• Title/Summary/Keyword: Diagnosis of Decline

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Gender Differences in Behavioral Psychological Symptoms of Dementia in Patients with Alzheimer's Disease (알츠하이머병 환자에서 행동심리증상의 성별차이)

  • Lee, Ji Young;Im, Woo-Young;Kim, Hyun;Lee, Kang Joon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.71-78
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    • 2014
  • Objectives : Behavioral and psychological symptoms of dementia(BPSD) represent significant clinical problems, resulting in functional decline, caregiver distress, institutionalization and increased mortality. A recent study showed gender differences have important role in the development of BPSD, but relationship between BPSD and gender has never been studied in Korea. This study was designed to examine whether patients with Alzheimer's disease show gender differences in behavioral and psychological symptoms of dementia(BPSD). Methods : Ninety-eight subjects with Alzheimer's disease were included in this study. We carried out history taking and cognitive assessment for the diagnosis of Alzheimer's disease based on DSM-IV. Cognitive impairment and BPSD were measured using the Mini Mental State Examination(MMSE), Global Deterioration Scale (GDS), Clinical Dementia Rating(CDR) and the Korean Neuropsychiatric Inventory(K-NPI). Independent samples t-test was used to examine the differences across gender in BPSD. Correlation analysis between MMSE, CDR, GDS and NPI was performed using Pearson's correlation coefficient. Results : There were no significant gender differences between the gender in BPSD. We found statistically significant negative correlations between MMSE with NPI total score, and with scores of several sub-domains such as hallucination. Conclusions : This study showed that gender differences in BPSD are not significant. Further research is necessary to identify whether BPSD affect gender differences or individual differences.

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A Study on the Result of Application of Designation Criteria for Urban Regeneration Activation Zone by the Spatial Range (공간적 범위의 차이에 의한 도시재생 활성화지역 지정기준 적용 결과에 관한 연구)

  • Lee, Jong Hwi;Lee, Tae Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.567-573
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    • 2020
  • This study was done to develop indicators for cities that can be used in the long term and in a sustainable manner. Activation indicators were developed to improve the resilience in the downtown area of Seo-gu, Incheon. Preliminary indicators were derived from prior studies on similar indicators of resilience for urban regeneration, and an expert opinion survey was conducted to analyze the suitability and importance of the indicators. Activation indicators were established for improving urban resilience in six areas: population stability, social inclusion, industrial diversity, local productivity, environmental sustainability, and social-based convenience. From 60 preliminary indicators, 42 indicators were selected through the expert opinion surveys for securing an economically active population, establishing a living infrastructure, improving the settlement environment, and upgrading industry to reflect the characteristics of the West, including industrial complexes. It was found that diversification is necessary. Further study is still necessary to improve the objectivity of the indicators and calculate a resilience index. The significance of this study is that it looks at quantitative indicators, complements other studies on regional decline diagnosis, and presents realistic alternatives suitable for domestic situations based on the concept of resilience.

A Study on the Development of Old Down-town Activation Indicator -Focusing on Improving Urban Resilience in the Old Down-town of Seo-gu, Incheon- (원도심 활성화지표 개발에 관한 연구 -인천광역시 서구 원도심의 지역 회복력 향상을 중심으로-)

  • Chang, Dong-Min
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.11
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    • pp.561-569
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    • 2020
  • This study was done to develop indicators for cities that can be used in the long term and in a sustainable manner. Activation indicators were developed to improve the resilience in the downtown area of Seo-gu, Incheon. Preliminary indicators were derived from prior studies on similar indicators of resilience for urban regeneration, and an expert opinion survey was conducted to analyze the suitability and importance of the indicators. Activation indicators were established for improving urban resilience in six areas: population stability, social inclusion, industrial diversity, local productivity, environmental sustainability, and social-based convenience. From 60 preliminary indicators, 42 indicators were selected through the expert opinion surveys for securing an economically active population, establishing a living infrastructure, improving the settlement environment, and upgrading industry to reflect the characteristics of the West, including industrial complexes. It was found that diversification is necessary. Further study is still necessary to improve the objectivity of the indicators and calculate a resilience index. The significance of this study is that it looks at quantitative indicators, complements other studies on regional decline diagnosis, and presents realistic alternatives suitable for domestic situations based on the concept of resilience.

Assessment of Landscape Tree Vigor Using Cambial Electrical Resistance (형성층 전기저항을 이용한 조경용 수목 활력도 분석)

  • Hwang, Dong Kyu;Kim, Dong Yeob
    • Ecology and Resilient Infrastructure
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    • v.3 no.4
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    • pp.302-306
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    • 2016
  • There are various methods to evaluate tree vigor. Cambial electrical resistance represents tree vigor using the method of electrophysiological diagnosis. This study investigated the vigor of several tree species using Shigometer, and compared the differences among the species. The factors, such as foliation, trunk orientation and bark temperature, which affect electrical resistance were also investigated. The needle penetration into cambium was controlled to keep the depth consistent in order to minimize measurement error. Each of three trees were selected from Zelkova serrata, Ginkgo biloba, Metasequoia glyptostroboides, Pinus koraiensis, and Liriodendron tulipifera. The electrical resistances were measured at 60 and 120 cm height of the stem in 4 directions from March until May 2011. The soil conditions in surrounding areas and tree stress responses were also measured. The results were analyzed for the relationship between electrical resistance and the affecting factors. The electrical resistance showed a relatively higher level before foliation until mid-March. The values started to decline from April and recorded a minimal level on May 11. The changes of soil moisture, soil electric conductivity, and tree stress responses during the measurement period showed a similar trend to that of electrical resistance. The Pinus koraiensis, an evergreen conifer, showed few changes on the electrical resistance values during the measurement period. Zelkova serrata, Ginkgo biloba, and Metasequoia glyptostroboides showed the highest bark temperatures and lowest electrical resistances at their south-facing stem. Shigometer can provide measures simple to assess tree vigor in the fields, and to the management of trees.

Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.

The Clinical Analysis of Modified B-T Shunt Using 3 mm and 3.5 mm PTFE graft (3mm와 3.5mm PTFF graft를 이용한 변형 B-T 단락술의 임상적 분석)

  • 정성호;윤태진;임한중;민경석;서동만;윤소영;김영휘;고재곤;박인숙
    • Journal of Chest Surgery
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    • v.33 no.9
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    • pp.716-722
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    • 2000
  • Background: Modified Blalock-Taussig shunt using 3mm or 3.5mm PTFE graft has been performed in patients with small body weight or in candidates for single ventricle palliation. However, there are few reports concerning clinical outcomes in terms of pulmonary artery growth and shunt patency rate after shunt operations using such a small graft. Material and Method: Twenty-five patients rate after shunt operations using 3 or 3.5 mm sized grafts from September 1996 to August 1999. We retrospectively assessed the pulmonary artery growth and the shunt patency rate by reviewing the pre-and post-operative pulmonary angiograms. The risk factors for late death and second shunt operations were also analyzed. To assess the presence of any correlation between body weight and selection of the graft size, regression analysis was done in 81 cases of shunt operations performed during the same period. Result: There were 1(4%) early death and 5(20%) late deaths. The survivors were followed up for an average of 7.34 months. The pulmonary artery index increased significantly from 129$\pm$66$\textrm{mm}^2$/$m^2$ to 213$\pm$114 $\textrm{mm}^2$/$m^2$(p=0.002). The shunt patency rate assessed at postoperative 2, 4, 6 and 8 months were 82.5%, 77%, 73% and 42% respectively with a marked decline between 6 and 8 months. Asplenia was a frequent finding for the patients with late death although the incidence failed to reach statistical significance(p=0.078). Pre-operative diagnosis of PA with VSD was found to be a statistically significant risk factor for a second shunt operation(p=0.01). Body weight(a) at operation and graft size(b) used in the shunt operations revealed strong correlation and could be expressed by the following formula; b=0.128a + 3.233. Conclusion: Adequate growth of pulmonary artery and satisfactory early patency rate could be obtained by modified Blalock-Taussing shunt using 3mm or 3.5mm graft. However, during 6 to 8 months after shunt operations, the patency rate fell sharply, which implicates that close observation and early intervention are mandatory in this period.

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A Study on Recent Discussions ahout the Pysician's Explanation in Medical Litigation (의료소송에서 의사의 설명에 대한 최신 지견)

  • Baek, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.37-63
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    • 2023
  • In medical litigation, there are various cases where a doctor's 'explanation' of a patient becomes problematic. Medical explanations and guidance are required from the doctor, starting from the beginning of diagnosis, through treatment processes such as surgery, when hospitalization is necessary for treatment, during hospitalization, upon discharge, and after discharge. Furthermore, notification from the doctor or medical institution may be requested regarding the economic costs that will be incurred due to medical treatment. South Korea's judiciary has been developing legal principles regarding such doctor's explanations by distinguishing between explanations for obtaining consent for medical treatment and medical explanations related to guidance on patient treatment methods, taking into account related laws such as the stage of treatment and the Medical Service Act. Additionally, the Constitutional Court recently ruled on the non-benefit cost notification system linked to the explanation of economic costs. However, holding a doctor accountable solely because the doctor's explanation was insufficient has aspects that do not correspond to the actual situation in clinical reality, and may have a reflexive disadvantage that results in a decline in legal rights. Therefore, the doctor's explanation needs to be examined from both perspectives: guaranteeing the patient's right to self-determination and protecting his or her right to decision.

Studies on the Changes of Sex Hormone Concentrations in Milk during the Reproductive Stages of Dairy Cows (유우의 번식과정에 따른 유즙중의 성호르몬 수준 변화에 관한 연구)

  • 김상근;이재근
    • Korean Journal of Animal Reproduction
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    • v.9 no.1
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    • pp.9-30
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    • 1985
  • The study was carried out to find out the changes of the sex hormone levels in the milk of Holstein cows during the reproductive stages such as the estrous cycle, pregnancy and periparturient period. The FSH, LH, estradiol-17$\beta$ and progesterone from the milk samples were assayed by radioimmunoassay methods. The results of this study were summarized as follows: 1. The levels of progesterone and estradiol-17$\beta$ were similar among inter-quarters, but they were higher in after milking than before milking times, with no statistical significance. 2. The milk progesterone levels during the estrous cycles reached a peak mean level of 3.55$\pm$0.26ng/$m\ell$ at 15 days after estrus and they did not show any differences among the length of estrous cycles. The estradiol-17$\beta$ levels during the estrous cycles showed a peak level of 36.40$\pm$2.38pg/$m\ell$ at estrus, and decreased(17.20$\pm$0.46 pg/$m\ell$ to 18.65$\pm$1.26pg/$m\ell$) at luteal phase. 3. The FSH levels during the estrous cycles ranged from 2.25$\pm$0.23mIU/$m\ell$ to 4.35$\pm$0.24mIU/$m\ell$ showing significant changes. The LH levels during the estrous cycles gradually increased and remained a peak level of 10.90$\pm$0.36mIU/$m\ell$ from 20 to 25 days after estrus. 4. The progesterone levels during the pregnancy were decreased from 30 to 60 days after artificial insemination, and therafter continuously increased until 240 days. The estradiol-17$\beta$ levels during the pregnancy were 24.56$\pm$1.19pg/$m\ell$ at day 30 after artificial inseminaton, and increased rapidly until 180 days. The levles were agagin decreased by 26.17$\pm$3.03pg/$m\ell$ until 210 days and markedly increased by 68.00$\pm$8.70pg/$m\ell$ until 240 days. 5. The prolactin levels during the pregnancy were 31.27$\pm$2.31ng/$m\ell$ and 42.60$\pm$2.37ng/$m\ell$ at day 150 and 240 after artificial insemination respectively. The LH levels during the pregnancy reached a peak of 27.47$\pm$7.90mIU/$m\ell$ at day 30 after artificial insemination, and thereafter gradually decreased. 6. The progesterone levels during the periparturient period reached a peak of 4.61$\pm$0.34ng/$m\ell$ at day 3 prepartum, and thereafter gradually decreased, and showed 2.05$\pm$0.60ng/$m\ell$ at day 7 postpartum. The estradiol-17$\beta$ levels during the periparturient period showed high level from 207.23$\pm$6.04pg/$m\ell$ at day 1 prepartum to 239.90$\pm$13.90pg/$m\ell$ at day 2 prepartum, and thereafter began to decline and reached 51.87$\pm$1.72pg/$m\ell$ at by 7 postpartum. 7. The prolactin levels during the periparturient period showed relatively higher level at the time of parturition. The LH levels during the periparturient period rnage from 6.32$\pm$0.32mIU/$m\ell$ to 13.90$\pm$1.37mIU/$m\ell$ showing significant changes. 8. The progesterone levels(4.6$\pm$0.8ng/$m\ell$) of the pregnant cows were significantly higher than those (1.84$\pm$1.4ng/$m\ell$) of nonpregnant cows. The cows of artificial insemination from 61 to 90 days after parturition showed higher progesterone levels. 9. During 20 to 25 days after artificial insemination, the accuracy of pregnancy diagnosis from milk progesterone levels were 94.4% for nonpregnant cows(<2.3ng/$m\ell$), and 75.0% for pregnant cows( 3.2ng/$m\ell$). The average overall accuracy of pregnancy prediction for nonpregnant and pregnant cows 83.3% 10. The results obtained this study suggest that the understanding of the endocrinological mechanisms by means of milk hormone analysis during the estrous cycle, pregnancy and parturition would give the basic information needed for increasing efficiency of reproduction. This study would not only provide an accurate method of the early pregnancy diagnosis by milk progesterone levels but also contribute to the research of providing the method of detecting of FSH levels in milk, which was difficult in blood serum.

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Improvement Way for Mobile X-ray Examinations by Rule Revision about Safety Management of Diagnosis Radiation Occurrence System (진단용방사선발생장치의 안전관리에 관한 규칙 개정에 따른 이동형 방사선검사의 개선방안)

  • Choi, Jun-Gu;Kim, Gyeong-Su;Kim, Byeong-Gi;Ahn, Nam-Jun;Kim, Hyeong-Sun;Kim, Sang-Geon;Lim, Si-Eun
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.53-59
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    • 2007
  • A safety management rule of the diagnosis radiation system which opened a court 2006 February 10th was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this study is to minimize injury by radiation that can happen to patients and people around a sick ward when managing mobile X-ray system. This study analyzed sickroom environment of mobile X-ray examination and the statistical data of the Konkuk medical Information System(KIS) and the Picture Archiving Communication System(PACS). This study also investigated patient conditions, infection, relation information and related data, when the sickroom mobile X-ray examination is used. Through data analysis, many problems were expected such as restriction of space side, manpower and expense of business side, satisfaction degree decline of patient and protector of operation side. Therefore, we tried to restrict examination of multi bed sickroom, and to use treatment room in each ward to solve problem mentioned. As a result, the whole sickroom mobile X-ray examination rate decreased to near 50%, and mobile X-ray examination rate for inpatients decreased to more than 85%. This study shows that several attempts we did should be helpful for manpower, patients satisfaction and expenses. Also, they should protect patients in sickroom from unnecessary radiation exposure and could minimize inconvenience of patients and their family members from x-ray examination.

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Association of Body Mass Index and Cognitive Function in Alzheimer's Disease and Mild Cognitive Impairment (알츠하이머병과 경도인지장애에서 체질량지수와 인지기능과의 연관성)

  • Lim, Eun Jeong;Lee, Kang Joon;Kim, Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.2
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    • pp.184-190
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    • 2016
  • Objectives : This study analyzed the differences of body mass index(BMI) in Korean patients with Alzheimer's diseases(AD), Mild Cognitive Impairment(MCI), and healthy controls to verify whether low BMI is associated with cognitive impairment. Furthermore, this study also sought to examine any association between BMI and Mini Mental State Examination-Korean version(MMSE-K), Clinical Dementia Rating(CDR), and Global Deterioration Scale(GDS). Methods : A total of 257 subjects were included in the study. History taking, mental status examination, physical examination and neurocognitive function test were carried out for the diagnosis of AD and MCI. The subjects' demographic data and presence of diseases were also surveyed. The overall cognitive function and severity of diseases were assessed using MMSE-K, GDS, and CDR. Results : The order of BMI was found to be healthy controls>MCI>AD, with statistically significant differences among the groups. The order of MMSE-K scores was similar, with healthy controls>MCI>AD in statistically significant differences. The healthy controls had the lowest CDR and GDS scores, and AD patients had the highest scores. There was a significant positive correlation between BMI and MMSE scores(r=0.238, p=0.000). BMI was negatively correlated with CDR(r=-0.174, p=0.008) as well as with GDS(r=-0.233, p= 0.000). Conclusions : Measuring BMI of patients with AD or MCI is expected to be meaningful in that BMI could be a clinical indicator of AD. We expect this to be beneficial for the diagnosis, prevention, and therapeutic approach of AD and also expect large-scale, long-term longitudinal studies to follow.