Object : Since autonomic nerve system dysfunction was known as the mechanism of panic disorder, many researchers used heart rate variability (HRV) as means of measuring autonomic nerve function of patients with panic disorder. We aimed to examine the effect of paroxetine medication for 3 months on symptom improvement and change of heart rate variability of the patients with panic disorder. Methods : The subjects were patients with panic disorder who visited the psychiatric outpatient clinic of Samsung Medical Center in Seoul. We included panic disorder patients who were aged from 20 to 50 and in normal BMI range (from 18 to 30) to minimize the effect of age and weight on HRV data. We excluded the patients with EKG abnormalities, hypertension or other major psychiatric disorders. They took 20-40 mg paroxetine medication a day for 3 months. Alprazolam was used only during the first month to control the acute panic symptoms and was tapered off after that. We measured the acute panic inventory (API), Hamilton rating scale for anxiety and depression (HAM-A & HAM-D), Spielberger state-trait anxiety inventory (STAIS, STAIT), and Beck depression inventory (BDI) in order to assess clinical improvement of the patients. And we measured time and frequency domain HRV in the resting, standing and cognitive stress states to assess the change of HRV. All measurements were done before and after paroxetine treatment. Result : After paroxetine medication, patients showed significant improvement in all psychiatric scales. In time domain of HRV, standard deviations of all R-R intervals (SDNN) were significantly increased in all states. In frequency domain of HRV, the ratio of high frequency to total power (HF/TP) in the standing state was significantly increased. Conclusion : After 3 months paroxetine medication, panic disorder patients showed significant clinical improvement and change in HRV data such as SDNN in all states and HF/TP ratio in the standing state. This result suggests that paroxetine medication is effective for the improvement of autonomic nerve system dysfunction in panic disorder patients.
Background: Chronic myeloproliferative diseases are clonal stem cell diseases which occur as a result of uncontrollable growth and reproduction of hematopoietic stem cells, which are the myeloid series source in bone marrow. Recent studies have suggested that chronic inflammation can be a triggering factor in the clonal change in chronic myeloproliferative neoplasia (CMPN). In our study, we evaluated the existence of a chronic inflammation process in our Philadelphia negative (Ph-)CMPN patients using inflammation parameters in combination with demographic, laboratory and clinical characteristics of the patients. Materials and Methods: Demographic characteristics, clinical and laboratorial data, and thrombosis histories of 99 Ph-CMPN patients, who were diagnosed at our outpatient clinic of hematology in accordance with WHO 2008 criteria, were analyzed retrospectively,with 80 healthy individuals of matching gender and age included as controls. Complete blood counts, sedimentation, C reactive protein (CRP), JAK V617F gene mutations, abdomen ultrasound images and previous thrombosis histories of these patients were retrospectively analyzed. Results: Ph-CMPN and healthy control groups included 99 and 80 cases, respectively. PV, ET and MF diagnoses of patients were 43 (%43.4), 44 (44.4%) and 12 (12.1%), respectively. JAK V617F gene mutation was found to be positive in 64 (71.1%) of all cases and in 27(65.8%), 32 (82%), 5 (50%) of the cases in PV, ET and PMF groups, respectively. Thrombosis was determined as 12 (12%) in the entire group, 12.5% in the JAK V617F negative and 15.3% in the positive patients, with no statistical significance (p=0.758). No significant difference was observed between patients with and without previous thrombosis history in respect to hemogram parameters, sedimentation and CRP (p>0.05), neutrophil to lymphocyte ratio (NLR), erythrocyte distribution width (RDW), mean platelet volume (MPV) and sedimentation levels of the patient.
Tanik, Serhat;Albayrak, Sebahattin;Zengin, Kursad;Borekci, Hasan;Bakirtas, Hasan;Imamoglu, M. Abdurrahim;Gurdal, Mesut
Asian Pacific Journal of Cancer Prevention
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제15권15호
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pp.6375-6379
/
2014
Purpose: The aim of this study was to evaluate inflammation parameters and assess the utility of the neutrophil-lymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in patients with nenign prostate hyperplasia BPH. We also aimed to investigate the relationship between inflammatory parameters with ${\alpha}$-blocker therapy response, and evaluate the potential association between NLR and the progression of benign prostatic hyperplasia (BPH). Materials and Methods: We examined 320 consecutive patients (July 2013-December 2013) admitted to our outpatient clinic with symptoms of the lower urinary tract at Bozok University. The mean age was 60 (range, 51-75) years. Complete blood count (CBC), prostate-specific antigen (PSA), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Correlations between PSA, CRP, ESR, prostate volume, International Prostate Symptom Score (IPPS), maximum urinary flow rate (Qmax), and NLR were assessed statistically. Patients were divided into two groups: high and low risk of progression. Results: NLR was positively correlated with IPSS (p=0.001, r=0.265), PSA (p=0.001, r=0.194), and negatively correlated with Qmax (p<0.001, r=-0.236). High-risk patients a had a higher NLR compared with low-risk patients, based on IPSS (p<0.001), PSA (p=0.013), and Qmax (p<0.001); however, there were no significant differences between the groups in terms of age (p>0.05), and prostate volume (p>0.05). Conclusions: NLR can predict BPH progression. We propose that increased inflammation is negatively associated with clinical status in BPH patients and suggest that NLR can give information along with LUTS severity which may be used as a readikly accessible marker for patient follow-up.
Purpose: The purpose of this study was to explore the quality of life (QoL) in patients with Alzheimer's disease (AD) and their and caregivers and its influencing factors. Methods: A descriptive research design was used. 211 pairs of AD patients and their caregivers were recruited from a neurology outpatient clinic of S medical center in Seoul, Korea. Caregivers completed several structured questionnaires regarding AD patients' QoL as well as their QoL, patients' behavioral and psychological symptoms, patients' activities of daily living (ADL), social support, and quality of relationship between AD patients and caregivers. Cognitive status of AD patients was assessed by the researchers using Korean Mini-Mental State Examination. Results: The scores of QoL were 26.91 for AD patients and 85.62 for their caregivers. In the multiple regression, factors associated with AD patients' QoL were the quality of relationship (${\beta}$=.44), ADL (${\beta}$=-.33), patient's age (${\beta}$=.20), caregivers' QoL (${\beta}$=.20), and patient's gender (${\beta}$=.11). Factors associated with caregivers' QoL were the quality of relationship (${\beta}$=.34), relationship (${\beta}$=.32), patient's QoL (${\beta}$=.26), caregivers' gender (${\beta}$=.18), social support (${\beta}$=.12), and the level of caregivers' education (${\beta}$=.12). Conclusion: To improve the QoL in AD patients and their caregivers, strategies to promote their quality of relationship are needed.
Background: To compare prevalence of anxiety in ovarian cancer patients following primary treatment to that of normal women and to examine predicting factor. Materials and Methods: In this cross-sectional study, 56 ovarian cancer patients who had primary surgical treatment within the past five years (cancer group) and 56 age-matched women who attended an outpatient clinic for check-ups (non-cancer group) were recruited from June 2013 to January 2014. The hospital anxiety and depression scale (HADS), was used to determine anxiety level of the participants with the score of ${\geq}11$ suggestive of anxiety. The prevalence of anxiety symptoms and mean HADS scores for anxiety were compared between the study groups. For those with ovarian cancer, associations of demographic and clinical factors with anxiety was examined. A p-value of <0.05 was considered significant. Results: Participants in the non-cancer group had higher rate of medical comorbidity, higher salary, and more frequent university education. The prevalence of anxiety was not different between the groups, at 7.1% each. The mean HADS scores for anxiety subscale were not significantly different between the groups, 5.0 in the cancer group vs 6.1 in the non-cancer group (p=0.09). On multivariable analysis, no demographic or clinical factors significantly associated with anxiety were identified. For the cancer group, no association between any particular factors and anxiety was demonstrated. Conclusions: The prevalence of anxiety in women with ovarian cancer following primary treatment was comparable to that of normal women seeking routine check-up.
The purpose of this study was to identify the effect of social support revealed in the time duration of sick role behavior compliance on the patients with hypertension using Quasiexperimental research design. Data collection was made through the interview survey technique from the hypertensive patients who received social support intervention (experimental group, n=41) and from those who were not exposed to the intervention(control group, n= 34). The subjects were registered in the cardiovascular outpatient clinic at the Chonnam National University Hospital from June 3, 1996 to November 30, 1997. $\chi^2$-test or t- test, Repeated measures ANOVA were utilized in the data analysis. The results were as follows: 1. The effect of social support intervention on sick role behavior compliance was significant in 1 month(F=69.17, p=.000), 6 months (F=11.51, p=.001), and 12 months(F=.07, p=.789) and between two groups(1 month; F=153.70, p=.000, 6 months; F=13.94, p=.000, 12 months; F=6.72, p= .011). 2. The effect of social support intervention on blood pressure was not significant through all the periods of time (F=1.21, p=.274) between the two groups(F=.12, p=.732). In conclusion, it was showed that social support had an effect on sick role behavior compliance and the effect of social support continued for twelve months(F= 10.03, p=.002) However, the score of compliance tends to decrease after 6 months of intervention. Therefore, this study indicated that social support re-intervention would be needed between six and twelve months.
The purposes of study were to investigate the prenatal psychological adaptation and the perception of birth experience, and to identify the relationship between them. The subjects consisted of 162 women who visited the obstetrical outpatient clinic for prenatal examinations and who delivered the in babies at SNUH during the period from June 20 to August 10, 1990. The tools used for measurement were Lederman's Prenatal Self Evaluation Questionnaire and Marut & Mercer's scale of the Perception of Birth. The results are summarized as follows : 1. The orders and item means of psychosocial adaptation in pregnancy were the Acceptance of pregnancy(1.58). Identification of motherhood role(1.63). Relationship with husband(1.65) and Relationship with mother(1.67). The preparation for labor, concern for wellbeing of self and baby, and fear of pain, helplessness and loss of control were found to be less adaptive. 2. The level of the perception of the birth experience was mid-range(item mean : 3.22). The score of the perception of birth experience for primiparas was higher than for multiparas. However there was not a significant difference the groups. There were significant differences in the perception of the birth experience between certain general characteristics, namely, sex of the baby(p<0.05), type of delivery(p<0.005), and type of anesthesia(p<0.005). 3. There were significant differences in the perception of the birth experience between the groups below the mean and above the mean of concerti for wellbeing of self and baby, Fear of pain, Helplessness and loss of control, Relationship with husband and Identification of motherhood role (p<0.05). The perception of the birth experience was predicted by Fear of pain, Helplessness and loss of control (11%), Type of Delivery(6%), Concern for wellbeing of self and baby(3%), Preparation for labor(1%), sex of baby(1%), Relationship with mother(1%), Parity(1%) and Identification of motherhood role(1%). The Childbirth education should be revised to improve the psychosocial adaptation in pregnancy.
임상에서 치료가 어려운 건선을 오래 앓아온 환자가 홍피성 건선이 발생하여 집중적인 입원치료 후 꾸준한 외래진료를 거쳐 호전된 경과를 볼 수 있었기에 보고하는 바이다. 상기 환자는 심장 질환을 동반하고 있었으며 그와 관련된 부종 등의 증상에도 한방치료로 긍정적인 효과를 얻었다. 앞으로 홍피성 건선의 한방치료에 대한 치료의 기준을 마련할 필요가 있을 것으로 생각된다.
Postherpetic neuralgia is frequently painful, incapacitating, mood depressing, and sometimes lifelong. We investigated the influence of duration from eruption to nerve blocks in conjunction with patients age on analgesic and preventive effect for postherpetic neuralgia. We retrospectively evaluated 50 outpatient medical records for the above T4 dermatome. Patients had been referred to pain clinic and were treated over 2weeks from Jan. 1988 to Dec. 1993. Fifty patients were divided into 4 groups as follows: Group I (a): less than 4weeks from eruption to nerve block and younger than 65 years old. Group I (b): less than 4weeks from eruption to nerve block and older than 65 years old. Group II (a): more than 4weeks from eruption to nerve block and younger than 65 years old. Group II(b): more than 4weeks from eruption to nerve block and older than 65 years old. Mean number of stellate ganglion blocks were 29.7. Tramadol, amitriptyline, nicardipine were most commonly prescribed. Group I (a): had the most improvement rate(77.8%) as compared with other group(46.6, 52.7, 56.0%). Number of patients who complained of severe pain (VAS > 5) were 0, 3(39%), 2(15.4%), 5(30%) in I (a), I (b), II (a), II (b) group respectively. In conclusion, analgesic effect was best in cases of patients younger than 65 years old whose treatment were started within 4 weeks of eruption. Patients older than 65 yrs, analgesic effect did not vary on the timing of treatment.
Kwun, Yoojin;Hong, Soo-Jong;Lee, Jin Seong;Son, Da Hye;Seo, Jong Jin
Clinical and Experimental Pediatrics
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제57권9호
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pp.420-424
/
2014
The Epstein-Barr virus (EBV) is oncogenic and can transform B cells from a benign to a malignant phenotype. EBV infection is also associated with lymphoid interstitial pneumonia (LIP). Here, we report the case of a 14-year-old boy who was diagnosed with a latent EBV infection and underlying LIP, without any associated immunodeficiency. He had been EBV-seropositive for 8 years. The first clinical presentations were chronic respiratory symptoms and recurrent pneumonia. The symptoms worsened in the following 2 years. The results of in situ hybridization were positive for EBV, which led to a diagnosis of LIP. The diagnosis was confirmed by the results of a thoracoscopic lung biopsy. The EBV titer of the bronchoalveolar lavage specimens obtained after acyclovir treatment was found to be fluctuating. The patient had latent EBV infection for 8 years, until presented at the hospital with intermittent abdominal pain and distension. Physical examination and pelvic computed tomography revealed a large mesenteric mass. A biopsy of the excised mass led to a diagnosis of Burkitt's lymphoma (BL). The patient received combination chemotherapy for 4 months, consisting of vincristine, methotrexate, cyclophosphamide, doxorubicin, and prednisolone. He is now tumor-free, with the LIP under control, and is being followed-up at the outpatient clinic. This is the first report of a Korean case of chronic latent EBV infection that developed into LIP and BL in a nonimmunocompromised child.
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