This study was designed to evaluate anxiety & depression symptoms and pressure pain threshold in patients with posttraumatic stress disorder(n=23) and to find out the relationship between the affective symptoms and the pressure pain threshold scores. And this was compared with healthy control subjects(n=18). The scores of pressure pain threshold were checked with algometer. The results were as follows : PTSD patients showed higher scores of anxiety & depression symptoms than that of the control group. In contrast with our hypothesis, pressure pain threshold in PTSD patients presented statistically significant higher scores than that of the control group. These results may be derived from following factors. First, chronic depression has influenced the pain perception of patients with PTSD rather than anxiety symptoms, second, abnormal state of the opiate system in PTSD patients, third, the sick role of the PTSD patients, fourth, the socio-environmental factor of the PTSD patients. In conclusion, affective symptoms, especially depression, were related to the chronic pain in patients with PTSD, however, the causality of elevated pressure pain threshold was uncertain in this study. To understand more clearly the relation between affective symptoms and chronic pain, it will be necessary to control the other specific factors.
Purpose : The purpose of this study is to assess and compare the stress of mothers and fathers in families with epileptic children, and to assess contributing factors to their stress. Methods : We used a family stress survey with 35 questionnaires to obtain data concerning the parents' perceived stress. Data were analyzed with SPSS 8.0 program using Pearson correlation coefficient, oneway ANOVA, and multiple range test. Results : The parents' stress level seemed not so high and there was no significant difference in stress level between mothers and fathers. There was no significant correlation between most demographic variables of the parents and parents' stress level. But the time of bringing epileptic children correlates positively with the stress level. Oneway ANOVA showed the differences of parents' stress level according to the education institution, seizure type, number of antiepileptic drugs, and the combined disabilities of the sufferer. Conclusion : The results of present study indicate that the stress level in the families with epileptic children may be influenced by some treatment-related characteristics of epileptic children such as seizure type, number of antiepileptic drugs, combined disabilities and the raising method of hospital expenses.
Purpose: This study was conducted to identify current health care management and barriers in health care management according to ecological systems, and to develop an ecological model for enhancing health care in child care centers. Methods: Focus group interviews were conducted with directors and teachers of child care centers, and with parents of children enrolled in child care. Data were analyzed by the latent content analysis method. Results: Twelve categories of health care management were identified. Barriers to child health care included knowledge deficit and lack of competence in health care by teachers, lack of useful health care manuals, non-existence of professional child health care personnel in child care centers, lack of mutual information sharing and disagreement on child health conditions between child care personnel and parents, lack of specific health related child care inspection criteria and time flexible child care centers with a lack of policy on collaboration with health care facilities. The ecological model developed included specific strategies to improve health care management in child care. Conclusion: The proposed ecological model to improve child health care management should be useful to plan future health care program considering both the immediate and indirect social environment surrounding children in child care.
As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.
This study, based on the research on the history of life, aimed to recompose and analyze into what life progressive structure the life experience by the mentally ill, after the onslaught of the disease, developed in a bid to understand the risk progress in the mentally ill's life, and to determine what contributed to the current stabilized recovery and adjustment. Five mentally ill persons participated in the study, and Sch$\ddot{u}$tze's narrative interview was used to gather data. The gathered data were analyzed according to Sch$\ddot{u}$tze's process structure of life. The interviewees' life experiences were chronologically organized as understood, and significant stories were recomposed that not only brought about changes but also helped overcome their disabilities in the process of treatment and rehabilitation after the onslaught of the disease. As a result, their experiences were recomposed into the stage of onslaught of the mental illness and confusion, and into the stage of intensive treatment and rehabilitation. The former was categorized into suppression by the disease, repetition and endurance of the painful life, and separation from their family and frustration. The latter was categorized into the rediscovery of self through social role change, others who helped realize the life potential, the expansion of mental health services in the community, obstacle to the integration of communities, re-integration of family relationships, re-analysis of experience of the disease through the examination of the life prior to onslaught of the disease, and expectation for the future. Also, these themes were comparatively examined so as to examine the crisis progress in the mentally ill's life after the onslaught of the disease, as well as the life transfer process through positive rehabilitation. Lastly, on the basis of these results, important areas of mental health services for the mentally ill were discussed.
Alzheimer's disease causes progressive neuronal loss that leads to cognitive disturbances. It is not currently curable, and there is no way to stop its progression. However, since medical treatment for Alzheimer's disease is most effective in the early stages, early detection can provide the best chance for symptom management. Biomarkers for the diagnosis of Alzheimer's disease include amyloid β (Aβ) deposition, pathologic tau, and neurodegeneration. Aβ deposition and phosphorylated tau can be detected by cerebrospinal fluid (CSF) analysis or positron emission tomography (PET). However, CSF sampling is quite invasive, and PET analysis needs specialized and expensive equipment. During the last decades, blood-based biomarker analysis has been studied to develop fast and minimally invasive biomarker analysis method. And one of the remarkable findings is the involvement of platelets as a primary source of Aβ in plasma. Aβ can be transported across the blood - brain barrier, creating an equilibrium of Aβ levels between the brain and blood under normal condition. Interestingly, a number of clinical studies have unequivocally demonstrated that plasma Aβ42/Aβ40 ratios are reduced in mild cognitive impairment and Alzheimer's disease. Together, these recent findings may lead to the development of a fast and minimally invasive early diagnostic approach to Alzheimer's disease. In this review, we summarize recent advances in the biomarkers of Alzheimer's disease, especially the involvement of platelets as a source of peripheral Aβ production and its potential as a blood-based biomarker.
The main purposes of the study were to identify factors affecting health-related quality of life of elderly stroke survivors, and to suggest social work interventions for improving their quality of life. The participants were 328 elderly stroke survivors over 55 years old recruited from 18 long-term care hospitals and 13 nursing care facilities in Chung-Nam Province, Korea. The data was collected through a direct survey method from Dec. 16, 2008 to Jan. 17, 2009. Statistical analysis revealed that the overall health-related quality of life among participants was relatively low, especially in the social relationships domain. As a result of hierarchical multiple regression analysis, depression emerged as the most significant predictor of elderly stroke survivors' health-related quality of life, followed by financial burden in future, activities of daily living, acceptance of disability, comorbidity, and major financial supporter(spouse). Health-related quality of life of elderly stroke survivors in long-term care facilities was affected by a variety of variables from disease-related factors to environmental ones. Particularly psychosocial variables were the most powerful factors to predict HRQOL of elderly stroke survivors. Based on the results, social work implications were discussed in the context of developing clinical strategies to alleviate elderly stroke survivors' health-related quality of life in long-term care facilities. Living with chronic illness and disability is a great challenge to the elderly. Most of all long-term residence in care facilities can cause deterioration of quality of life in old age. From now on, studies on health-related quality of life of elderly with chronic illness and disability should be activated in social work field.
Plastic products have long been widely used in both industrial and household applications. However, tiny plastic particles derived from plastic products, such as microplastics (MPs) and nanoplastics (NPs), can infiltrate the human body through inhalation, ingestion, or skin contact. Once inside cells via endocytosis, MPs and NPs (MNPs) can trigger autophagy, but lysosomal dysfunction can block autophagic flux. Accumulating in the cytoplasm, these particles induce cellular stress, including oxidative stress from free radicals, mitochondrial dysfunction, and increased inflammatory response. Meanwhile, cellular senescence is a hallmark of aging and is defined as the stable termination of the cell cycle in response to cell damage and stress. In particular, the accumulation of oxidative stress, a key factor in inducing cellular senescence, induces the expression of major senescence markers. Senescent cells increase the secretion of senescence-associated secretory phenotype, including inflammatory cytokines and chemokines. Despite growing interest in how MNPs induce cellular senescence, there remains a gap regarding their onset and therapeutic targets. Therefore, this review focuses on identifying recent research trends on how MNPs induce cellular aging in key human cell types and proposes future research directions to overcome these challenges.
Journal of The Korean Society of Inherited Metabolic disease
/
v.16
no.1
/
pp.34-41
/
2016
Adult-onset type II citrullinemia (CTLN2) is characterized by episodes of neurologic symptoms associated with hyperammonemia leading to disorientation, irritability, seizures, and coma. CTLN2 is distinct from classical citrullinemia, which is caused by a mutation of the argininosuccinic acid synthetase (ASS) gene. The serum citrulline level is elevated, while the activity of ASS in liver tissue is decreased. CTLN2 is known to have a poor prognosis if the proper treatment is not taken. We reported a female aged 37 years who developed recurrent attacks of altered consciousness, aberrant behavior, and vomiting. We initially suspected the patient had CTLN2 because of the signs of hyperammonemic encephalopathy, such as altered mentality, memory disturbance, and aberrant behaviors provoked by exercise-induced stress and excessive intravenous amino acid administration. Through her peculiar diet preferences and laboratory findings that included hyperammonemia and citrullinemia, we diagnosed the patient as CTLN2, and SLC25A13 sequencing revealed known compound heterozygous mutations (IVS11+1G>A, c.674C> A). Her parents were heterozygous carriers, and we identified that her older sister had the same mutations. The older sister had not experienced any episodes of hyperammonemia, but she had peculiar diet preferences. The patient and her sister have been well with conservative management. When considering the clinical course of CTLN2, it was meaningful that the older sister could be diagnosed early in an asymptomatic period and that preemptive treatment was employed. Through this case, CTLN2 should be considered in adults who present symptoms of hyperammonemic encephalopathy without a definite etiology. Because of its rare incidence and similar clinical features, CTLN2 is frequently misdiagnosed as hepatic encephalopathy, and it shows a poor prognosis due to the lack of early diagnosis and proper treatment. A high-carbohydrate diet, which is usually used to treat other urea cycle defects, can also exaggerate the clinical course of CTLN2, so proper metabolic screening tests and genetic studies should be performed.
Objectives : This study analyzed the differences of body mass index(BMI) in Korean patients with Alzheimer's diseases(AD), Mild Cognitive Impairment(MCI), and healthy controls to verify whether low BMI is associated with cognitive impairment. Furthermore, this study also sought to examine any association between BMI and Mini Mental State Examination-Korean version(MMSE-K), Clinical Dementia Rating(CDR), and Global Deterioration Scale(GDS). Methods : A total of 257 subjects were included in the study. History taking, mental status examination, physical examination and neurocognitive function test were carried out for the diagnosis of AD and MCI. The subjects' demographic data and presence of diseases were also surveyed. The overall cognitive function and severity of diseases were assessed using MMSE-K, GDS, and CDR. Results : The order of BMI was found to be healthy controls>MCI>AD, with statistically significant differences among the groups. The order of MMSE-K scores was similar, with healthy controls>MCI>AD in statistically significant differences. The healthy controls had the lowest CDR and GDS scores, and AD patients had the highest scores. There was a significant positive correlation between BMI and MMSE scores(r=0.238, p=0.000). BMI was negatively correlated with CDR(r=-0.174, p=0.008) as well as with GDS(r=-0.233, p= 0.000). Conclusions : Measuring BMI of patients with AD or MCI is expected to be meaningful in that BMI could be a clinical indicator of AD. We expect this to be beneficial for the diagnosis, prevention, and therapeutic approach of AD and also expect large-scale, long-term longitudinal studies to follow.
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