• Title/Summary/Keyword: Borderline State

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Genetic Variations in the HIF1A Gene Modulate Response to Adjuvant Chemotherapy after Surgery in Patients with Colorectal Cancer

  • Zhang, Yi;Wang, Peng;Zhou, Xing-Chun;Bao, Guo-Qiang;Lyu, Zhuo-Ming;Liu, Xiao-Nan;Wan, Shao-Gui;He, Xian-Li;Huang, Qi-Chao
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.11
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    • pp.4637-4642
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    • 2014
  • Background: Hypoxia-inducible factor $1{\alpha}$ (HIF-$1{\alpha}$) plays an important role in regulating cell survival and angiogenesis, which are critical for tumor growth and metastasis. Genetic variations of HIF1A have been shown to influence the susceptibility to many kinds of human tumors. Increased expression of HIF-$1{\alpha}$ has also been demonstrated to be involved in tumor progression. However, the prognostic value of single nucleotide polymorphisms (SNPs) inthe HIF1A gene remains to be determined in most cancer types, including colorectal cancer (CRC). In this study, we sought to investigate the predictive role of HIF1A SNPs in prognosis of CRC patients and efficacy of chemotherapy. Materials and Methods: We genotyped two functional SNPs in HIF1A gene using the Sequenom iPLEX genotyping system and then assessed their associations with clinicopathological parameters and clinical outcomes of 697 CRC patients receiving radical surgery using Cox logistic regression model and Kaplan Meier curves. Results: Generally, no significant association was found between these 2 SNPs and clinical outcomes of CRC. In stratified analysis of subgroup without adjuvant chemotherapy, patients carrying CT/TT genotypes of rs2057482 exhibited a borderline significant association with better overall survival when compared with those carrying CC genotype [Hazard ratio (HR), 0.47; 95% confidence interval (95% CI): 0.29-0.76; P < 0.01]. Moreover, significant protective effects on CRC outcomes conferred by adjuvant chemotherapy were exclusively observed in patients carrying CC genotype of rs2057482 and in those carrying AC/CC genotype of rs2301113. Conclusions: Genetic variations in HIF1A gene may modulate the efficacy of adjuvant chemotherapy after surgery in CRC patients.

Effects of Mindfulness Based Stress Reduction Program on Depression, Anxiety and Stress in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Joo, Hye-Myung;Lee, Sung-Jae;Chung, Yong-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.345-351
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    • 2010
  • Objective : In this study, the Mindfulness Based Stress Reduction (MBSR) program was applied to patients presenting with depression and anxiety after surgery from spontaneous subarachnoid hemorrhage (SAH) and the effects were assessed. Methods : The subjects were patients admitted for cerebral aneurysm rupture and treated by means of surgery from March to December, 2007. More than 6 months had passed after surgery, without any special lesions showing up on computed tomography (CT), and the Glasgow outcome scale (GOS) was 5 points. Among patients with anxiety and depression symptoms, 11 patients completed the program. The MBSR program was conducted once a week, 2.5 hours each, for 8 weeks. The evaluation criteria were : 1) the Beck Depression Inventory (BDI): it measures the type and level of depression, 2) the State-Trait Anxiety Inventory : the anxiety state of normal adults without mental disorder, and 3) Heart Rate Variability (HRV) : the influence of the autonomous nervous system on the sinoarterial node varies continuously in response to the change of the internal/external environment. Results : The BDI value was decreased from 18.5 ${\pm}$ 10.9 to 9.5 ${\pm}$ 7.1 (p = 0.013) : it was statistically significant, and the depression level of patients was lowered. The state anxiety was decreased from 51.3 ${\pm}$ 13.9 to 42.3 ${\pm}$ 15.2; the trait anxiety was reduced from 50.9 ${\pm}$ 12.3 to 41.3 ${\pm}$ 12.8, and a borderline significant difference was shown (p = 0.091, p = 0.056). In other words, after the treatment, although it was not statistically significant, a decreased tendency in anxiety was shown. In the HRV measurement, standard deviation normal to normal (SDNN), square root of the square root of the mean sum of squared differences between adjacent normal to normal intervals (RMSSD), and total power (TP) showed significant increase, Physical Stress Index (PSI) showed a significant reduction, and thus an improvement in the homeostatic control mechanism of the autonomic nervous system was ween. Conclusion : The MBSR program was applied to the patients showing anxiety and depression reaction after SAH treatment, and a reduction in depression symptoms and physiological reactions were observed. The application of the MBSR program may be considered as a new tool in improving the quality of life for patients after surgery.

A Basic Study of the Needs for Menu Development Considering Stress and Eating Habit of Adult in Restaurants (외식업체에서 성인의 스트레스 및 식습관을 고려한 메뉴 개발 필요성에 관한 기초연구)

  • Lee Young-Nam;Kim Kyoung-Hee
    • Journal of the East Asian Society of Dietary Life
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    • v.15 no.6
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    • pp.773-781
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    • 2005
  • Menu-development is one of the important parts in restaurant business. Menu in restaurant has to be developed by customer's net which is the key for the success in restaurant management, The purpose of this study is to determine stress level, food intake, food habit, food preference of employees in certain companies and to develop proper menus for employees who are under high stress state. This study also determine whether the customers under stress will visit restaurant which provide stress-release-menu or not This study was conducted to people who live in Seoul and its adjunct area, including Gyunggi Province. The subjects were selected at random and the Questionnaires were sent to the subject by mail. The surveys included personal information, extent of stress, food habits related to the stress. The statistical tests were performed with SPSS computer software program. The male subjects were $44.9\%$ and females were $55.1\%$, aged between $30\~40$ years old. The percentages of no risk, borderline, and at risk, in the stress level of subjects, were 48.3, 16.5 and $35.2\%$, respectively. Most of the subjects, $61.8\%$, had normal food habit and $29.2\%$ had bad food Habits. The ideal costs of meals were $3,000\~5,000Won$ for breakfast$(57.3 \%)$, $5,000\~10,000Won$ for lunch$(54.7\%)$, and $10,000\~20,000Won$ for dinner$(38.2\%)$. Subjects under high stress answered 0 need a dietary supplementation for stress release. This study also showed that $92\%$ of the subjects under stress were willing to visit restaurants which have stress-release menus. In conclusion, adults who are under stress are shown to be interested in stress and nutrition management and they are willing to visit restaurants providing stress-release menus.

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Nucleophilic Displacement at Sulfur Center (ⅩⅢ). Solvolysis of para-Substituted Benzenesulfonyl Chlorides in MeOH-MeCN Mixtures (황의 친핵성 치환반응 (제13보). 메탄올-아세토니트닐계에서의 파라치환 염화벤젠술포닐의 가용매 분해반응)

  • Ikchoon Lee;In Sun Koo
    • Journal of the Korean Chemical Society
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    • v.25 no.1
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    • pp.7-12
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    • 1981
  • Solvolysis of $p-CH_3, p-H, p-Cl and p-NO_2$-benzenesulfonyl chlorides have heen studied in MeOH-MeCN mixtures. A nonlinear Hammett plot with a ratio order of p-NO_2 > p-CH_3 > p-H > p-Cl was obtained; the reaction was thought to proceed by an S_N1-S_N2 borderline mechanism. In all cases the reactivity was a maximum at 90∼95%(v) methanol, whereas methanol monomer selectivity defined as fi = \frac{k1}{ki}i (k1; observed pseudo-first order rate constant: ki; hypothetical rate constant for MeOH solution having the same polymer structure as in the pure MeOH) was a maximum at 80% methanol with a decreasing order of fi as p-NO_2 > p-Cl > p-H > p-CH_3.$ This was interpreted as the decrease in tightness of transition state; the larger the fi, the tighter is the MeOH attached to the substrate, and hence the more susceptible the substrate becomes to the approaching monomer methanol.

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A Study on the Depression and Anxiety of High School Students in an Urban Area (도시지역 일부 고등학생들의 우울과 불안에 관한 조사 연구)

  • 곽은주;송인순;정용준;조영채
    • Korean Journal of Health Education and Promotion
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    • v.20 no.2
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    • pp.63-79
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    • 2003
  • This study has examined the degree of depression and anxiety among high school students in an urban area and then explored the factors influencing their depression and/or anxiety status. Self-administered questionnaires were offered to 2,381 students from ten high schools in Daejon Metropolitan City. The items for investigation included such factors as various characteristics of school and family life, daily life style, and the degree of depression and anxiety. Based on the study results, the following conclusions were made; 1. The distribution according to the depression degree has shown that 61.9% of students were normal, 32.9% of students had mild depression, 5.0% moderate depression, and 0.3% severe depression. As for anxiety, 40.2% of students were normal, while 19.1% were classified as having anxiety and 40.7% borderline anxiety. 2. As regards to the degree of depression and anxiety, it was greater in girls than boys, in 3rd graders than 1st and 2nd graders, and in the groups who have recieved lower grades in studies, who had poor relations with their friends and a low feeling of satisfaction with school life. In particular, concerning various characteristics of family life, the scores of depression and anxiety were higher in the groups whose financial conditions were poor, whose parents' interests were lower, whose degree of satisfaction with their family and school life was lower, than their counterparts. 3. According to their life styles higher scores of depression and anxiety were found in the groups whose sleeping time was inappropriate, whose breakfasts were skipped, who ate daily snacks, who didn't take regular exercises, and who had poor health habits, compared to their counterparts, respectively. 4. As for the correlation between the degree of depression and its associated variables, the higher scores of depression were in positive correlation with the groups who had lower grades in studies, poor relation with their friends, low feeling of satisfaction with school and home life, low parents' interest, poor subjective condition of health, breakfast skipping, lack of regular exercises, and lower indices of health habits. 5. As for anxiety, the higher scores of anxiety were in the positive correlation with the groups with poor relation with their friends, low feeling of satisfaction with school and family life, poor subjective condition of health, lack of regular exercises, and poor health habits. 6. The influential factors on the depression of students were selected such as subjective condition of health, sex, feeling of satisfaction with family and school life, grades in studies, relation with their friends, presence of regular exercises, degree of interest of parents, sleeping time, cigarette smoking and eating breakfast. 7. The influential factors on the anxiety state of students were selected such as subjective condition of health, feeling of satisfaction with family and school life, sex, sleeping time, regular exercises, cigarette smoking, snacking and relations with their friends. The present study results suggest that girls rather than boys, higher graders than lower ones are more vulnerable to anxiety and depression state, and besides, various characteristics of school and family life, and daily life style can be influential on students' emotional states. Therefore, better management of psychological status of students is thought to require a wide variety of measures to modify the influencing factors and to encourage social support.

PSYCHOPATHOLOGY IN ADOLESCENTS WITH PARENT ABUSE (부모학대 청소년의 정신병리)

  • Kwak, Young-Sook;Bang, Hyun-Soog
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.13-25
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    • 1998
  • Aim:We think that the most important etiology in parent abuse is the psychodynamic and psychopathology in the family. So, we investigated the adolescents being admitted in SNMH, whose chief complaints were parent abuse. We were trying to explore families psychodynamic and psychopathology, especially mother-child interaction and to differentiate them in according to developmental psychopathology. Method:Our objects were the adolescent patients admitted in SNMH from 1987 to 1997 because they attacked parents verbally and physically. We examined 21 adolescents except those with psychosis, organic mental disorder, autism and mental retardation by means of interview or chart review. Result and Conclusion:The number of male patients was 14 and the number of female patients was 7. The most common diagnosis was conduct disorder and borderline personality disorder. The mean age was in the mid-teens. We observed 4 subgroups that were divided developmentally in object relation. 1) Symbiotic group with mother:(1) They did not separate and remain in symbiotic relationships with their mothers based on insecure attachment. Fathers were abscent emotionally and physically, and their mothers were prominent in close relationships with the patients in their family , where as the patients were the only man in the family. Adolescents entered the second separation-individuation. They expressed anger and internal tension involved with the close attachment with their mothers and also attempted separation from their mothers through physically attacking them. (2) These patients had suffered from physical illness and developmental delay since birth. Therefore the parents overprotected their children. The children had persistent infantile omnipotence and fantasies of power, so they could not deal with unrealistic states, adapt to reality, and depended on their parents overtly. They easily acted out unless their demands were fulfilled. 2) Borderline personality disorder:We observed deficiencies in care taking. Their parents had personality problems and immaturity. They coulden’t help their children to be separated in the rapproachment phase. Their conflict about dependence-independence was revived in the second separation-individuation adolescent period. We understand parent abuse as an attempt to overcome the conflict. 3) Conduct disorder:They did not build up basic attachment with their parents. They think of their parents as only a means of fulfilling their needs. When patients’ need were not fulfilled and remained in a conflicted state, they attacked their parents, unable to control their aggressions and impulses.

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Cognition of registered nurse on emergency treatment for oral and maxillofacial injury in Jeju province (제주 지역 간호사의 구강 악안면 영역 손상에 대한 응급 처치 인식도)

  • Lee, Byoung-Jin;Song, Hyo-Jeong;Lim, Gil-Chai;Kahm, Se-Hoon;Kim, Sung-Joon
    • The Journal of the Korean dental association
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    • v.50 no.12
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    • pp.763-770
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    • 2012
  • The purposes of this work were to assess the cognition of the registered nurse(RN) on oral and maxillofacial emergency treatment and to compare cognition of the RN with that of the 119 emergency medical technician(EMT). 450 RNs who were working at each of secondary hospitals in Jeju province had responded to the questionnaire. Independent sample t-test and chi-square test were used to assess the state of RN on dental emergency treatment and to compare RN with EMT. The question 'education time on dentistry in formal education' that marked '0 hour' and '1-3 hours' were 73.3% and 20.0%, respectively. The question 'refresher training class on dentistry' that marked '0 hour' and '1-3 hours' were 92.9% and 6.7%, aggregately 99.6%. The results showed low score in the question 'reduction of temporo-mandibular joint(TMJ)'($1.67{\pm}0.857$), 'fixation of dislocated TMJ'($1.70{\pm}0.853$) and 'post-avulsed tooth treatment'($1.78{\pm}0.774$) by 5-point Likert scale. Likewise, the scores were $2.02{\pm}0.806$ in the question 'treatment of maxillofacial trauma', $2.76{\pm}1.061$ in the question 'emergent care of avulsed tooth', $2.70{\pm}1.095$ in the question 'treatment time of avulsed tooth' and $2.79{\pm}1.056$ in the question 'mouth guard', respectively. Compared to EMT, results of RN showed a statistically lower figure(p<0.05) in all items compared except the question 'medicine control', and the question 'doctor care in emergency room' was borderline(p=0.069). From this study, it is necessary for RN and student of nursing science to be educated on the oral and maxillofacial emergency treatment for the initial management of injuries. Authors suggest further co-study and nation-wide research with nursing care.

Thyroid Function Test in Thyroid Diseases and Pregnancy - The diagnostic value of free thyroxine by RIA - (임신 및 각종 갑상선질환에서 갑상선 기능 판정에 관한 연구 - 혈청유리 $T_4$의 진단적 의의에 관한 고찰 -)

  • Yoo, M.H.;Yoon, H.J.;Shin, Y.T.;Lee, J.C.;Chung, S.I.;Cho, B.Y.;Lee, M.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.1
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    • pp.1-11
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    • 1981
  • To evaluate the diagnostic accuracy of the measurement of free thyroxine (FT4) by radioimmunoassay, we measured free $T_4\;and\;T_4,\;T_3,\;T_3RU$, TSH and TBG serum levels by radioimmunoassay in 18 healthy persons and 52 patients with various thyroid diseases and 11 normal pregnant women. The results are as follows. 1. In 19 cases of overt hyperthyroidism, $T_3,\;free\;T_4$ and FTI, $T_4/TBG$ ratio reflect hyperfunction in all cases. $T_4$ is increased in 94% (18/19) and TBG and TSH are decreased in 79% (15/19). 2. In 8 patients with overt hypothyroidism, TSH is increased in all cases and free $T_4$ and FTI is decreased in all cases. $T_4$ is decreased in 87.5% (7/8), $T_3$ is decreased in 75% (6/8) and $T_4/TBG$ ratio is decreased in 62.5% (5/8). 3. In 5 patients who are clinically in euthyroid state after treatment of hyperthyroidism, $T_4,\;free\;T_4$, FTI and TSH are in the normal range in all cases and $T_3$ is normal in 60% (3/5) and slightly increased in 40% (2/5). 4. In 10 patients who showed clinically borderline hypothyroidism after treatment of hyperthyroidism, TSH is increased in all cases and free $T_4$ and FTI are decreased in all cases, but $T_4\;and\;T_3,\;T_4/TBG$ ratio are in the normal limit in all cases. So after treatment of hyperthyroidism, TSH, free $T_4$ or FTI are recommended as optimal thyroid function test. 5. In normal pregnancy, free $T_4$, FTI and $T_4/TBG$ ratio reflect normal function, but the other parameters revealed unreliable due to the influence of increased TBG. Also TBG and TSH level in pregnancy is increased significantly compared with normal healthy control group. 6. The coefficients of correlation between free $T_4$ and FTI were 0.862 (p<0.001) and 0.685 (p<0.001) between free $T_4\;and\;T_4/TBG$ ratio. In most patients, diagnostic value of free $T_4$ was comparable and even superior to FTI, so free $T_4$ measurement can be used routinely with thyrotropin assay in the diagnosis of hypothyrodism or with $T_3$ for the diagnosis of hyperthyroidism.

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A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment (지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例))

  • Sohn, Chang-Ho;Shin, Min-Sup;Hong, Kang-E;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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