• Title/Summary/Keyword: MUSCLE FATIGUE

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Clinical Characteristics, Histology and Prognosis of Autoimmune Hepatitis in Korean Children (소아 자가면역성 간염: 임상적 특성, 조직 소견 및 예후)

  • Chung, Dae-Lim;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Park, Sung Hye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.186-196
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    • 2004
  • Purpose: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. Methods: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. Results: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. Conclusion: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.

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Development and Evaluation of a Stage Matched Exercise Intervention Program for Elders - Application of the Tran Theoretical Model - (노인 운동행위 변화단계별 중재프로그램의 개발 및 평가 - 범이론적 모형의 적용 -)

  • Kwon, Yeun-Jung
    • Research in Community and Public Health Nursing
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    • v.13 no.2
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    • pp.205-215
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    • 2002
  • Objectives: This study was designed to develop and evaluate a stage matched exercise intervention program to effectively increase exercise behaviors in urban elders. Methods: The study included three phases: preliminary descriptive data collection, program development, and program evaluation. The data for the preliminary descriptive phase were collected between May and June 2001. The study participants were 89 urban elders who responded a questionnaire that included general characteristics, exercise related experiences, stage, and process of change in exercise behaviors. Data were analyzed using descriptive statistics, $x^2$-test, and content analysis. Development of the program was based on the preliminary data. and a literature review, and was guided by the tran theoretical model. It consisted of strategies to facilitate the process of changes used in each stage. Evaluation of the program was achieved from October to December 2001, using a case study method, in which eight urban female elders participated. Interviews were conducted on a weekly basis in the form of either an individual interview, or group discussion. Each elder subject received education in accordance with the program strategies and education materials. In the case that a subject's stage of change moved into another one, the scores for the process of change were re-measured. The data were analyzed using the content analysis technique. Results: The results were as follows: 1. Elders who participated in the preliminary data collection phase were over 75 years of age, and the majority of them were women. They had a higher educational level, and fewer number of illnesses than the subjects in other studies. Their stage of change was divided into pre-contemplation and maintenance. The social liberation scores were the highest across all stages of change. There was no difference between men and women on scores for processes of change in each stage. 2. The stage matched exercise intervention program that was developed in this study consisted of one counseling type program and three distinguished educational booklet materials. 3. The results of the case studies are as follows: 1) The study participants were 8 women between 75 and 87 years of age. At the first interviews, all of them were in the pre-contemplation stage. All of them reached the action stage before the 7th week. The scores for processes of change that were the focus in each stage increased more than the scores for other processes of change. During the early stages of change, experimental processes increased more than behavioral processes. However. this pattern was reversed during later stages of change. 2) Characteristics of the subjects in each stage were identical as presented at the tran theoretical model. The intervention strategies were effective in the transition occurred in any stage. 3) Barriers for exercise included unwillingness to exercise, fatigue, shortness of breath, and pain. Ways to overcome these barriers were 'learning an alternative exercise method that can be done at home', 'self-promising/ exercise-promising', and 'use of cues to exercise'. 4) The factors that affected the application of the program were consideration of age and personal preference in selecting an exercise pattern, individualized intervention, and use of education materials appropriate to elders. Women over 80 years of age preferred muscle strengthening and stretching exercise, because they can be easily done at home. They also preferred individualized interventions, materials that were easy to read, and education contents appropriate for elders. Conclusion: In conclusion, the stage matched exercise intervention program that considered the characteristics of the elders was effective to facilitate exercise behaviors of the elders.

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Cumulative Risk Assessment of Organophosphorus Pesticides in the Diet (식품을 통한 유기인계농약류의 동시노출위해성평가)

  • 이효민;한지연;윤은경;김효미;황인균;최동미;이강봉;원경풍;송인상
    • Journal of Food Hygiene and Safety
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    • v.16 no.1
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    • pp.21-26
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    • 2001
  • Risk assessment traditionally are conducted on individual chemicals; however, humans are exposed to multiple chemicals in daily life. The organophosphorus (OP) pesticides are considered in a single risk assessment because they act by a common mechanism of toxicity, and there is likely to be expose to multiple OP pesticides simultaneously or sequentially. The OP pesticides act by inhibiting the enzyme acetylcholinesterasc (AChE) and have available extensive database. AChE is widely distributed throughout the body, most importantly in the nervous system. Inhibition of AChE results in accumulation of acetylcholine in the nervous system that results in clinical signs of cholinergic toxicity, including increased salivation and lacrimation, nausea and vomiting, muscle fasciculation, lethargy and fatigue, among others. To conduct an exposure assessment for pesticides in the diet, we need to know the food consumption patterns of the populations, and the pesticide residue levels in the foods that are consumed. This study was conducted to identify cumulative dietary risk due to multiple OP pesticides that can be exposed through various foods. Total 22 food samples including cereals, vegetables and fruits were collected randomly two times from food markets in several sites (4 cities). The subjected foods were selected by regarding of highly consumed foods to general Korean people. The 12 OP pesticides including Acephate, Azinphos-methyl, Chlorpyrifos, and Diazinon were monitored. For the exposure assessment, general adult group of 60 kg body weight was regarded as target population and food consumption data suggested by Lee et al. (2000) were used as consumed value of individual food. Analyses of samples for OP pesticides have been carried out according to the multiclass multiresidue analysis method and acephate and methamidophos analysis method of Korea Food Code. In general the levels of OP pesticides found in the food samples were very low or not detected.

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The Significance of Acetylcholine Receptor Autoantibody Test (아세틸콜린 수용체 항체(Acetylcholine receptor autoantibody) 검사의 의의)

  • Yoo, Soh-Yeon;Lim, Soo-Yeon;Pack, Song-Ran;Seo, Mi-Hye;Moon, Hyung-Ho;You, Sun-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.113-116
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    • 2011
  • Purpose: Acetylcholine receptor antibodies cause acetylcholine receptor loss, which is responsible for failure of the neuromuscular junction in the acetylcholine receptor autoantibody. The disease characterized by muscle weakness and fatigue, myasthenia gravis(MG) occurs when the body inappropriately produces antibodies against acetylcholine receptors, and thus inhibits proper acetylcholine signal transmission. And this reason, the measurement of acetylcholine receptor antibodies can be of considerable value in disease diagnosis. Methods: From 2010. August to September, we tested orderd AchRAb 19 samples to get the results. 1. Pipette $5{\mu}{\ell}$ undiluted patient sera and kit control and add 125I AChR $50{\mu}{\ell}$ and incubate at R.T for 2 hours. 2. Pipette $50{\mu}{\ell}$ of anti-human IgG into each tube, and incubate at $2{\sim}8^{\circ}C$ for 2 hours. 3. Pipette $25{\mu}{\ell}$ precipitation enhancer into each tube and add 1mL washing solution into all tubes. 4. Centrifuge each tube for 20minutes at $2{\sim}8^{\circ}C$ at 1500g. 5. Aspirate or decant the supernatant. 6. Pipette 1 mL washing solution into all tubes and resuspend the pellet and repeat centrifugation. 7. Aspirate or decant the supernatant and count all tubes on a gamma counter. Results: Cut off value is 0.2 nmol/L and the results taken below 0.2 nmol/L are negative, the results above that identified as being positive values. We assayed the 19 patients samples and got 7 positive results. Of which, 6 patients were diagnosed as MG.(85.7%). Conclusions: Acetylcholine Receptor autoantibody test is intended for use by persons only for the quantitative determination of it in human serum. Even if measurement of the antibodies is not a routine test, it can be of considerable value in disease diagnosis.

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The clinical study of Myasthenia Gravis (중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究))

  • Chae, Byung-Yoon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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An Analytical Study of the Relationship between Climacteric Symptoms and the Stress of Life Events (갱년기 증상과 생활스트레스의 관계에 관한 연구)

  • Im Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.8 no.2
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    • pp.1-34
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    • 1994
  • This study has been done in order to analyze the relationship between climacteric symptoms and the stress of life events. For the purpose of this study. objectives set up were as followings. : 1. Climacteric symptoms complained by middle aged women are studied. 2. The stress of life events experienced by middle aged women is studied. 3. The relationship between climacteric symptoms and the stress of life events is studied. 4. The relationship between climacteric symptoms and general characteristics is studied. and the relationship between the stress of life events and general characteristics is also studied. The sample size of this study was 462 cases. The subjects were middle-aged women. who were from 40 to 60 years old and resided in Seoul. Data were collected by using questionnaires which consisted of 122 questions from Jan. 1 to Feb. 7 in 1992. The questionnaires include questions about general characteristics. climacteric symptoms and life events. The measurement scales for this study were adopted from the climacteric symptoms scale developed by Chi. Sung-Ai and the measurement scale of stress related to life events devised by Lee. Pyoung Sook. The analysis of data collected was done by using SPSS-pc package. Firstly. general characteristics were analyzed by using descriptive statistical methods. Secondly. climacteric symptoms were analyzed by using descriptive statistical methods. the analysis of variance and correlation analysis. Thirdly. the stress of life events was studied by using descriptive statistical methods. the analysis of variance. and tests of independence. The results of this study are as followings. 1. General characteristics of the respondents are as followings: The average age is 49. 13. and the age group from 46 to 50 has $30.5\%$ in the respondents. Christianity is the major religion $(42.6\%)$. and the respondents with a high school diploma are $(43.1\%)$ of the respondents. $60\%$ of all respondents are housewives. and $90.5\%$ are married. The average number of children is 2.71. and the average number of family is 4.24 Monthly income of $39.1\%$ of the respondents is from l,010,000 Won to 2,000,000 Won. The premenopausal group is $4.9\%$. and $45.5\%$ of all respondents are satisfied with marrital life. $43.3\%$ of all feel happy. and $13.9\%$ feel economic frustration. $27.9\%$ of respondents are satisfied with sexual life. and $45\%$ of all report that the amount of recreational activities are more needed. 2. The average score of climacteric symptoms is 1. 8461 (The maximum score is 5.0). The symptoms complained frequently are nervousness. muscle-ache. fatigue. headache and knee-ache. Climacteric symptoms are significantly different in menopausal states. age groups. the number of children, marrital satisfaction. the feeling of life. self-reported health states and sexual satisfaction. 3. The life events occurred frequently were 'discord with husband', 'children's important exams', 'separation from husband related to works' and 'vacation'. When life events are analyzed by factors. the most frequently mentioned factor is 'marrital life'. The stress of life events is significantly different in a few general characteristics (age. the number of children, the number of family, monthly income, menopausal status, the feeling of life. self-reported health states, economic satisfaction). 4. The score of climacteric symptoms complained is significantly different according to the stress of life events (p<0.051, Especially, the difference is the widest in psychological symptoms according to the factor of 'couple. marrital life' among stressful life events. In Summary, climacteric symptoms complained by middle-aged women are related to the amount of the stress of life events. Whether life events are positive of negative is not important. Yet. climacteric symptoms and stressful life events are deeply related to general characteristics. so we can not insist strongly that one be directly related to the other.

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