• Title/Summary/Keyword: 증상의 중증도

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Isolated Leptomeningeal Enhancement in Anti-N-Methyl D-Aspartate Receptor Encephalitis: The Diagnostic Value of Contrast-Enhanced Fluid-Attenuated Inversion Recovery Imaging (항-NMDA 수용체 항체와 관련된 뇌염에서 단독 연수막 조영증강: 조영증강 유체감쇠반전회복기법 영상의 진단적 가치)

  • Jun Kyeong Park;Eun Ja Lee;Kwang Ki Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.945-950
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    • 2022
  • Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a common autoimmune encephalitis that is noted to be a severe but treatable disease entity. Patients with anti-NMDAR encephalitis often develop psychotic symptoms, including delusions, hallucinations, and paranoia, as well as memory impairment and persistent loss of attention. However, MRI findings in such patients show no abnormalities in most cases. Although typical brain abnormality features, known as T2 hyperintensities, involve the brain parenchyma and contrast enhancement at the cerebral cortex or overlying meninges, isolated leptomeningeal enhancement has been rarely reported in anti-NMDAR encephalitis. Herein, we report a patient with anti-NMDAR encephalitis who presented with isolated leptomeningeal enhancement, additionally showing the diagnostic value of contrast-enhanced fluid-attenuated inversion recovery imaging.

A Study on Psychosocial Trait and Mental Health of the Adolescent's Addiction to Cybersex (인터넷 섹스중독 청소년의 심리사회적 특성과 정신건강 연구)

  • Lee, Sang-June
    • Korean Journal of Social Welfare
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    • v.55
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    • pp.341-364
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    • 2003
  • The purpose of this study was to investigate the relationship between adolesccents' cybersexual addiction and psychosocial traits. In addition, the relationship between cybersexual addiction and mental health were examined. For the study, 1,742 students attending middle schools and high schools were surveyed. According to the results of study, first, 1.3% of the adolescents reported the severe degree of cybersexual addiction, 2.3% of them had the moderate degree of addiction, 4.2% of them showed the minor degree. The result indicated that 7.8% of entire adolescents had cybersexual addiction. Second, middle school students showed the highest rate of cybersexual addiction and the students attending general high schools reported the lowest rate. Third, the following groups were likely to have the higher levels of cybersexual addiction; students who were males, had low self-control and less emotional support from the family and friends, and whose parents had marital problems. Fourth, the cybersexually addicted adolescents had experienced more psychological symptoms than general internet users had. Fifth, there was the positive relationship between cybersexual addition and psychological symptoms among adolescents. In particular, cybersexual addiction had the most serious effect on phobic anxiety. Finally, T-score measuring the degree of psychopathological symptoms had the positive relationship with the level of cybersexual addiction among adolescents. Moreover, adolescents who had clinical psychopathology and T-score over 70 showed the various rates from 10.9% to 45.2% in the 9 domains of symptoms.

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Predictive factors for severe infection among febrile infants younger than three months of age (발열을 주소로 내원한 3개월 미만의 영아에서 중증 감염의 예측 인자)

  • Cho, Eun-Young;Song, Hwa;Kim, Ae-Suk;Lee, Sun-Ju;Lee, Dong-Seok;Kim, Doo-Kwun;Choi, Sung-Min;Lee, Kwan;Park, Byoung-Chan
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.898-903
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    • 2009
  • Purpose : This study investigated the predictive factors for identifying infection-prone febrile infants younger than three months. Methods : We conducted a retrospective study of 167 infants younger than three months with an axillary temperature >$38^{\circ}C$ who were hospitalized between 2006 and 2008. If they met any of the following criteria, positive blood culture, CSF WBC ${\geq}11/mm^3$ or positive CSF culture, urinalysis WBC ${\geq}6$/HPF and positive urine culture, WBC ${\geq}6$/HPF on microscopic stool examination or positive stool culture, they were considered at high risk for severe infection. Infants with focal infection, respiratory infection or antibiotic administration prior to admission to the hospital were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and the clinical course between the high risk and low risk groups for severe infection. Results : The high-risk group included 77(46.1%) infants, and the most common diagnosis was urinary tract infection (51.9%). Factors, such as male sex, ESR and CRP were statistically different between the two groups. But, a multilinear regression analysis for severe infection showed that male and ESR factors are significant. Conclusion : We did not find the distinguishing symptoms and laboratory findings for identifying severe infection-prone febrile infants younger than three months. However, the high-risk group was male and ESR-dominated, and these can possibly be used as predictive factors for severe infection.

Association of Leukotriene C4 Synthase Gene Polymorphism with Clinical Response to Montelukast in Childhood Asthma (소아 천식환자에서 Leukotriene C4 Synthase 유전자 다형태와 Montelukast의 임상적 효과와의 연관성)

  • Shin, Kyung Sue;Kim, Youn Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.766-771
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    • 2005
  • Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.

Clinical Impact of Bronchial Reactivity and Its Relationship with Changes of Pulmonary Function After Asthmatic Attack Induced by Methacholine (기관지 반응성의 임상적 의의 및 메타콜린으로 유도된 천식 발작시 폐기능 변화와의 관계)

  • Ryu, Yon-Ju;Choi, Young-Ju;Kwak, Jae-Jin;Lee, Ji-A;Nam, Seung-Hyun;Park, Chang-Han;Chaon, Saon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.24-36
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    • 2002
  • Background: Bronchial reactivity is known to be a component of airway hyperresponsiveness, a cardinal feature of asthma, with bronchial sensitivity, and is increments in response to induced doses of bronchoconstrictors as manifested by the steepest slope of the dose-response curve. However, there is some controversy regarding methods of measuring bronchial reactivity and clinical impact of such measurements. The purpose of this study was to evaluate the clinical significance and assess the clinical use by analyzing the relationship of the bronchial sensitivity, the clinical severity and the changes in pulmonary function with bronchial reactivity. Method: A total of 116 subjects underwent a methacholine bronchial provocation test. They were divided into 3 groups : mild intermittent, mild persistent, moderate and cough asthma. Severe patients were excluded. Methacholine PC20 was determined from the log dose-response curve and PC40 was determined by one more dose inhalation after PC20. The steepest slope of log dose-response curve, connecting PC20 with PC40, was used to calculate the bronchial reactivity. Body plethysmography and a single breath for the DLCO were done in 43 subjects before and after methacholine test. Results: The average bronchial reactivity was 38.0 in the mild intermittent group, 49.8 in the mild persistent group, 61.0 in the moderate group, and 41.1 in the cough asthma group. There was a weak negative correlation between PC20 and bronchial reactivity. A heightened bronchial reactivity tends to produce an increased clinical severity in patients with a similar bronchial sensitivity and basal spirometric pulmonary function. There were significant correlations between the bronchial reactivity and the initial pulmonary function before the methacholine test in the order of sGaw, Raw, $FEV_1$/FVC, MMFR. There were no correlations between the bronchial sensitivity and the % change in the pulmonary function parameters after the methacholine test. However, there were significant correlations between the bronchial reactivity and the PEF, $FEV_1$, DLCO. Conclusion: There was weak significant negative correlation between the bronchial reactivity and the bronchial sensitivity, and the bronchial reactivity closely reflected the severity of the asthma. Accordingly, measuring both the bronchial sensitivity and the bronchial reactivity can be of assistance in assessing of the ongoing disease severity and in monitoring the effect of therapy.

Two cases of Chryseobacterium meningosepticum infection in a neonatal intensive care unit (신생아 중환자실에서 발생한 Chryseobacterium meningosepticum 감염 2례)

  • Yoon, Hye Sun
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.698-701
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    • 2007
  • We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.

Acute BVDV-1b Outbreak in Korean Indigenous Calves (한우 송아지에서 급성 BVDV-1b 발생보고)

  • Choi, Kyoung-Seong
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.395-399
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    • 2012
  • In 2011, several herds in Youngju city in Gyeongbuk province underwent an outbreak of bovine viral diarrhea virus (BVDV) causing high morbidity and mortality. Genetic analysis revealed that two subgenotypes of BVDV-1b (n = 21) and BVDV-2a (n = 7) were identified. The BVDV-1b subgenotype was most frequently detected from our field cases and BVDV-2a subgenotype was also identified in this outbreak. These BVDV-1b infections showed severe acute clinical manifestations similar to BVDV-2 infection. This result reports the detection of BVDV-1b associated with an acute and fatal outbreak of BVDV in Korean indigenous calves.

Pathobiological Analysis of Bovine Viral Diarrhea Virus Identified in the Republic of Korea (한국에서 분리된 소 바이러스성 설사 바이러스의 병리생물학적 분석)

  • Choi, Kyoung-Seong
    • Journal of Veterinary Clinics
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    • v.28 no.3
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    • pp.287-290
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    • 2011
  • Phylogenetic and nucleotide analysis revealed that severe acute bovine viral diarrhea virus (BVDV) outbreaks from Korean indigenous calves belonged to BVDV-2a, and were identical to those of the highly pathogenic BVDV-2 strain 890, with identical virulence markers and classified as highly virulent. These outbreaks affected young calves (20 and 40 day-old) and were characterized by hemorrhagic diarrhea, depression, anorexia, and weakness. The identification of the highly virulent BVDV-2 isolates among Korean indigenous calves may have important implications for epidemiological studies, diagnostic and immunization strategies.

Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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Clinical characteristics of severe respiratory syncytial virus infection requiring mechanical ventilation in neonatal period and early infancy (신생아기와 조기 영아기에 발생한 기계환기요법이 필요했던 중증 respiratory syncytial virus 감염의 임상적 특성)

  • Shin, Seung Han;Kim, Jae Ri;Lee, Jin-A;Choi, Chang Won;Kim, Ee-Kyung;Choi, Eun Hwa;Kim, Han-Suk;Kim, Beyong Il;Lee, Hoan Jong;Choi, Jung Hwan
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.372-376
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    • 2008
  • Purpose : To identify clinical characteristics of severe respiratory syncytial virus (RSV) in neonatal period and early infancy and provide information in clinical practice. Methods : Twelve neonates and young infants (<6 months) who were infected by respiratory syncytial virus and required mechanical ventilation between March 2005 and July 2007 were enrolled. Diagnosis of RSV infection was made based on the positive results by rapid antigen immunoassay or polymerase chain reaction. Results : There were four premature infants, of whom three were near-term. Birth weight of subject patients was $2.8{\pm}0.6kg$, gestational age was $37{\pm}2weeks$ and the age at the time of admission was $35{\pm}15days$. Nine of them showed apnea and in five patients, apnea itself was an indication for mechanical ventilation. In seven of the apneic patients, apnea was the first manifestation of RSV infection. In three of these seven apneic patients, apnea preceded definite respiratory distress signs or typical stethoscopic findings by 1-3 days. Mean duration of mechanical ventilation was $3{\pm}2days$, and mean duration of stay in intensive care unit was $6{\pm}2days$. Conclusion : RSV is a major cause of severe respiratory tract infection in term or near-term infant younger than 2 months. For apnea could be the first manifestation of the RSV infection, high level of suspicion is required in practice of neonates or young infants who show any upper respiratory infection symptoms during RSV season.