancer showed increased tendencies at an advanced stage, the correlation between early and advanced cancers was insignificant. In adenocarcinomas, the expressions of VEGF and C-erbB-2 were significantly (p<0.05). Conclusion: The overexpression fo C-erbB-2 was significantly higher in adenocarcinomas than squamous cell carcinomas, and correlated with the expression of VEGF in adenocarcinomas of the lungs.

Correlation of Nitric Oxide and Corticosteroids Along the Course of Sepsis (패혈증의 경과에 따른 혈중 스테로이드와 Nitric Oxide의 연관성)

  • Lee, Keu Sung;Kim, Young Sun;Lee, Hyoung No;Park, Joo Hun;Oh, Yoon Jung;Sheen, Seung Soo;Choi, Young Hwa;Park, Kwang Joo;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.4
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    • pp.308-313
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    • 2007
  • Background: The nitric oxide (NO) released by inducible NO synthase (iNOS) plays an important role in the pathophysiology of sepsis. Corticosteroids also play a role in the hemodynamic and inflammatory reactions in sepsis. Both have been shown to have a relationship theoretically, but their correlation and clinical impacts have rarely been evaluated. Methods: 26 patients with sepsis and 14 healthy controls were enrolled in this study. The initial random plasma total NO and the serum cortisol levels were measured. The same measurements were serially carried out on the $3^{rd}$, $5^{th}$, and $7^{th}$ days. Results: The initial total plasma levels of NO and cortisol were higher in the patients with sepsis than in the healthy controls. The total NO levels were higher in patients with severe sepsis than in the those with mild sepsis. There was a correlation between the total NO and cortisol level throughout the study. Conclusion: In patients with sepsis, the levels of plasma NO and cortisol were well correlated during the first week of sepsis, which suggests an interrelationship. However, the clinical and pathogenetic implications await further evaluation.

The association of dietary patterns with insulin resistance in Korean adults: based on the 2015 Korea National Health and Nutrition Examination Survey (한국 성인의 식사 패턴과 인슐린 저항성 간의 상관성: 2015년도 국민건강영양조사를 이용하여)

  • Kim, I Seul;Yang, Yoon Jung
    • Journal of Nutrition and Health
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    • v.54 no.3
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    • pp.247-261
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    • 2021
  • Purpose: This study was conducted to identify the association between insulin resistance and the major dietary patterns of Korean adults. Methods: This study used data from the 2015 Korea National Health and Nutrition Examination Survey. The subjects were 2,276 adults aged 19 to 64 years old. Based on the food frequency questionnaire data, 112 food items were reclassified into 30 food groups. The principal component analysis method was applied to identify major dietary patterns. We used homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) value as indicators of insulin resistance. The association between major dietary patterns and insulin resistance was investigated using logistic regression analysis. Results: Three major dietary patterns were identified and assigned descriptive names based on the food items with high loadings: 'healthy Korean meal pattern', 'western meal pattern', and 'white rice, alcohol, meat pattern'. As the 'white rice, alcohol, meat pattern' score increased, significant increasing trends for fasting glucose concentration and HOMA-IR and a significant decreasing trend for QUICKI were observed after adjusting for age and sex. The odds ratio of insulin resistance according to the 'healthy Korean meal pattern' and the 'western meal pattern' were not statistically significant. the 'white rice, alcohol, meat pattern' showed a significant positive association with the risk of insulin resistance after adjusting for covariates. Conclusion: These results suggest that the 'white rice, alcohol, meat pattern' is positively associated with the risk of insulin resistance. The white rice, alcohol, meat pattern was related to the high consumption of alcohol together with rice or meat. This pattern was also associated with the high intake of sodium and low intakes of vitamin C, calcium, potassium, and dietary fiber. To confirm the association, further longitudinal studies are required.

Clinical Evaluation of Patients with Unilateral Non-functioning Kidney on $^{99m}Tc-DMSA$ scan ($^{99m}Tc-DMSA$ 스캔에서 일측성으로 동위원소 섭취가 안되는 환아들에 대한 임상적 고찰)

  • Bae Hyun-Chul;Kim Hyun-Young;Kim Pyung-Kil;Han Sang-Won
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.31-37
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    • 1997
  • The DMSA scan is a useful radiologic study in diagnosis of morphologic and functional diseases of kidney. We evaluated the distribution of sex and age, clinical manifestations, diagnosis, combined diseases, treatment and prognosis of the 61 patients with non-functioning kidney(no isotope uptake or uptake below 5% in DMSA scan) who admitted in our hospital from 1980 to 1995. The proportion of patients under 1 year old age was 46%. Sex ratio was 1.4:1 with male predominance. Most diagnosis of non-functioning kidneys were congenital such as multicystic dysplastic kidney, hydronephrosis due to ureteropelvic junction obstruction, renal agenesis and renal hypoplasia. In order of frequency thirty one percent of them were previously detected on antenatal ultrasonogram. Treatment consisted of operation in 47.5%, mostly nephrectomy and 32.8% of patients were followed up at OPD base without definite treatment. The most common combined diseases was hydronephrosis, in 4patients who had both kidneys inveloved progressed to chronic renal failure, but the prognosis in most cases were good. It is important to evaluate renal diseases in perinatal periods, and we believe that highly sensitive diagnostic study contribute to early treatment plan and thus to good prognosis.

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