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Anger-Related Characteristics and Childhood Adversity in Somatic Symptom Disorder (신체증상장애와 관련된 분노정서특질과 아동기 역경 경험)

  • Kang, Sung-Hyuk;Park, Chun Il;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Anxiety and mood
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    • v.16 no.2
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    • pp.49-56
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    • 2020
  • Objective : The present study aims to investigate differences in anger-related features in patients with somatic symptom disorder (SSD) compared to healthy controls, and to examine whether anger trait and anger regulation strategy are associated with clinical characteristics in patients with SSD. In addition, we examined the relationship between childhood adversity and SSD. Methods : 26 patients with SSD and 28 healthy controls were included. Anger-related features were assessed with State-Trait Anger Expression Inventory (STAXI). Clinical somatic symptoms were assessed using the somatization subscale of the Symptom Checklist-90-Revised and the Somatosensory Amplification Scale. Childhood adversity was assessed by the Childhood Traumatic Events Scale. Multivariate analysis of covariance was performed. Results : Disease status of SSD had a significant overall effect on anger-related features (Wilks λ=0.725, F(5, 44)=3.332, p=0.012). Patients with SSD showed a significantly high Trait-Anger (p=0.017) and they had a high score in both Anger-Out (p=0.013) and Anger-In (p=0.001) of anger expression styles. In particular, a directed inward style of anger expression was significantly associated with somatization symptom severity (p=0.003). Regarding childhood adversity, more childhood extreme illness was experienced by the SSD group than the control group (p=0.012). Within the SSD group, childhood extreme illness was associated with higher Trait-Anger (p=0.027) and Anger-Out (p=0.001). Conclusion : The present findings suggest that trait anger, anger expression styles, and childhood adversity of extreme illness may be involved in SSD. Further studies are needed to explore the role of anger-related features and its relationship with childhood adversity in the pathophysiology of SSD.

Direct Pars Repair Surgery Using Two Different Surgical Methods : Pedicle Screw with Universal Hook System and Direct Pars Screw Fixation in Symptomatic Lumbar Spondylosis Patients

  • Shin, Myung-Hoon;Ryu, Kyeong-Sik;Rathi, Nitesh Kumar;Park, Chun-Kun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.1
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    • pp.14-19
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    • 2012
  • Objective : The authors performed a retrospective study to assess the clinical and radiological outcome in symptomatic lumbar spondylolysis patients who underwent a direct pars repair surgery using two different surgical methods; pedicle screw with universal hook system (PSUH) and direct pars screw fixation (DPSF), and compared the results between two different treated groups. Methods : Forty-seven consecutive patients (PSUH; 23, DPSF; 15) with symptomatic lumbar spondylolysis who underwent a direct pars repair surgery were included. The average follow-up period was 37 months in the PSUH group, and 28 months in the DPSF group. The clinical outcome was measured using visual analogue pain scale (VAS) and Oswestry disability index (ODI). The length of operation time, the amount of blood loss, the duration of hospital stay, surgical complications, and fusion status were also assessed. Results : When compared to the DPSF group, the average preoperative VAS and ODI score of the PSUH group were less decreased at the last follow-up; (the PSUH group; back VAS : 4.9 vs. 3.0, leg VAS : 6.8 vs. 2.2, ODI : 50.6% vs. 24.6%, the DPSF group; back VAS : 5.7 vs. 1.1, leg VAS : 6.1 vs. 1.2, ODI : 57.4% vs. 18.2%). The average operation time was 174.9 minutes in the PSUH group, and 141.7 minutes in the DPSF group. The average blood loss during operation was 468.8 cc in the PSUH group, and 298.8 cc in the DPSF group. The average hospital stay after operation was 8.9 days in the PSUH group, and 7 days in the DPSF group. In the PSUH group, there was one case of a screw misplacement requiring revision surgery. In the DPSF group, one patient suffered from transient leg pain. The successful bone fusion rate was 78.3% in the PSUH group, and 93.3% in the DPSF group. Conclusion : The present study suggests that the technique using direct pars screw would be more effective than the method using pedicle screw with lamina hook system, in terms of decreased operation time, amount of blood loss, hospital stay, and increased fusion success rate, as well as better clinical outcome.

Clinical Experience of the Dynamic Stabilization System for the Degenerative Spine Disease

  • Lee, Soo-Eon;Park, Sung-Bae;Jahng, Tae-Ahn;Chung, Chun-Kee;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.221-226
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    • 2008
  • Objective : The aim of the present study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases. Methods : The study population included 20 consecutive patients (13 females, 7 males) with a mean age of $61{\pm}6.98$ years (range 46-70) who underwent decompression and dynamic stabilization with the Dynesys system between January 2005 and August 2006. The diagnoses included spinal stenosis with degenerative spondylolisthesis (9/20, 45%), degenerative spinal stenosis (5/20, 25%), adjacent segmental disease after fusion (3/20, 15%), spinal stenosis with degenerative scoliosis (2/20, 10%) and recurrent intervertebral lumbar disc herniation (1/20, 5%). All of the patients completed the visual analogue scale (VAS) and the Korean version of the Oswestry Disability Index (ODI). The following radiologic parameters were measured in all patients : global lordotic angles and segmental lordotic angles (stabilized segments, above and below adjacent segments). The range of motion (ROM) was then calculated. Results : The mean follow-up period was $27.25{\pm}5.16$ months (range 16-35 months), and 19 patients (95%) were available for follow-up. One patient had to have the implant removed. There were 30 stabilized segments in 19 patients. Monosegmental stabilization was performed in 9 patients (47.3%), 9 patients (47.3%) underwent two segmental stabilizations and one patient (5.3%) underwent three segmental stabilizations. The most frequently treated segment was L4-5 (15/30, 50%), followed by L3-4 (12/30, 40%) and L5-S1 (3/30, 10%). The VAS decreased from $8.55{\pm}1.21$ to $2.20{\pm}1.70$ (p<0.001), and the patients' mean score on the Korean version of the ODI improved from $79.58%{\pm}15.93%$ to $22.17%{\pm}17.24%$ (p<0.001). No statistically significant changes were seen on the ROM at the stabilized segments (p=0.502) and adjacent segments (above segments, p=0.453, below segments, p=0.062). There were no patients with implant failure. Conclusion : The results of this study show that the Dynesys system could preserve the motion of stabilized segments and provide clinical improvement in patients with degenerative spinal stenosis with instability. Thus, dynamic stabilization systems with adequate decompression may be an alternative surgical option to conventional fusion in selected patients.

The Effect of Positive Feedback and Reinforcement on the Enhancement of Performance and the Regulation of Anxiety (긍정적 사고가 운동 수행 능력의 향상과 불안조절에 미치는 영향)

  • Han, Doug-Hyun;Cho, Kyu-Hyun;Min, Kyung-Joon;Na, Churl
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.2
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    • pp.107-112
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    • 2007
  • Introduction : A positive thinking has been known to affect the enhancement of performance. One of temperament characters, harm avoidance is thought to be associated with anxiety related behaviors. Golfer showed highest anxiety and lowest score of harm avoidance, compared to any other sports. We hypothesized that positive feedback and reinforcement in golfer would decrease the anxiety and improve the performance. Methods : Fifty one golfers with the age from 15 to 19 were classified into two groups; 25 golfers who used Zinsser's Changing Negative thoughts to Positive thoughts and Beswick's positive self talk when exercise and competition (P-FB) and 26 golfers who had not (controls). Harm avoidance, Spielberg's Trait and State Anxiety, and Golf scores has been assessed at baseline and 6 months later. Results : There was no significant difference in baseline harm avoidance, anxiety, and golf scores between P-FB and controls. The total golf scores in both groups have improved after 6 month later. However, P-FB group showed greater improvement of total scores and putting scores, compared to controls. The state anxiety in PFB group has been decreased, while there was no change in controls. The change in the state anxiety was correlated with harm avoidance and the change in total golf scores. Discussions : The positive thinking has enhanced performance and state anxiety. The improvement of performance and anxiety in golfers was associated with high harm avoidance. The current study showed that the regulation of anxiety with positive thinking was helpful to the performance enhancement in subject with high harm avoidance.

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Comparison of Rib Fracture Location for Morbidity and Mortality in Flail Chest (늑골 골절의 위치가 동요흉의 이환율 및 사망률에 미치는 요인)

  • Byun, Chun Sung;Park, Il Hwan;Bae, Geum Suk;Jeong, Pil Yeong;Oh, Joong Hwan
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.170-174
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    • 2013
  • Purpose: A flail chest is one of most challenging problems for trauma surgeons. It is usually accompanied by significant underlying pulmonary parenchymal injuries and mayled to a life-threatening thoracic injury. In this study, we evaluated the treatment result for a flail chest to determine the effect of trauma localization on morbidity and mortality. Methods: Between 2004 and 2011, 46 patients(29 males/17 females) were treated for a flail chest. The patients were divided into two group based on the location of the trauma in the chest wall; Group I contained patients with an anterior flail chest due to a bilateral costochondral separation (n=27) and Group II contained patients with a single-side posterolateral flail chest due to a segmental rib fracture (n=19). The location of the trauma in the chest wall, other injuries, mechanical ventilation support, prognosis and ISS (injury severity score) were retrospectively examined in the two groups. Results: Mechanical ventilation support was given in 38 patients(82.6%), and 7 of these 38 patients required a subsequent tracheostomy. The mean ISS for all 46 patients was $19.08{\pm}10.57$. Between the two groups, there was a significant difference in mean ventilator time (p<0.048), but no significant difference in either trauma-related morbidity (p=0.369) or mortality (p=0.189). Conclusion: An anterior flail chest frequently affects the two underlying lung parenchyma and can cause a bilateral lung contusion, a hemopneumothorax and lung hemorrhage. Thus, it needs longer ventilator care than a lateral flail chest does and is more frequently associated with pulmonary complications with poor outcome than a lateral flail chest is. In a severe trauma patient with a flail chest, especially an anterior flail chest, we must pay more attention to the pulmonary care strategy and the bronchial toilet.

Relationship between Life Style, the Level of Stress and Irritable Bowel Syndrome on 1498 Male White Collars (남성 사무직 관리자의 생활습관, 스트레스 수준과 과민성 대장증후군)

  • Kim, Jong-Ryul;Urm, Sang-Hwa;Chun, Jin-Ho;Jeong, Soo-Jin;Lee, Chang-Hee;Jeong, Kui-Won;Choi, Soon-Seok;Pai, Ki-Taek
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.791-804
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    • 1997
  • Irritable bowel syndrome(IBS) is one of the common health problem that has been considered as stress-induced. This study was conducted to investigate the relationship between life style and the level of stress and IBS by structured questionnaire which included questions on life style, the self-esteemed gastrointestinal symptoms, and Psychosocial Well-being Index(PWI). Subjects were 1,498 male white collars who get the regular health check and participated in survey at Inje University Health Promotion Center from January to ,December, 1996. The overall prevalence of IBS was 37.5%(561 cases), and the level of stress by PWI score was higher in IBS group$(41.8{\pm}14.2)$ than symptom-free group$(34.6{\pm}12.6)$. As the result of comparison between the two groups, heavier smoking (adjusted O.R=2.48, 95% C.I 1.81-3.41), longer daily working time (adjusted O.R=5.19, 95% C.I 3.59-7.56), stimulatory food materials-mainly hot or salty (adjusted O.R=1.87, 95% C.I 1.44-2.45), higher body mass index (adjusted O.R=1.80, 95% C.I 1.27-2.57), and higher level of stress (adjusted O.R=2.81, 95% C.I 1.80-4.43) were estimated as risk factors of IBS. On the contrary, 6-8 hours sleeping per day (adjusted O.R=0.38 95% C.I 0.21-0.70), 3-4 times exercise per week (adjusted O.R=0.57 95% C.I 0.39-0.83), and tenure more than 20 years (adjusted O.R=0.25 95% C.I 0.16-0.35) were considered as protective factors to IBS. In summary, the assessment of the stress level might be placed in the first priority to control IBS, at least by some degree, which suggested that IBS could be controlled by avoiding such risk factors and by encouraging such protective factors.

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Evaluation of soybean oil rancidity by pentanal and hexanal determination (Pentanal과 hexanal 측정에 의한 대두유의 산패도 측정)

  • Chun, Ho-Nam;Kim, Ze-Uook
    • Applied Biological Chemistry
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    • v.34 no.2
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    • pp.149-153
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    • 1991
  • Several commercial soybean oils were stored at $20^{\circ}C,\;40^{\circ}C$ and $60^{\circ}C$ with daily exposure of fluorescent light for 12 hours and evaluated their rancidity by headspace gas chromatographic analysis of pentanal and hexanal. The data of gas chromatographic analysis was compared with organoleptic flavor evaluation. For headspace gas chromatographic analysis, the volatile compounds were recovered by porous polymer trap and flushed into a fused silica capillary column at $250^{\circ}C$, The pentanal and hexanal separated were identified by gas chromatography and gas chromatography-mass spectrometric method. The results showed that the contents of pentanal and hexanal were linearly increased during storage for 100 days. A very simple linear relationship was found between organoleptic flavor scores and amounts of two volatile compounds with very high correlation coefficient. A similar linear relationship was also obtained for acid and peroxide value with sensory data. This results suggested the possible implication of pentanal and hexanal as an quality index for rancidity evaluation of soybean oil.

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Professional Job Perception, Job Stress and Job Satisfaction of Doctors Practicing in Local Clinic in Daegu City (개원의사들의 전문직업성과 직무스트레스가 직업만족도에 미치는 영향)

  • Jin, Dae-Gu;Kang, Yune-Sik;Cho, Yong-Kee;Lee, Sang-Won;Kim, Jong-Yeon;Ahn, Soon-Gi;Chun, Byung-Yeol;Yeh, Min-Hae;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.2
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    • pp.153-162
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    • 2003
  • Objective : This study was conducted in order to investigate professional job perception, job stress and job satisfaction in doctors. Method : The authors conducted a survey using a self-administered questionnaire, conducted between August and September,2001. The study subjects were 457 doctors practicing at local clinics in Daegu City. Results : For the professionalism scale, the score for 'sense of calling to field' and 'feeling of autonomy' were relatively high, Age, working hours per day, and perception of socioeconomic status significantly influenced the professionalism scale scores (p<0.01). For the job stress scale, the scores for 'clinical responsibility/decision' factor were the highest of all the surveyed factors. Working hours per day significantly influenced the job stress scores (p<0.01). To investigate the overall relationship between the variables, the authors conducted a linear structural equation model analysis. The equation was statistically appropriate and a good fit. The job stress, and the professionalism factors, respectively influenced job satisfaction negatively and positively (T>2.0). The working hours per day and status perception also influenced their job satisfaction (T>2.0). Conclusion : To promote the iob satisfaction of doctors, the development of coping tools and other intervention methods are needed to increase doctor's professional job perception and reduce their job stress. Further studies are required to understand the characteristics of job satisfaction and for its promotion with doctors.

Prognosis in the Patients with Prolonged Extracorporeal Membrane Oxygenation

  • Kim, Tae-Hun;Lim, Cheong;Park, Il;Kim, Dong-Jin;Jung, Yo-Chun;Park, Kay-Hyun
    • Journal of Chest Surgery
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    • v.45 no.4
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    • pp.236-241
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    • 2012
  • Background: Prolonged usage of extracorporeal membrane oxygenation (ECMO) may induce multi-organ failure. This study is aimed to evaluate prognostic factors in the patients with ECMO. Also, the prognosis of ECMO with Kidney Injury Network Scoring system is studied. Materials and Methods: From May 2005 to July 2011, 172 cases of ECMO were performed. The cases of perioperative use of ECMO were excluded. Renal failure patient and younger than 15 years old one were also excluded. As a result, 26 cases were enrolled in this study. Male patients were 15 (57.7%), and mean age was $56.57{\pm}17.03$ years old. Demographic data, ECMO parameters, weaning from ECMO, and application of continuous renal replacement therapy are collected and Acute Kidney Injury Network (AKIN) scores were evaluated just before ECMO and day 1, day 2 during application of ECMO. Results: Venoarterial ECMO was applied in 22 cases (84.6%). The reasons for applications of ECMO were cardiac origin in 21 (80.8%), acute respiratory distress syndrome in 4, and septic shock in 1 case. Successful weaning from ECMO was achieved in 15 cases (57.7%), and survival discharge rate was 9 cases (34.6%). Mean duration of application of ECMO was $111.39{\pm}54.06$ hours. In univariate analysis, myocarditis was independent risk factors on weaning failure. Using the receiver operating characteristic curve, level of hemoglobin on 24 hours after ECMO, and base excess on 48 hours after ECMO were showed more than 0.7. AKIN score was not matched the prognosis of the patients with ECMO. Conclusion: In our study, the prognosis of the patients with myocarditis was poor. Hemoglobin level at first 24 hours, and degree of acidosis at 48 hours were useful methods in relating with prognosis of ECMO. AKIN scoring system was not related with the prognosis of the patients. Further study for prognosis and organ injury during application ECMO may be needed.

Studies on the Properties of the Stirred Yogurt Manufactured by Exopolysaccharide Producing Lactic Acid Bacteria (Exopolysaccharide 생성 유산균을 이용한 Stirred Yogurt 특성에 관한 연구)

  • Kang Ho-Jin;Baick Seung-Chun;Yu Je-Hyun
    • Food Science of Animal Resources
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    • v.25 no.1
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    • pp.84-91
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    • 2005
  • We investigated fermentation characteristics and the amount of exopolysaccharide (EPS) produced, and the correlation between EPS and rheological properties in stirred yogurt fermented with Streptococcus thermophilus St-Body 1. The changes of pH and lactic acid concentrations of yogurt showed different patterns according to fermentation temperatures. About 20 to 40% of lactose was utilized during 6 hrs incubation. The higher number of lactic acid bacteria was obtained at 31℃ incubation temperature rather than other incubation temperatures. The higher amount of EPS was produced at 12 hr or 24 hr rather than other incubation period at the same fermentation temperatures. The viscosity continuously increased during the fermentation period, however the syneresis of yogurt was shown the lowest value at 37℃ for 30 hrs incubation. In physical properties, the hardness and adhesiveness increased continuously with decreasing cohesiveness and elasticity as incubation process was extended. The stirred yogurt fermented with S. thermophilus St-Body 1 at 37℃ for 24 hr resulted in the highest score at each sensory evaluation category.