• Title/Summary/Keyword: Clinical characteristic

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NT-pro BNP : A new diagnostic screening tool for Kawasaki disease (가와사끼병에서 진단적 지표로서의 NT-proBNP)

  • Lee, Hyunju;Kim, Heejung;Kim, Hae Soon;Sohn, Sejung
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.539-544
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    • 2006
  • Purpose : The purpose of this study was to determine whether N-terminal fragment of B-type natriuretic peptide(NT-proBNP) may be used to differentiate acute Kawasaki disease(KD) from other clinically similar diseases. Methods : Using electrochemiluminescence immunoassay, NT-proBNP concentrations were measured in the acute phase within 10 days after the onset of KD(n=58) and in the convalescent phase, 60 to 81 days after the onset(n=51), and also in patients with acute febrile disease as a control(n=34). Echocardiography was performed to detect pericardial effusion(PE) and coronary artery lesions(CAL), and to measure the left ventricular dimension at diastole(LVIDd) and ejection fraction(LVEF). The cutoff value of NT-proBNP for separating KD from other diseases was determined. Results : NT-proBNP concentration in the acute phases of KD was significantly higher than that in the control group($1,501.6{\pm}2,132.6$ vs. $139.0{\pm}88.8pg/mL$, P<0.0001). In KD patients, NT-proBNP was elevated in the acute phase and was lowered in the convalescent phase($1,466.0{\pm}2,173.2$ vs. $117.5{\pm}95.5pg/mL$, P<0.0001). The cutoff value of 260 pg/mL discriminated KD patients from other patients, with a sensitivity of 93 percent and a specificity of 88 percent. The NT-proBNP was higher in patients with PE(n=17) compared with those without PE(n=41)($1,784.2{\pm}1,903.1$ vs. $1,384.4{\pm}2,232.6pg/mL$, P=0.52). Comparison of NT-proBNP could not be done between patients with CAL and those without, owing to a small number of patients with CAL(n=3). There was no correlation between NT-proBNP and LVEF index(r=0.104, P=0.46) or LVIDd index(r=0.171, P=0.22). Conclusion : NT-proBNP increases in the acute phase of KD and decreases to within normal range in the convalescent phase. NT-proBNP >260 pg/mL may be highly suggestive of acute KD. NT-proBNP may be used as a diagnostic tool for KD.

MMPI and SCL-90-R Profiles in Patients with Sleep-Related Breathing Disorder (수면관련 호흡장애 환자의 MMPI 및 SCL-90-R 반응 특성)

  • Kim, Kyoung-Woo;Yoon, Seok-Joon;Yang, Chang-Kook;Han, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.1
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    • pp.37-47
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    • 2002
  • Objective : Previous studies have suggested an association between sleep-related breathing disorder (SRBD) and several psychological problems, and there were increasing recognition of the link. The purpose of this study is to evaluate the characteristic profiles of MMPI and SCL-90-R in patients with SRBD. Methods : This study consisted of 80 SRBD patients(73 men, 7 women) referred from Sleep Disorder Clinic of Dong-A University Hospital, Busan, Korea. Basic informations including demographic findings and physical examination were collected. Subjects completed the Epworth Sleepiness Scale(ESS), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revision (SCL-90-R) prior to standard overnight polysomnography that was performed at hospital sleep laboratory. SRBD was divided into two groups of primary snoring(PS) and obstructive sleep apnea(OSA) according to polysomnographic findings. Results : SRBD showed significant elevation rate of Hs, D, and Hy scales of MMPI and SOM scale of SCL-90-R, which exceeded the rate expected in normal individuals(>5%, 2SD). On comparison of clinical scales of SCL-90-R, OSA group had significantly greater mean score than that of PS group in terms of O-C, DEP, PAR, GSI(p<0.05), SOM and PST(p<0.01). OSA group also showed significantly higher elevation rate in Hs scale of MMPI and SOM scale of SCL-90-R than that of PS. Among OSA group, three scales of MMPI(D, Pt, Si) and three scales of SCL-90-R(ANX, PAR, PSDI) had significant correlation with some PSG variables including total sleep time and sleep efficiency. Among PS group, two scales of MMPI(Hy and Pt), elevation rate of MMPI scales and three scales of SCL-90-R(I-S, PAR, PSDI) had significant correlation with some PSG variables including sleep efficiency, sleep latency and REM sleep percent. Conclusion : The above results suggest that SRBD show neurotic profiles in MMPI and SCL-90-R. This study also clearly indicates that PS group are suffered from clinically meaningful psychiatric symptoms, which are quantitatively lessened but qualitatively similar as compared to that of OSA group.

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The Investigation Regarding the Psychiatric Consultation of the Inpatient from General Hospital (일 종합병원 입원 환자의 정신과 자문 의뢰의 최근 3년간의 특성에 대한 연구)

  • Lee, Soo-Jin;Lee, Joong-Kwaun;Wang, Kwuan-Shu;Kim, Jung-Gee;Cho, Dong-Hwan;Kim, Hyun-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.13 no.1
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    • pp.49-59
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    • 2005
  • Objectives: This clinical study investigates the status of psychiatric consultation from 2001 to 2003 at Maryknoll General Hospital, located in Busan to evaluate the characteristic patterns of current psychiatric consultation and to contribute for further data of consultation study. Methods : The subjects of this study were hospitalized at Maryknoll General Hospital from 1 January, 2001 to 31 December, 2003, who were referred for psychiatric consultation during hospitalization. This study was analysed demographic data, reason for referral, psychiatric diagnosis by patient's chart and psychiatrist's report retrospectively. Results : 1) The psychiatric consultation rates was 1.72%. 2) There was 47.8% in referral among the age group over 60 years, especially the age group over 70 years was 20.3%. 3) The most frequent referral source was department of internal medicine(72.5%). 4) The frequency of psychiatric consultation was the highest at March and the lowest at December. 5) The reasons of psychiatric consultation, according to frequency, were affective change, somatic symptom without abnormal finding. And drug intoxication. alcohol problem were increased. 6) Somatoform disorder was the most common psychiatric diagnosis followed by depressive disorder, organic mental disorder. The diagnosis of somatoform disorder, depressive disorder, alcohol dependence were increased, but anxiety disorder, organic mental disorder were decreased. 7) Pharmacotherapy was the most recommendation, and diagnostic procedure and psychotherapy were increased. Conclusion : In review of consultation referral subjects, the referral rate was 1.72%. The consultation referral of the old(over 60 years) was 42.8%, and annually increased. The most frequent request source was from department of internal medicine. The reasons of consultation referral was the most due to affect change. The recommendation of pharmacotherapy was the most numerous. and psychotherapy was increased annually. Further studies warranted on geriatric psychiatric consultation, pattern change of consultation.

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Assessment of Chromosomal Analyses of 1,180 Cases Suspected of Chromosomal Aberrations (염색체이상을 의심한 1,180례의 염색체 분석 결과 검토)

  • Jeong, Hyeon Kyoung;Ahn, Eun Young;Rim, Sung Soo;Kim, Eun Young;Kim, Kyoung Sim;Kim, Yong Wook;Kim, Ki Bok
    • Clinical and Experimental Pediatrics
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    • v.45 no.3
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    • pp.311-319
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    • 2002
  • Purpose : We have performed this study to obtain reference data for the distribution of chromosomal aberrations in Korea. Methods : We analyzed 1,180 chromosomal study cases from Kwang ju Christian Hospital during the past 25 years. 756 cases suspected of characteristic chromosomal aberration syndromes and 424 cases with hermaphroditism, mild sexual abnormalities, multiple anomalies, or mental & growth retardation were included. Results : The male to female ratio of autosomal aberration syndromes was 1.2 : 1. 78.6% of autosomal aberrations were diagnosed under 1 year of age, whereas 89.8% of sex chromosomal aberrations were diagnosed over 12 years of age. Among 1,180 cases, 612 ones had chromosomal aberrations(51.9%) : 590 of 756 cases suspected of chromosomal aberration syndromes had aberrations( 78.0%), whereas 22 of 424 showing the above other features had aberrations(5.2%). Autosomal aberrations appeared in 514 cases(83.8%) and sex chromosomal aberrations appeared in 98 cases(16.2%). The most frequently observed abberation in autosomal aberrations was Down syndrome, followed by E, D, B, A and C group aberrations. The most common abberation in sex chromosomal aberrations was Turner syndrome, followed by Klinefelter syndrome and Fragile X syndrome. Conclusion : It is of vital importance that patients suspected of chromosomal aberrations undergo chromosomal analysis. Further advanced chromosomal staining and molecular genetic methods will raise the detection rate of chromosomal aberrations.

Metabolic syndrome in the overweight and obese adolescents and the impact of obesity on the cardiovascular system (과체중과 비만 청소년에서 대사증후군과 비만이 심혈관에 미치는 영향)

  • Hong, Young Mi;Song, Young Whan;Kim, Hae Soon;Park, Hae Sook;Min, Jung Hae;Jung, Jo Won;Kim, Nam Su;Noh, Chung Il
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1109-1118
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    • 2009
  • Purpose : Metabolic syndrome (MS), characterized by obesity and insulin resistance, elicits risk factors such as hyperlipidemia, hypertension, and glucose intolerance with additive effects on atherosclerosis, leading to cardiovascular diseases. The purposes of this study were to evaluate the prevalence of MS among overweight and obese adolescents and to investigate the impact of obesity on the cardiovascular system. Methods : In all, 684 adolescents were included in the study. Blood pressure, body mass index (BMI), fasting blood glucose, total cholesterol, triglyceride, low-density-lipoprotein (LDL)-cholesterol, high-density-lipoprotein (HDL)-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and high-sensitive C-reactive protein (hs-CRP) were measured in the patients with a BMI of >85 percentile. Brachial-ankle pulse wave velocity (BaPWV) and ankle brachial index were measured using Vascular Profiler (VP)-1000. Results : MS was confirmed in 19.5% of the overweight and obese adolescents and 50.8% of the obese adolescents. The systolic and diastolic blood pressure, height, weight, fat mass, %fat, BMI, obesity index, and waist circumference were higher in the overweight and obese adolescents with MS. Moreover, the triglyceride, AST, ALT, and hs-CRP levels were higher, whereas HDL-cholesterol level was significantly lower in this group. The overweight and obese adolescents with MS showed shorter diastolic and systolic times, higher heart rate and BaPWV, and longer E-wave deceleration time by echocardiography. Conclusion : Overweight and obese adolescents showed characteristic MS features such as hypertension and hyperlipidemia. Thus, obese adolescents predisposed to MS should be provided early treatment for obesity.

The Clinical Study on the Constitutional symptomatic pattern of Soyangin and Taeumin inpatients in stroke (중풍입원환자(中風入院患者)의 소양인(少陽人)·태음인(太陰人) 체질병증유형(體質病證類型)에 관한 임상적(臨床的) 고찰(考察))

  • Lee, Jun-hee;Koh, Byung-hee;Song, Il-byung
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.120-135
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    • 2000
  • Objective ; The purpose of this study is to find out the constitutional symptomatic pattern of Soyangin and Taeumin through investigation of difference between two groups in stroke. Method ; 70 inpatients(Soyangin 31, Taeumin 39) in stroke, admitted into Kyung-Hee Oriental Hospital from 1. July. 1999 to 20. Sept. 1999, were investigated through questionnare which consists of 16 parts 155 questions, and the problems which have significant difference between Soyangin and Taeumin group were analyzed statistically. Result 1. The analysis of general characteristic difference between Soyangin and Taeumin group (1) The number of Soyangin patients is 31, Taeumin 39 and the number of Male patients 43, Female 27. (2) The mean weight of Taeumin group is heavier than that of Soyangin group and the degree of obesity of Taeumin group higher. (3) The number of patients who have smoking history is more at Soyangin group. (4) In neurological problem, dizziness is more complained of in Soyangin group. 2. The analysis about the result of Questionnare (1) In problems related with 'Sleeping', the time of going to bed and getting up and the duration of sleeping are more irregular in Taeumin group. (2) In problems related with 'Defecation', the shape of stool is more variable in Taeumin group. (3) In problems related with 'Urination', Soyangin group have more complaint. (4) In problems related with 'The condition of digestion', Taeumin group have a good appetite and more compalint in lower abdominal region, but on the contrary Soyangin group lose appetite and have more complaint in upper abdominal region. (5) In problems related with 'Head and Face', Soyangin group have more complaint. (6) In problems related with 'Eye, Ear and Nose', Soyangin group have more complaint at eye and ear. (7) In promlems related with 'Chest region', Soyangin group easily feel choked up and Taeumin group heart throbs. (8) In problems related with 'Skin', Taeumin group easily feel change of color tone at skin and Soyangin group dry.

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Tissue Failure of the Low-Profile lonescu-Shiley Pericardial Valve in Mitral Position (승모판에서의 단고형 이오네스큐판막의 조직실패)

  • 김종환
    • Journal of Chest Surgery
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    • v.30 no.7
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    • pp.670-676
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    • 1997
  • The structural failure of the glutaraldehyde-treated xenograft valves has been the primary concern about the limited durability as predicted from the begimling of clinical use, and long-term follow-up has shown a significant incidence of primary tissue failure(PTF) from both biological and mechanical reasons. Twenty-seven patients with the low-profile lonescu-Shiley valves explanted from mitral position for PTF(Group III) were studied on the patient characteristics and valve pathology, and the results were compared with the matched observations of the Haycock(Group I) and of the standard-profile lonesiu-Shiley valves(Group II). Patients were aged 16 to 56 years(mean, 38.0$\pm$ 11.0 years), and the size of the failed mitral bioprosthesis was 30.8$\pm$ 1.3 mm. The hemodynamic consequences were stenosis in 29.6%, insufficiency in 44.4%, mixed steno-insufficiency in 14.8%, together with normal function for the rest of patients of prophylactic re-replacement. Pathology revealed calcification with or without tissue damage in 63.0% and tissue damage with or without calcification in 58.l%, in contrast with the observations of predominant tissue damage(76.8%) over calcification in Group I and of calcification(76.1%) over tissue damage in group II. Although dystrophic calcification has long and repeatedly dealt with patient's young age as a determinant of valve durability, such a characteristic evidence was not reached even in patients with calcified valves. Moreover, the prolonged explantation p riods from the studied on the previous report suggested strongly yet possibly evolving destructive processes among the valves in the remaining patients, and awaits further follow-up. In conclusion, PTF of the xenograft valves seems to result from more complicated biologic and metabolic reasons as well as more complex mecharical factors than the reported, and newer generation prostheses, with tissue preservation with glutaraldehyde, do not likely to provide decisive improvement in the occurrence of structural failurebioprostheses is generally limited to the highly aged.

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A STUDY OF DENTAL CROWDING AND ITS RELATIONSHIP TO MANDIBULAR INCISOR SHAPE BY MODEL ANALYSIS IN ADOLESCENTS (청소년 석고 모형 분석에 의한 하악절치 형태와 치아밀집의 상관관계에 관한 연구)

  • Surh, Jeong-Eun;Baik, Hyoung-Seon
    • The korean journal of orthodontics
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    • v.25 no.5 s.52
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    • pp.593-604
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    • 1995
  • Mandibular incisor crowding is one of the most common features of malocclusion and is interesting characteristic in view of relapse and stability after orthodontic treatment. There are many potential factors in the etiology of lower anterior crowding. The tooth size variation is one of them, but biologic significance for the faciolingual width of the teeth has been overlooked. Peck and Peck reported that persons with ideal mandibular incisor alignment were shown to have incisor with smaller mesiodistal and larger faciolingual dimensions than persons with incisor crowding. On the basis of these findings they suggested MD/FL index as a clinical guideline for the assessment for lower incisor crowding. The present study was undertaken to examine the relationship between mandibular incisor crowding and mandibular incisor dimension, and determine their correlation with arch length discrepancy. 154 dental casts of people from 11 to 17 years of age were made, and were divided into normal group with irregularity index less than of 1, and crowding group with irregularity index greater than 1.The casts were measured and analyzed statistically. The results were as follows. 1. The mean mesiodistal width for mandibular incisor was larger in crowding group, and has significant difference in central inciosr measurement. There are no significant differences in the faciolingul width and MD/FL index. 2. Irregularity index has significant correlation coefficients with mesiodistal width and MD/FL index for mandibular incisor in crowding group, but no correlation with faciolingual width. It also has correlation with maxillary and mandibular arch length discrepancy, total tooth material, mandibular intercanine width, and mandibular inter first premolar width. 3. Upper and lower arch length discrepancy have significant correlation with mesiodistal width of mandibular incisor and overbite, but have no correlation with faciolingual width. Lower arch lenth discrepancy has significant correlation with MD/FL index for mandibular incisor and upper arch length discrepancy has correlation with MD/FL index for mandibular lateral incisor. 4. Significant differences were observed between normal and crowding group for the mandibular arch length discrepancy and overbite.

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A SURVEY OF THE PSYCHOSIS AMONG SCHOOL VIOLENCE VICTIMS (학교폭력 피해자의 정신병 실태 조사)

  • Kwon, Seok-Woo;Shin, Min-Sup;Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.124-143
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    • 2000
  • Objectives:The primary purpose of this study is to understand the psychopathology of the victims of school violence in terms of early psychosis. By doing this, the early detection of psychosis among the victims is possible, and early detection may lead to early intervention. Methods:Two-thousand and nine-hundred seventy two students from 16 middle schools in Seoul were asked to fill out questionnaire comprised of popularity and intellectual and school status of Piers-Harris Children's Self Concept Inventory, Symptom Check List-90-Revised, and Ostracism Scale. The subjects whose scores upon Ostracism Scale were higher than average by two standard deviation were labeled as ‘Repelled and Isolated group', and subjects whose scores on popularity were significantly lower than average and whose scores on psychoticism of SCL-90-R were higher than average were defined as 'tentative early psychosis group'. Odds ratios were calculated from the numbers of subjects with and without high psychoticism scores and high ostracism scores. On the subjects of 'tentative early psychotic group', we examined every clinical characteristic and conducted correlation analysis and regression analysis in order to find out the risk factors and to construct theoretical model that explains the psychoticism scores. Results:The results were as follows:1) Total 157(5.3%) subjects were rated significantly higher on ostracism scale, and among them, 47 subjects(29.9%) were rated significantly higher than average on psychoticism scale, while only 50 subjects among 2,135 students who were rated within normal range showed significantly higher score on psychoticism scale. Odds ratio for psychotic group of isolated group were 17.82 and it was statistically significant. 2) Forty-seven subjects(31 boys, 16 girls) who were rated as they were unpopular and rejected from peers had significantly higher psychoticism scores. They were not significantly different from simply high psychoticism subjects in anxiety, social anhedonia scale, magical thinking, obsessivecompulsive symptoms, phobic anxiety, psychoticism, somatization, but showed higher ostracism scores and paranoid tendencies. Among school violence victims, who rated themselves unpopular and showed higher psychoticism scores, the psychoticism scores were mainly explained by anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization scales($r^2=0.93$). Conclusion:Thus, it can be concluded that the subjects with higher ostracism score have the substantially high risk for psychosis development. By these results, we propose that school violence victims with anxiety, depression, hostility, interpersonal sensitivity, obsessive-compulsive symptoms, paranoid tendency, somatization should be tested individually considering school adjustment, attentional deficit, concept formation problems.

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A Research on Perception and Exposure to Hepatitis-B Virus of Dental Hygienists (치과위생사의 B형 간염에 대한 인지도와 노출에 대한 조사)

  • Kang, Eun-Ju;Kim, Jin;Choi, Mi-Hye
    • Journal of dental hygiene science
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    • v.7 no.1
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    • pp.13-20
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    • 2007
  • This study is aimed at providing basic data for measures to prevent dental hygienists who are highly exposed to hepatitis-B virus due to their characteristic working conditions from being infected of it. In order to determine their perception and the extent of their exposure to the risk of infection with hepatitis-B virus, a survey was conducted with questionnaires distributed to 354 dental hygienists who are working at dental offices in Seoul. Gyeongi and Jeolla provincial areas. From the survey, following conclusions could be drawn: 1. Sixty three point seven to 100 percent of them are found to have been vaccinated against hepatitis-B virus as is generally expected from their working environment. 2. Their general characters are found to be statistically significant in terms of vaccinating point of time among those who have been vaccinated. Most respondents are either vaccinated one year or 5 years ago. The completion of 3 requested vaccinations lies in the level of 64.3%~100% depending on the general characters. By age, the best result comes from the age group of 25~29, followed by the groups older than 30 and 20-24 in order (p < 0.05). Formation of antibody belongs to the level of 45%~100% generally. But statistically significant of them is the extremely unhealthy state with 100%, followed by normal, generally healthy, very healthy and not healthy in sequence (p < 0.05). 3. In terms of family's clinical history, it is known that the older (p < 0.01), the more unhealthy (p < 0.01) and the married (p < 0.01), the more possibility of having anamnesis of hepatitis-B virus infection. 4. The level of knowledge about Hepatitis-B virus is shown to be in the extent of 4.39~5.01 out of maximum 8 points in general terms. 5. It is revealed that there are high chances for dental hygienists to get spattered with body matters of patients like blood or sputum on their faces in general characters (87.%~100%). 6. A high rate (75%~100%) of respondents has experienced being shot by needles. The older(p < 0.05) and the longer(p < 0.05) their career, the higher the rate becomes.

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