• Title/Summary/Keyword: Precipitating factors

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Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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A Convergence Study on Influencing Factors on the Sleep of University Students -Focusing on the Dependence of Smartphone- (대학생의 수면 관련 요인에 대한 융합 연구 : 스마트폰 의존을 중심으로)

  • Han, Suk-Jung;Chun, Ji-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.12
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    • pp.465-476
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    • 2019
  • This study was convergence study to determine sleep and its factors in university students on the basis of Spielman's 3P model. The participants were 191 graduate and undergraduate students who were scheduled to take the exam after 1~2 weeks. The related variables of quality of sleep were self-control, stress, test anxiety, smartphone dependence, and daytime sleepiness. Chi-square test and t-test were used to make a comparison of the quality of sleep between the good and the bad sleep quality group. Pearson's coefficient correlation analysis was performed for correlation between the quality of sleep and the general characteristics, self-control, stress, test anxiety, smartphone dependence, and daytime sleepiness. Stress and test anxiety as precipitating factors for sleep disturbance, smartphone dependency as a perpetuating factor for sleep disorder, and daytime sleepiness as a sleep-related factor were correlated with the quality of sleep; no statistically significant correlation was found with self-control as a predisposing factor in the biopsychological area. It is necessary to solve such problems with mental health as stress and test anxiety, which are factors for sleep disturbance, and smartphone dependency as a perpetuating factor for sleep disorder, in pursuit of higher quality of sleep for university students.

The Result of Repeat Discectomy for Ipsilateral Recurrent Lumbar Disc Herniation (재발성 요추 추간판 탈출증에 대한 추간판 재절제술의 결과)

  • Kim, Woo-Sung;Na, Hwa-Yeop;Oh, Sang-Hoon;Park, Sub-Ri;Son, Eui-Young
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.59-64
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    • 2017
  • Purpose: To analyze the result of a repeat discectomy for ipsilateral recurrent lumbar disc herniation and to investigate the potential factors that influenced the outcomes for this surgery. Materials and Methods: Fifty-nine patients, who underwent reoperation after lumbar discectomy with a minimum follow-up period of 2 years, were reviewed. The surgical outcome was assessed using the visual analogue scale (VAS) and Macnab classification, and the recovery rate was calculated in accordance with VAS. A statistical analysis was carried out by SPSS to evaluate the possible factors that may have influenced the outcomes of the reoperation. Results: The rate of reoperation after lumbar disc surgery due to the recurrent disc herniation was 6.0% (59/983 cases). The average recovery rate of VAS from the 1st operation was approximately 77%, and from the 2nd operation was 71%. According to the Macnab criteria, the results were "excellent" or "good" in 96% of cases. Statistical analysis revealed that there was no difference of the average recovery rate (p<0.05). There is no additional instability after repeat discectomy. Factors, such as smoking, precipitating traumatic events, and diabetes mellitus did not have much influence on the average recovery rate after repeat discectomy for ipsilateral recurrent lumbar disc herniation. Conclusion: The outcomes of repeat discectomy were satisfactory. Moreover, factors, smoking, trauma history and diabetic mellitus, only had a minor impact on the outcomes of a repeat discectomy.

Nitrate Removal and Recycling Technique (질산 제거 및 재이용 기술)

  • Lee, Kyoung Hee;Sim, Sang Jun;Choi, Guang Jin;Kim, Young Dae;Woo, Kyoung ja;Cho, Young Sang;Choi, Eui-So
    • Clean Technology
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    • v.3 no.2
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    • pp.87-93
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    • 1997
  • A new process has been developed for nitrate and other salts removals from polluted waters. Alumina cement and calcium oxide served as precipitating agents to remove nitrate with stirring at basic pH. Low content of alumina in the commercialized alumina cements resulted in a increasing in nitrate removal yield. It is found that the compositions of aluminium and calcium are the most important factors in successful nitrate insolubilization. In order to remove high concentration of nitrate in polluted water, multi-stage precipitation was found to be very effective. Sulfate, chloride, and phosphate ions as well as nitrate were also removed by the precipitated reaction. After precipitation, post-treatments including Na2CO3 addition and neutralization with acid alleviated the level of aluminium and calcium in the treated water.

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Clinical Observation for Evaluation Protocol on Tinnitus (이명에 대한 평가지침 수립을 위한 임상 연구)

  • Kim Yaan Bum
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.2
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    • pp.403-407
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    • 2002
  • The objective of this study is to establish the new evaluating method of tinnitus and to evaluate the effect of acupuncture therapy. Fourteen patients with tinnitus were studied. The patients answered the questionnaire designed to identify and describe the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus. After acupuncture therapy, the survey was conducted again among the patients and we evaluated the difference between pre-acupuncture therapy and post-acupuncture therapy. 1. Precipitating factors of tinnitus among the patients group consisted of 14 members were stress, noise, drug, overwork, URI, and otitis media in order. 2. Significant improvements in subjective symptoms of tinnitus and discomfort in daily life after acupuncture therapy were identified among the patient group of 14 members 3. Patient group of 14 members were divided into 2 groups by digestion status: patients who have poor digestion and patients who have good digestion. The patients who have good digestion showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. 4. Patient group of 14 members were divided Into 2 groups by urination and defecation status: patients who have poor urination and defecation and patients who have good urination and defecation. The patients who have good urination and defecation showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. 5. Patient group of 14 members were divided into 2 groups by sleeping status: patients who sleep well and patients who don't sleep well. The patients who sleep well showed significant improvement both in subjective symptoms of tinnitus and in discomfort in daily life after acupuncture therapy. This study shows that the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus are involved in urination and defecation factor, sleep factor, and digestion factor. This study also shows that acupuncture therapy is effective in improving the subjective symptoms of tinnitus and discomfort in daily life due to tinnitus.

Compensatory Hyperhidrosis after Thoracoscopic Sympathectomy in Essential Hyperhidrosis (본태성 다한증 환자의 수술 후 발생하는 보상성 다한증)

  • Seo, Eui Kyo;Cho, Yong Eun;Yoon, Do Heum;Kim, Young Soo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.4
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    • pp.486-492
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    • 2001
  • Objective : Essential hyperhidrosis is a pathological condition of excessive sweating beyond that required to cool the body, though poorly understood, originating from a dysfunction of the sympathetic nervous system. Thoracoscopic sympathectomy is the most popular treatment for upper limb hyperhidrosis, because it is a safe, effective, minimally invasive, and time-saving method. However, the common complication is the compensatory hyperhidrosis in other areas of the body, notably on the back, chest, abdomen, and buttocks. Compensatory hyperhidrosis is severe enough for some people, especially those living in a warm climate or engaging in heavy physical activities, to regret ever having had operation. The pathophysiological mechanisms underlying compensatory hyperhidrosis are incompletely understood, even though it is thought to be a truly compensatory feature related to thermoregulation of the body. Materials and Methods : we studied the clinical features of total 233 patients who were diagnosed as essential hyperhidrosis and treated with thoracoscopic sympathectomy or sympathicotomy from March 1992 to July 2000. Results : The success rate of thoracoscopic sympathetic surgery(sympathectomy or sympathicotomy) was 98.7%. The global rate of compensatory hyperhidrosis was 77% ; 84% in group T2, 3 sympathectomy, 76% in group T2 sympathectomy, 43% in group T2, 3 sympathicotomy and 59% in group T2 sympathicotomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathectomy and in T2, 3 sympathectomy than in T2 sympathicotomy and T2, 3 sympathicotomy with significancy in statistic analysis(p<0.01). The precipitating factors of compensatory hiperhidrosis, including heat(warm weather), anxiety, stress, and exertion were noted. The compensatory hyperhidrosis was the main cause of patient dissatisfaction after thoracoscopic sympathectomy. Conclusion : The degree of compensatory hyperhidrosis is closely related to the extent of thoracic sympathectomy.

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The Efficacy of Stellate Ganglion Block in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss (성상신경절 차단의 돌발성 난청에 대한 효과)

  • Nam, Sang-Beom;Yoon, Duck-Mi;Lee, Youn-Woo;Kim, Jung-Sub;Nam, Yong-Taek
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.30-35
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    • 1998
  • Background: Idiopathic sudden sensorineural hearing loss(ISSHL) has been generally defined as an abrupt loss of auditory acuity without precipitating factors. Since ISSHL was first described as a disease entity, numerous reports assessing a variety of treatment regimens have been published. But its etiology, pathogenesis, treatment, and prognosis are controversial at the present time. Stellate ganglion block(SGB) has been used for the treatment of ISSHL by vasodilatation and increased blood flow to the inner ear. Methods: We reviewed the records of 152 patients to investigate the efficacy of SGB for ISSHL. The control group was managed with medications such as hypaque, heparin, steroid, nicotinic acid, and vitamins. The SGB group was managed with SGB and the same medications. SGB was performed with 8 ml of 1.0% mepivacaine. The efficacy of treatment was evaluated by pure-tone average following therapy. The recovery of hearing was defined as Siegel's criteria I, II, or III. Results: The recovery rate of the SGB group was higher than that of the control group(61.5 vs. 42.9%, p<0.05). The recovery rate was higher in patients who were treated early, within 7 days from the onset of symptoms, especially in the SGB group(79.7%). And in the case that initial hearing loss was severe (>70dB), the SGB group had a higher recovery rate(64.2%) than the control group(42.5%). Conclusions: SGB is thought to be a useful therapy for ISSHL, especially in the patients who were treated soon after onset or whose initial hearing loss was severe.

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Spontaneous Lumbar Epidural Hematoma Mimicking Lumbar Disc Herniation (요추 추간판 탈출증과 유사한 자발성 경막외 혈종)

  • Kyung, Dong Hyun;Moon, Byung Gwan;Kim, Joo Seung;Kang, Hee In;Lee, Seung Jin
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.623-627
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    • 2000
  • Objective : Spontaneous lumbar epidural hematoma is a rare entity, although the precipitating factors such as anticoagulation therapy frequently precede it. The authors report four cases of surgically confirmed spontaneous epidural hematoma mimicking lumbar disc herniation. Methods : Between 1995 and 1998, four patients with spontaneous lumbar epidural hematoma were diagnosed. The clinical findings which are identical to that of acute disc herniation are included in this study. The operative findings and radiological characteristics are also included. Results : The magnetic resonance(MR) image findings demonstrated epidural lesions of intermediate to low signal intensity equivalent to those of normal discs on $T_1$-weighted images, and epidural lesions of high signal intensity higher than these normal discs on a $T_2$-weighted image. The image findings also showed rim enhanced pattern of the gadolinium-enhanced $T_1$-weighted MR images. All of the hematomas was associated with a small concomitant disc herniation or underlying annular tear. Conclusion : The authors speculate that spontaneous lumbar epidural hematoma results from tearing of the fragile penetrating vein caused by underlying disc or annulus disruption between Batson' plexus and vertebral body.

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A case of hereditary pancreatitis with a N29I mutation in the cationic trypsinogen gene (Cationic Trypsinogen N29I 유전자 변이에 의한 유전 췌장염 1례)

  • Shin, Jee Youn;Oh, Dae Sung;Rheu, Jeong Min;Shim, Jeong Ok;Park, Ji Sook;Ko, Jae Sung;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1111-1115
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    • 2006
  • Hereditary pancreatitis is an autosomal dominant disease characterized by recurrent episodes of pancreatitis, often beginning in childhood, with a positive family history involving at least two other affected family members with no known other precipitating factors. Most forms of hereditary pancreatitis are caused by one of two common mutations, i.e., R122H in exon 3 and N29I in exon 2 of the cationic trypsinogen (CT) (PRSS1) gene, located on chromosome 7. The authors describe the case of a 15-year-old boy who had suffered from recurrent attacks of pancreatitis since age three. His mother and grandmother had chronic pancreatitis and diabetes mellitus. Mutation analysis was performed on the family due to the suspicion of hereditary pancreatitis. The CT gene was analyzed in DNA samples extracted from the peripheral blood of three family members, the mother, the proband, and the proband's sister. Two members of the family, the mother and the proband, were found to have a N29I mutation in the CT gene. The authors document the first family with hereditary pancreatitis associated with the N29I mutation in Korea.

An Epidemiologic Study on the Frequency of Stress Symptoms in the Orofacial Region (스트레스에 의한 구강안면증상의 발혀에 관한 역학적 연구)

  • 오민정;한경수
    • Journal of Oral Medicine and Pain
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    • v.22 no.2
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    • pp.359-371
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    • 1997
  • Stress is recognized as a major predisposing and/ or precipitating factor in long-lastig intractable chronic pain, such as temporomandibular disorders, headache, and other psychophysiological disorders. So it is necessary to detect physical and psychological changes induced by stress as soon as possible for positive treatment outcome. This study was performed to investigate the occurrence rate of stress symptoms according to anatomic region, type of symptom, and other personal and social factors. 859 subjects from general population answered the stress symptom questionnaire devised by the author and composed of 50 items. Data from the questionnaire were analyzed statistically with SPSS program and the results obtained were as follows : 1. Oral symptom which showed the highest frequency rate of 38.8% was vesicular lesion of the lip and cheek. The other symptoms with more 20% occurrence rate were ulcerative leion of lip and cheek, toothache, paresthesia of teeth, eruption of tongue, tongue coating and taste change in descending order. 2. In extraoral symptoms, ?데 disturbance was the item which showed the highest frequency rate of 62.0%, and the items for stiffness of suboccipital region and neck, headache, facial swelling, furuncle of face were answered more than 45% of the subjects whereas only 14.0% of the subjucts complained jaw pain under stress. 3. The better one who thought his or her health status was, the fewer items were answered and the difference of symptom frequency by dwelling place and by having hobby were shown in extraoral symptoms only. 4. For relief of stress symptoms, 79.2% of the subjects replied only to take a rest whereas not more than 13, 5% of the subjects visited dental clinic. Correlationship between symptom sites were very high.

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