• Title/Summary/Keyword: Condition Rating

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Symptomatic and Clinical Profiles Across Motoric Subtypes in Delirium (섬망의 운동성 아형에 따른 증상과 임상적 특징)

  • Paik, Soo-Hyun;Min, Seongho;Ahn, Joung-Sook;Park, Ki-Chang;Kim, Min-Hyuk
    • Korean Journal of Psychosomatic Medicine
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    • v.23 no.2
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    • pp.79-85
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    • 2015
  • Objectives : To investigate clinical and symptomatic differences among motoric subtypes of delirium. Methods : A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. Results : Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype($69.62{\pm}13.976$ vs. $73.97{\pm}11.569$, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive($7.14{\pm}3.543$ for hyperactive, $5.62{\pm}3.279$ for mixed subtype) and cognitive subscales($10.00{\pm}3.574$ for hyperactive, $6.38{\pm}2.875$ for hypoactive, $7.43{\pm}3.771$ for mixed subtype, p<0.001). Conclusions : We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.

A Case of Korean Medical Treatment on Parkinson's Disease Patient with Postural Instability, Presenting as Camptocormia (몸통굽힘증을 주소로 하는 파킨슨병 환자의 자세 이상에 대한 한의 치료 증례 1례)

  • Kim, Ha-ri;Jeong, Hye-seon;Shin, Hee-yeon;Choi, Jeong-woo;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.40 no.2
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    • pp.220-227
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    • 2019
  • Objectives: Parkinson's disease is the neurodegenerative disease that affects both motor and non-motor function, including postural instability. Camptocormia is an abnormal condition in which the thoracolumbar spine bends forward during walking or standing. However, the treatment options are limited and often not effective. The purpose of this study was to report on the Korean medical treatment of a Parkinson's disease patient with postural instability who presented with camptocormia. Methods: We used Korean medical treatment including herbal medicine (Jemageopung-tang), acupuncture and pharmacopuncture therapy to the patient who was admitted to the hospital for 21 days. The clinical symptoms were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS) and walking time without assistance. Results: After treatment, the UPDRS Parts 2 and 3 scores were decreased from 5 to 3 and 20 to 9, respectively. Also, the walking time without assistance was improved. Conclusion: This study suggested that Korean medical treatment could be an effective option for treating Parkinson's disease with postural instability.

Association between Sleep and Loneliness in the Elderly Living Alone (독거노인의 외로움과 수면의 관계)

  • Choi, Yu Jung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Kim, Dohyun;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.168-176
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    • 2020
  • Objectives : Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results : The Pittsburgh Sleep Quality Index (PSQI) mean score of "lonely group" (9.2±4.2) was significantly higher than that of "not lonely group" (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly associated with PSQI (standardized β=0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β=0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions : Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

Effect of Hominis Placenta Pharmacopuncture for a Patient with Mild Cognitive Impairment: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center Trial

  • Kim, Yunna;Eom, Yoon Ji;Kwon, Dohyung;Lee, Jae Hyok;Jung, In Chul;Cho, Eun;Lee, Ji Eun;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.2
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    • pp.81-93
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    • 2021
  • Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

Correction of the Ground Subsidence Risk Ratings during Open Cut Excavation (개착식 굴착공사 중 지반함몰 위험등급 분류시트의 등급 보정에 관한 연구)

  • Shin, Sang-Sik;Kim, Hak Joon
    • The Journal of Engineering Geology
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    • v.31 no.2
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    • pp.135-148
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    • 2021
  • Ground subsidence risk ratings obtained from the site investigation during pre-excavation stages could be changed depending on the parameters revealed during construction activities. A method of correcting the pre-excavation ground subsidence risk ratings based on the site conditions observed in the field is suggested in this study. The elevation of groundwater table during the excavation may be different from the predicted value depending on the application of waterproofing methods and construction conditions. The drastic drawdown of groundwater table during the excavation could cause ground subsidence due to soil volume decrease related to consolidation or compression of the ground, whereas the rising of groundwater table caused by the intense rainfall may result in a high potential for ground subsidence due to heaving or boiling of the excavation bottom. Excessive displacements of retaining walls or ground settlements may cause ground subsidence, which also results in a high risk of ground subsidence caused by the destruction of buried pipelines. Reevaluation of ground subsidence risk ratings is suggested considering the fluctuation of groundwater table, condition of groundwater leakage, measured ground displacements, and soil types. Finally, the ground subsidence risk rating system is improved for better evaluation by using 12 factors in 5 categories.

A Case of Adult Otitis Media with Effusion Accompanied by Atopic Dermatitis (아토피피부염을 동반한 성인 삼출성 중이염 치험례)

  • Song, Ji-Hoon;Yu, Pei-Yen;Kim, Jong-Han;Jung, Min-Yeong;Choi, Jung-Hwa;Park, Soo-Yeon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.2
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    • pp.95-104
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    • 2022
  • Objectives : This study is to report a case of otitis media with effusion accompanied by atopic dermatitis improved by Korean medicine monotherapy. Methods : A 31-year-old woman patient visited our clinic for aural fullness, hearing loss, and tinnitus of the left ear on August 14th, 2021. She also had abdominal pain, diarrhea, and general weakness because of side effects of antibiotics. Besides, she had nasal congestion, rhinorrhea, and dry skin. Through otoscopy, her tympanum was fully filled with yellow effusion. She only took Korean medicine therapy including acupuncture and herbal medicine weekly. The treatment continued for about 4 months(total 14 visits) until December 4th, 2021. Otoscopy, numerical rating scale(NRS), scoring atopic dermatitis(SCORAD) index were used to assess the symptoms. Results : On August 30, 2021, her intestinal symptoms improved. The left tympanum was recovered to normal condition as the treatment continued. The effusion disappeared on October 16th, 2021. On November 6th, 2021, peritympanic blood congestion also almost alleviated. Subjective symptoms including aural fullness, hearing loss, and tinnitus disappeared on October 16, 2021. Nasal symptoms and dry skin also improved. The SCORAD index dropped from 15 to 4. Conclusions : These results suggests that otitis media with effusion can be sufficiently managed by Korean medicine therapy. Further, active application of Korean medicine therapy to common otolaryngological diseases is necessary.

Feasibility Analysis of the Bridge Analytical Model Calibration with the Response Correction Factor Obtained from the Pseudo-Static Load Test (의사정적재하시험 응답보정계수에 의한 교량 해석모델 보정의 타당성 분석)

  • Han, Man-Seok;Shin, Soo-Bong
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.25 no.6
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    • pp.50-59
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    • 2021
  • Currently, the response correction factor is calculated by comparing the response measured by the load test on a bridge with the response analyzed in the initial analytical model. Then the load rating and the load carrying capacity are evaluated. However, the response correction factor gives a value that fluctuates depending on the measurement location and load condition. In particular, when the initial analytical model is not suitable for representing the behavior of a bridge, the range of variation is large and the analysis response by the calibrated model may give a result that is different from the measured response. In this study, a pseudo-static load test was applied to obtain static response with dynamic components removed under various load conditions of a vehicle moving at a low speed. Static response was measured on two similar PSC-I girder bridges, and the response correction factors for displacement and strain were calculated for each of the two bridges. When the initial analysis model was not properly set up, it is verified that the response of the analytical model corrected by the average response correction factor does not fall within the margin of error with the measured response.

Two Cases of Korean Medicine Treatment for Patients Complaining of Long-lasting Discomfort after COVID-19 Vaccination (장기간 지속된 코로나 백신 접종 후유증에 대한 한의 치험 2례)

  • Lee, Hye-Jin;Hwang, Ye-Chae;Lee, Kyeong-Hwa;Yim, Tae-Bin;Jung, Sang-Yeon;Park, Seong-Uk;Park, Jung-Mi;Ko, Chang-Nam;Cho, Seung-Yeon
    • The Journal of Korean Medicine
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    • v.43 no.2
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    • pp.124-139
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    • 2022
  • Objectives: This study examined the effectiveness of Korean medical treatment for two patients complaining of discomfort after receiving Pfizer COVID-19 vaccine. Methods: The patients were hospitalized for 50 days and 12 days, respectively. They were treated with herbal medicine, acupuncture, electroacupuncture, and moxibustion. We used the Numerical Rating Scale (NRS) on numbness in extremities and headache, Manual Muscle Testing Grading System (MMT), Criteria for Sweating Categorization, and 36-Item Short Form Health Survey (SF-36) to evaluate the clinical effects of the treatment. Results: In Case 1, headache improved from peak NRS 9 and average NRS 7 on admission day to both NRS 3 on discharge. The SF-36 score was also increased, suggesting that the quality of life was improved. In Case 2, numbness in the extremities improved from NRS 8 on the day before admission to NRS 2 on discharge, and general condition also improved. Conclusions: This study suggests that Korean medicine can be an effective treatment for patients who experience long-lasting discomfort after being vaccinated with COVID-19, but with no abnormal findings in the examination.

Two Cases of Gami-Guibitang on Cognitive Impairment after Stroke with Improved Recall Memory including Korean Medicine (가미귀비탕을 포함한 한방치료로 회상기억이 향상된 뇌졸중 후 인지저하 환자 2례)

  • Kim, Jeong-Hwa;Lee, Hyeong-min;Shin, Hee-yeon;Kim, Hari;Yang, Seung-Bo;Cho, Seung-Yeon;Park, Seong-Uk;Ko, Chang-Nam;Park, Jung-Mi
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.19 no.1
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    • pp.21-30
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    • 2018
  • ■ Objectives This case study is to report the two cases of Gami-Guibitang on cognitive impairment after stroke with improved recall memory. ■ Methods We used Korean medicine treatments including Gami-guibitang, acupuncture and moxibustion to treat patients who had cognitive impairment after stroke for at least two months. We observed the changes of symptoms by measuring Korean version of Mini-mental status examination (MMSE-K), Clinical Dementia Rating (CDR) and Global Detration Scale (GDS). ■ Results After treatment, the patient's symptoms were improved including MMSE-K, CDR and GDS. Improvement appeared to be prominent in recall memory. The general condition were also improved after treatment. ■ Conclusion This clinical case study suggests that Korean medicine including Gami-guibitang could be used to treat patients who had cognitive impairment after stroke especially suffering from degraded recall memory.

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The Rate of Diagnostic Agreement and Concordance Ratings on Psychiatric Recommendation in Consulted Delirious Cases (자문의뢰된 섬망환자에 대한 진단 일치율과 정신과 의견의 반영도)

  • Oh, Eung-Seok;Nam, Jung-Hyun;Kim, Seok-Hyeon;Park, Yong-Chon;Kim, Sung-Mok
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.174-181
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    • 2001
  • Objectives : The author investigated the rate of diagnostic agreement between consultants and consultees and concordance ratings on the consultees' recommendation to examine the interactive collaborativeness and find the factors that influence the reflectiveness on treatment. Methods : The subjects were 54 patients with delirium selected from 583 cases referred from other departments who were admitted to Hanyang University Kuri Hospital from July 1, 1995 to Dec. 31, 1997. The information on demographic data, diagnostic impression, symptoms, management before consultation, psychiatric recommendation, management after consultation, diagnoses at the referring departments and the psychiatric department on delirium was obtained by medical records and consultation papers retrospectively. The reflectiveness of the psychiatric recommendation was divided into complete concordance, partial concordance, and nonconcordance and among them the complete and partial concordance were considered for concordance. The reflectiveness was compared among all the departments and between medical unit and surgery unit. Results: The rate of diagnostic agreement on the cause of delirium was highest(85.7%) in organic brain syndrome and lowest in general medical condition(0%). There was no statistically significant differences between medical unit and surgery unit. Neither differences were there among all the departments. In comparing symptoms affecting the reflectiveness, it was 73.5% in impulsive and aggressive behavioral changes, whereas 40.0% in behavioral changes. Reflectiveness of psychiatric recommendation showed higher scores in the case of behavioral changes. The cases of sleep problem showed higher scores of reflectiveness. When these two symptoms of behavioral change and sleep problem were compared as one factor, the results suggested that there were significant differences. The cases with both two symptoms showed 80% in reflectiveness, and the cases with only one symptom or no symptoms showed 44.8% in reflectiveness. There were no statistical significances between concordance ratings and symptoms such as disturbance of consciousness, disorientation, and hallucination that cannot be easily evaluated at the referring departments. Conclusions : The rate of diagnostic agreement on the cause of delirium was highest in the case of organic brain syndrome in which lesions can be easily recognized. The factors that influence the reflectiveness of psychiatric recommendation were behavior changes and sleep disorders in the symptoms of evaluated cases.

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