• Title/Summary/Keyword: 증상의 중증도

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Clinical and Epidemiological Study of 1,165 Hospitalized Cases of Rotaviral Gastroenteritis Before and After the Introduction of Rotavirus Vaccine, 2006-2013 (로타바이러스 백신 도입 전후 입원한 로타바이러스 위장관염 1,165례의 역학 및 임상적 연구, 2006-2013년)

  • Sohn, Tae-Young;Lee, Chan-Jae;Kim, Yoon-Joo;Kang, Min-Jae;Kim, Sung-Hye;Lee, So-Yeon;Lee, Dae-Hyoung;Lee, Hae-Ran;Kim, Kwang-Nam
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.174-180
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    • 2014
  • Purpose: This study was performed to assess the clinical and epidemiological changes after the introduction of the rotavirus vaccine in Korea, as well as to determine the efficacy of the rotavirus vaccine among hospitalized rotaviral gastroenteritis patients over the past two years. Methods: We analyzed yearly and seasonal patterns of 1,165 inpatients who were hospitalized for rotaviral gastroenteritis under the age of 5 years between 2006 and 2013. We also conducted a survey among 460 gastroenteritis patients who were hospitalized between 2012 and 2013 regarding the rotavirus vaccination and the symptoms of gastroenteritis. Among those individuals surveyed, clinical indices were analyzed for 124 patients who were tested positive for the rotavirus antigen. Results: The incidence of Rotaviral gastroenteritis have decreased significantly by year 2010. After the introduction and widespread dissemination of the rotavirus vaccine, the onset of the disease and the seasonal peak have been delayed. Overall, the vaccinated group showed a lower rate of positivity than the unvaccinated group. Among the hospitalized rotaviral gastroenteritis patients, the vaccinated group had a shorter hospitalization period, less severe clinical symptoms of gastroenteritis, and better laboratory test results. Conclusions: After introduction of the rotavirus vaccine in Korea, there were two main trends observed: 1) the overall level of disease incidence was reduced; 2) the severity of rotaviral gastroenteritis cases also decreased. Based on this data, more children should receive vaccination in order to prevent the rotavirus infection and decrease the severity of rotaviral gastroenteritis.

Predictive value of cobalt chloride solution for hypohidrosis with topiramate (약물 유발 소한증에서 cobalt chloride solution의 임상적 유용성)

  • Lee, Hyuk;Lee, Seung Hyun;Kim, Sun Jun
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1180-1185
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    • 2006
  • Purpose : The aims of this study were to verify the incidence of hypohidrosis and to determine the predictive value of noninvasive indicator test ($Neurocheck^{TM}$) for sweating after administration of topiramate in newly diagnosed pediatric epileptic patients. Methods : A total of 46 epileptic patients (22 boys; 24 girls) on topiramate treatment were evaluated in this study at the Department of Pediatrics, Chonbuk National University Hospital, from October 2004 to July 2005. We measured sweating functions using a noninvasive sweating test ($Neurocheck^{TM}$) before topiramate medication, and after 3 months when topiramate reached its target dosage. We performed a direct questionnaire survey for the hypohidrosis related symptoms during topiramate treatment. Results : The mean age was $7.8{\pm}3.2year$. The mean dosage of topiramate was $4.5{\pm}0.8mg/kg/day$. Among the patients, there were 40 complex partial seizures, one simple partial seizure, two partial seizures with secondarily generalization, two generalized seizures, and one Lennox-Gastaut syndrome case. Of the 46 epileptic patients, 17 patients (37.0 percent) experienced hypohidrosis and hypohidrosis related symptoms, 12 (26.1 percent) had facial flushing, four (8.7 percent) had heat intolerance, one (2.2 percent) had lethargy, but no one had anhidrosis. Among the 17 patients, the mild group numbered 12 and the severe group totalled five. Hypohidrosis by $Neurocheck^{TM}$ was diagnosed in 16 patients. The overall measures of agreement between $Neurocheck^{TM}$ and the survey was 76.5 percent. The specificity of this test was 89.7 percent. Patients who showed a time delay after medication, especially over 3 minutes, were seen only in the severe group. Conclusion : $Neurocheck^{TM}$ could be clinically useful to detect and predict topiramate induced hypohidrosis in pediatric epileptic patients. We recommend that patients who show a delay over 3 minutes in $Neurocheck^{TM}$ test after topiramate initiation should be monitored for hypohydrosis.

Result of Multiphasic Personality Inventory among Myasthenia Gravis in Late Adolescence Visiting for Conscription Examination (군신체검사를 받은 후기 청소년에서 중증근무력증의 다면적 인성검사 결과)

  • Seong, HyeYoon;Lee, Jonggook;Oh, Jungkeun;Seo, JeongSeok;Noh, Soo Rim;Kim, Taehyun;Nam, Beomwoo
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.85-89
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    • 2019
  • Objectives : The purpose of this study was to quantitatively assess the degree of myasthenia gravis (MG) affecting mental health through the results of multiphasic military personality inventory in late adolescence. Methods : We collected and analyzed the results of the military personality inventory for healthy controls and MG patients among the 19-year-old men who visited the Military Manpower Administration from February 2007 to January 2010. Military personality inventory invented for Korean military test has similar system to Minnesota multiphasic personality inventory. Results : Among validity scales, each score of faking good, faking bad and infrequency subscales showed no difference between healthy control and MG groups, respectively (t=-0.51, p=0.607 ; t=0.11, p=0.913 ; t=1.41, p=0.158). Among neurosis scales, the score of somatization subscale was higher (t=2.29, p=0.023) in MG group. Among psychopath scales, the score of schizophrenia subscale was lower in MG group (t=-2.38, p=0.018). Conclusions : According to MPI results, we can confirm that MG patients in late adolescence may be more concerned with their somatic symptoms than the control group, and that they may be more likely to abide by the regulation and be conventional in their behavior than the control group.

Melatonin for Treatment of Delirium in Hospitalized Patients : Retrospective Trial (입원 환자의 섬망 치료에서 멜라토닌의 효과에 관한 후향적 연구)

  • Yang, Jung Woo;Kim, Jong Woo;Kang, Won Sub;Lee, Sang Min;Kim, Young Jong;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.112-118
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    • 2018
  • Objectives : Delirium is one of the most common mental illnesses that can affect cognitive function. Melatonin has been shown to be effective in the treatment of insomnia, and recent studies have shown a protective effect to prevent delirium. This study was conducted to investigate the efficacy of melatonin in delirium patients. Methods : All patients were referred to psychiatric department for insomnia and symptoms of delirium, and were diagnosed delirium by the DSM-5 diagnostic criteria. We compared base line severity of delirium with K-DRS-R-98-R (Korean version of Delirium Rating Scale revised 98) and after taking 2mg of melatonin, retrospectively. The side effects were also identified by referring to the medical records. Results : A total 21 patients had taken melatonin for insomnia and delirious symptoms. The K-DRS-R-98 scores were decreased from $15.24{\pm}2.64$ before treatment to $6.57{\pm}5.42$ after treatment. And CGI-S scores were also decreased from $4.14{\pm}0.48$ before treatment to $2.81{\pm}0.93$ after treatment (p<0.05). Conclusions : This study illustrates the possibility of melatonin as an effective treatment option for delirious symptoms such as disorientation, motor agitation, lability of affect and hallucinations as well as insomnia, with less concerns of drug side effect. Further study with a larger sample and prospective design will be required to confirm these results.

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.619-625
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    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

Clinical Features of Acute Pancreatitis in Children (소아 급성 췌장염의 임상적 고찰)

  • Seo, Jung-Ho;Kim, Seong-Heon;Jeong, Sang-Geon;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.58-65
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    • 2010
  • Purpose: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. Methods: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. Results: Twenty males and 21 females (mean age, 8.7${\pm}$4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3${\pm}$553.2 and 766.2${\pm}$723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. Conclusion: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.

Association between Quality of Life and Symptom Severity in Obsessive-Compulsive Disorder Patients Using EQ-5D (EQ-5D를 이용한 강박장애 환자의 삶의 질과 증상 중증도의 연관성 연구)

  • Kim, Sung Nyun;Moon, Woori;Han, Jaewook;Lee, Junhee
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.129-133
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    • 2017
  • Objectives Obsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, and more attention is recently paid on the quality of life (QoL) in OCD patients. The Euro-QoL-5D (EQ-5D) is a widely used self-report to calculate a single score which represents 'health utilities'. The aim of this study was to assess the health-related QoL for patients with OCD using the EQ-5D and to examine the relationship between health-related QoL and symptom severity. Methods Seventy-three patients with a Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of OCD were recruited from the outpatient clinic in Seoul National University Hospital. Symptom severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and QoL was assessed with the EQ-5D-5L questionnaire. Using Korean valuation study, a single score of QoL was calculated. Results Most of the OCD patients were relatively young (< 45 years) with the mean YBOCS total score of 19.33. The mean EQ-5D score was 0.71 and significantly correlated with symptom severity (r = -0.483, p < 0.001). 25% of the EQ-5D score was predicted by the YBOCS total score (b = -0.011, p < 0.001) by regression analysis. Conclusions OCD patients suffer from lower health-related QoL and QoL significantly decreased as symptom severity increased. The results of the EQ-5D would enable further studies on QoL comparison across medical disease and mental disorders.

Implant overdenture with closed impression technique for patient with Myasthenia Gravis: A case report (중증 근무력증 환자에서 폐구 인상법을 이용한 임플란트 피개의치 수복 증례)

  • Park, Lydia;Park, Minhyuk;Park, Sangwon;Lim, Hyun-Pil;Jang, Woohyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.459-468
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    • 2021
  • In patients with myasthenia gravis, it is difficult to manufacture and maintain dentures because the muscles and nervous system in the oral cavity are not properly adjusted. In addition, excessively extended or thick dentures may cause muscle weakness by stimulating the muscles, so dentures should be manufactured in consideration of this. In this case, a denture was fabricated using the closed mouth technique in a patient with myasthenia gravis with mouth opening limitation. Using the closed mouth technique, the patient's masticatory pressure and muscle movements were reproduced and denture with good retention were manufactured.

Comparison of Usefulness of Laboratory Tests in Diagnosis of Myasthenia Gravis (중증 근무력증 진단에 있어서 제반 검사법들의 유용도 비교)

  • Park, Seung-Kwon;Do, Hyun-Cheol;Kim, Min-Jung;Lee, Seung-Yeop;Park, Mee-Yeoung;Hah, Jung-Sang;Kim, Wook-Nyeun;Lee, Jun
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.125-134
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    • 1998
  • Purpose: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). Method: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. Result: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). Conclusion: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the, Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.

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Pruritus in Burn Survivors (화상환자의 소양증 특성 조사)

  • Kim, Kyung Ja;Won, Mi Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.45-53
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    • 2016
  • This study examined pruritus to provide the data based on burn patient pruritus. A self-report questionnaire survey was conducted among ninety five burn survivors, who were over 18 years of age with admission periods longer than two weeks. The results indicated that the average burn range was $18.95{\pm}17.10%$, severity was $48.83{\pm}23.96$, and distress was $46.42{\pm}25.80$. A significant difference in pruritus consequences was observed according to frequency. The patients consistently experienced pruritus, even if it happened less often, difficulty in falling asleep (F=4.817, p=.004), poor mood (F= 5.955, p=.015)), and loss of concentration (F=6.483, p<.000). A significant difference in the pruritus consequences according to duration was observed, lasting for 30 minutes for all groups, more than the population and less than 30 minutes, difficulty in falling asleep (F=7.452, p<.000), poor mood (F=3.655, p<.015), and loss of concentration (F=12.564, p<.000). The frequency, duration (r=.29, p=.004), severity (r=.45, p<.000), distress (r=.44, p<.000), and consequences of pruritus in burn patients (r=.29, p=.004) showed a positive correlation. The results of this study could be used as a base material for the care of burn patients experiencing pruritus.