• Title/Summary/Keyword: Etiological Factors

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Fibromyalgia from the Psychiatric Perspective (정신과적 관점에서의 섬유근통)

  • Lee, Yunna;Lee, Sang-Shin;Kim, Hyunseuk;Kim, Hochan
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.99-107
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    • 2020
  • Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

A Case of Erythema Nodosum Associated with Mycoplasma pneumoniae Infection: Pathologic Findings and a Presumed Pathogenesis (마이코플라즈마 폐렴균 감염에 의한 결절성 홍반; 조직병리학적 소견과 병인론의 고찰)

  • Ju, Hee Young;Kim, Gou Young;Choi, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.67-71
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    • 2016
  • Erythema nodosum (EN) is a painful skin disease characterized by erythematous tender nodules located predominantly over the extensor aspects of the legs. Various etiological factors, including infection, drug administration, and systemic illness have been implicated as causes of EN. Mycoplasma pneumoniae is one of rare infectious agents to cause EN in children. We report a case of a 7-year-old boy with context of respiratory illness and skin lesions with arthralgia. From stepwise approaches, IgM antibody against M. pneumoniae was positive with titers of 12.18, consistent with respiratory infection of M. pneumoniae and histopathology showed findings of septal and lobular inflammation without vasculitis consistent with EN. In addition, we reviewed the pathogenesis of this disease based on our case and the previous reports.

Comparison Study on the General Characteristics of Acute Stroke Patients according to Tongue Fur Color (급성기 중풍 환자의 설태색(舌苔色)에 따른 특성 비교)

  • Park, Su-Kyung;Kim, Mi-Young;Choi, Won-Woo;Leem, Jung-Tae;Park, Sung-Wook;Jung, Woo-Sang;Cho, Ki-Ho
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.806-812
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    • 2009
  • Objective : The aim of this study was to provide basic background information on stroke by evaluation various etiological factors on the basis that the Tongue fur color of acute stroke patients. Method : We studied patients hospitalized within 4 weeks after their ictus who were admitted at Kyunghee University Oriental Medical Center, Dongguk University Oriental Medical Center, Kyungwon University Songpa Oriental Medical Center, and Kyungwon University Incheon Oriental Medical Center from April 2008 to August 2009. We compared the general characteristics of acute stroke patients according to tongue fur color. Result : Tongue fur color showed significant difference for past history of hypertension, hyperlipidemia, stroke, HDL-chol, BUN, Hg, and pulse pattern. Conclusion : The above results show that the overall tendency of acute stage cerebral infarction patients varies according to their tongue fur color. Further studies will be needed to better understand the difference between yellow fur group and white fur among acute stroke patients.

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An Epidemiology Study on Temporo-mandibular Disorders of Employees Residing at Seoul (서울에 거주하는 직장인의 측두하악장애에 대한 역학적 연구)

  • Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.308-323
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    • 1996
  • This study tried to find the prevalence and distribution of temporo-mandibulr disorders(TMD) for workers (employee) in Seoul area to investigate the correlation between TMD and possible etiological factors such as general muscle and joint symptoms, headache, unilateral chewing and parafunction. This study was an epidemiological investigation of answers obtained from 282 persons by questionaire from Aug. 1995 to Nov. 1995. The major findings from the questionaire were as follows. (1) 43.26% of the subjects(282 persons) has TMD. (41.88% of man and 43.26% of women) (2) The more often people have general muscle and joint symptoms and headache, the more susceptible they are to TMD. Their correlation was very significant(p<0.001). (3) The more people have bad oral habits such as bruxism, clenching and biting habit, the more likely they have TMD. The more sensitive people are to stress, the more frequently they have bad oral habits such as bruxism, clenching and biting habit. (4) Unilateral chewing has higher TMD index than bilateral chewing. There is no relationship between ache areas and TMD index.

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Effect of Gabapentin for the Treatment of Burning Mouth Syndrome Comorbid with Depression in Postmenopausal Women (폐경 후 여성의 우울증에 수반된 구강 작열감 증후군(Burning Mouth Syndrome)에 대한 Gabapentin의 효과)

  • Kim, Min-Jeong;Kim, Hyun-Seuk;Park, Si-Sung
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.138-142
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    • 2014
  • Burning mouth syndrome is characterized by intra-oral burning sensation without any organic abnormalities. This syndrome is associated with various etiological factors such as neuropathy, malnutrition, menopause and depression. Several medications have been tried for the treatment. Those are analgesics, hormones, anticonvulsants and antidepressants. However, optimal effective pharmacologic treatment remains still unknown. The purpose of this case study is to report the clinical effectiveness of gabapentin in the treatment of burning mouth syndrome in postmenopausal women with comorbid depression. We report two menopausal women. Antidepressants were effective for improving depressive symptoms, but it had no effects on intra-oral burning sensation. Gabapentin reduced intra-oral burning sensation effectively for all two patients. One patient reported 55% reduction(a decrease from 9 to 4 on VAS), the other patient reported 35% reduction(from 8 to 5) of the intra-oral burning sensation during 16 weeks. The minimal effective daily dose of gabapentin was 300mg. This study suggests that gabapentin might be a useful, effective therapeutic option for treating burning mouth syndrome in postmenopausal women with comorbid depression. Further prospective clinical studies are needed to investigate the effectiveness of gabapentin in patients with burning mouth syndrome.

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A Clinical Review of Surgically Treated 115 Cases of Lung Abscess (외과적 치료를 가한 폐농양 115례에 대한 임상적 관찰)

  • 문한배;이호일
    • Journal of Chest Surgery
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    • v.2 no.1
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    • pp.3-12
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    • 1969
  • Prior to availability of antibiotics, lung abscess has been recognized as one of the most serious pulmonary disease, and despite of diminished morbidity and mortality rate with the advent of antibiotics and development of better technique in the fields of surgery on pulmonary disease it continues to be a virulent form of pulmonary supuration. It is the purpose of this paper to present a clinical review of 115 lung abscess treated by surgically at "The National Medical Center" during past 9 years. 1. The most common age of occurrence is between the age of 30 and 50, and 105 cases were male and 31 cases occurred in female. 2. Numerous etiological factors may play a role in the formation of a pulmonary abscess; aspiration in 36 patients of which 2 patients had diabetes, 54 patients had preceding URI or pneumonia, and 5 patients followed liver abscess, one of which in hematogenous route. In 20 patients, no predisposing factor could be determined- 3. Clubbing digits were presented in 26 of 1315 patients suggesting chronicity of the disease, and gastric ulcer were combined in 3 of 136 patints. 4. Apparently the onset was insidious, and the progress was masked by indiscriminate administration of antibiotics for URI and TB remedies under impression of pul. tbc. Previous TB treatments were done in 56.%[76 cases] for one week to two years and administration of antibiotics in 51 cases. 5. 89 cases were on tbe right and 2t5 cascs were on the left side. 51 cases of pneumonectomy and 8 of open drainage, of which 4 of Monaldi procedure, were made and operative mortality rate was 5.2%. Numerous complications such as 8 of empyema, 4 of each bleeding and atelectasis, 2 of BPF, 1 of esophageal fistula and one of pneumothorax which were responded well to prolonged treatment with good results, were obtained. 6. The incidence of Klebsiella and Pseudomonas were increased recently. In these results, we submit the surgery should be performed if the conservative therapy had failed. The resection was most favorable operation for pulmonary abscess though drainage procedure may be of value in certain patients with grave systemic menifestations. In chronic long standing abscess, more complications and high mortality rate were assumable although the prognosis has been improved with the advent of antibiotics, the development of improved surgical technique and complete preoperative care.

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Association of an Anti-inflammatory Cytokine Gene IL4 Polymorphism with the Risk of Type 2 Diabetes Mellitus in Korean Populations

  • Go, Min-Jin;Min, Hae-Sook;Lee, Jong-Young;Kim, Sung-Soo;Kim, Yeon-Jung
    • Genomics & Informatics
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    • v.9 no.3
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    • pp.114-120
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    • 2011
  • Chronic inflammation has been implicated as one of the important etiological factors in insulin resistance and type 2 diabetes mellitus (T2DM). To investigate the role of anti-inflammatory cytokines in the development of T2DM, we conducted a case-control study to assess the association between IL4/IL4R polymorphisms and disease risk. We firstly identified single nucleotide poly-morphisms (SNP) at IL4 and IL4RA loci by sequencing the loci in Korean participants. Case-control studies were conducted by genotyping the SNPs in 474 T2DM cases and 470 non-diabetic controls recruited from community-based cohorts. Replication of the associated signals was performed in 1,216 cases and 1,352 controls. We assessed effect of IL4 -IL4RA interaction on T2DM using logistic regression method. The functional relevance of the SNP associated with disease risk was determined using a reporter expression assay. We identified a strong association between the IL4 promoter variant rs2243250 and T2DM risk (OR=0.77; 95% CI, 0.67~0.88; p=$1.65{\times}10^{-4}$ in the meta-analysis). The reporter gene expression assay demonstrated that the presence of rs2243250 might affect the gene expression level with ~1.5-fold allele difference. Our findings contribute to the identification of IL4 as a T2D susceptibility locus, further supporting the role of anti-inflammatory cytokines in T2DM disease development.

Aplastic anemia and dental implant rehabilitation: a clinical trial

  • Kim, Jun-Hwa;Shet, Uttom Kumar;Kim, Byeong-Guk;Kim, Myung-In;Kook, Min-Suk;Oh, Hee-Kyun;Ryu, Sun-Youl;Park, Hong-Ju;Jung, Seunggon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.41 no.5
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    • pp.265-269
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    • 2015
  • The purpose of this study was to investigate implant-supported restoration as a technique for restoring missing teeth in patients with aplastic anemia. Recurrent bleeding from wound sites leads to persistent release of iron in the tissue. Excessive iron in tissue is related to clinical findings, including fibrosis, poor wound healing, and high level of angiogenesis, which are possible etiological factors of reduced osseointegration. A 44-year-old female patient with aplastic anemia was treated with multiple endosseous implants throughout the mandible and in the posterior region of the maxilla. After 14 implants were placed, radiological and clinical parameters were assessed during the follow-up period. Marginal bone did not change significantly during the follow-up period. The fine trabecular bone in intimate contact and enclosing the implant fixture was sufficient for successful osseointegration. None of the 14 implants were associated with compilations during the seven-year experimental period. This study suggests that dental implant procedures are a safe and reliable treatment option for restoration of missing dentition in patients with aplastic anemia.

The Effects of MWM Taping and Diamond Taping on the Pain, Grip Strength and Functional Activity in Patients with Lateral Epicondylitis (멀리건 테이핑과 다이아몬드 테이핑이 외측상과염 환자의 통증, 악력, 기능수행능력에 미치는 영향)

  • Yang, Seong-Hwa;Park, Hyun-Sik;Sin, Young-Il
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.19 no.2
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    • pp.47-54
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    • 2013
  • Background: Lateral epicondylitis is the most common complaint with complex etiological and pathophysiological factors on the lateral side of elbow. Taping techniques commonly used for lateral epicondylitis. The purpose of this study was to investigate the effects of mobilization with movement taping and diamond taping on the pain, grip strength and functional activity in patients with lateral epicondylitis Methods: Twenty patients with lateral epicondylitis (mobilization with movement taping group: n=10, diamond taping group: n=10) were recruited. They were evaluated pre-treatment, after 1weeks, and after 3weeks, using visual analog scale, pain free grip strength test, patient-rated tennis elbow evaluation. Results: Analysis showed statistcally significant improvement in all time in both groups. and The mean improvement in pre-1weeks visual analog scale was significantly greater in the Diamond taping group than that in the mobilization with movement taping group. and the mean improvement in pre-1weeks pain free grip strength test was significantly greater in the mobilization with movement taping than that in the diamond taping group. Conclusion: Taping technique to patients with lateral epicondylitis can help improve pain, grip strength, functional activity and initial taping technique can be selected depending on the patient's condition and the desired goal.

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Dental Erosion (치아침식증)

  • Kim, Jiyeon;Kim, Shin;Jeong, Taesung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.213-220
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    • 2016
  • In recent decades, dental erosion has received a considerable amount of attention with a steady increase of the prevalence. However, the awareness of this matter in our society, including dentistry is still lacking. Dental erosion is an irreversible loss of dental hard tissue leading to a complex condition. To prevent detrimental effects, it is important to detect conditions as early as possible and inhibit progression. In children and adolescents, early intervention is more important than in adults. As dental erosion is a multifactorial condition, dentists need to fully understand the phenomena and do systematic oral examination with thorough history taking for early diagnosis. When the main etiological factor is detected, it is necessary to make an effort to eliminate it and stop progression of the lesions with preventive measures. Restorative treatment should not be started unless substance loss reaches a certain level. Once the decision is made for treatment, care must be taken to choose the least invasive method.