• Title/Summary/Keyword: Symptom Subgroups

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Symptom Clusters in Patients with Breast Cancer (유방암 환자의 증상 클러스터)

  • Kim, Soo-Hyun;Lee, Ran;Lee, Keon-Suk
    • Korean Journal of Adult Nursing
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    • v.21 no.6
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    • pp.705-717
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    • 2009
  • Purpose: The purpose of this study was to identify symptom clusters in patients with breast cancer and to investigate the associations among them with functional status and quality of life (QOL). Methods: A convenient sample of 303 patients was recruited from an oncology-specialized hospital. Results: Two distinct clusters were identified: A gastrointestinal- fatigue cluster and a pain cluster. Each cluster significantly influenced functional status and QOL. Based on these two clusters, we identified subgroups of symptom clusters using K-means cluster analysis. Three relatively distinct patient subgroups were identified in each cluster: mild, moderate, and severe group. Disease-related factors (i.e., stage, metastasis, type of surgery, current chemotherapy, and anti-hormone therapy) were associated with these subgroups of symptom clusters. There were significant differences in functional status and QOL among the three subgroups. The subgroup of patients who reported high levels of symptom clusters reported poorer functional status and QOL. Conclusion: Clinicians can anticipate that breast cancer patients with advanced stage, metastasis, and who receive mastectomy, and chemotherapy will have more intense gastrointestinal-fatigue or pain symptoms. In order to enhance functional status and QOL for patients with breast cancer, collective management for symptoms in a cluster may be beneficial.

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Symptom Cluster Presented by Non-small Cell Lung Cancer Patients on Gefitinib Treatment (게피티니브 치료를 받은 비소세포폐암 환자의 다발성 증상군 (Symptom Cluster))

  • Lee, Sung-Young;Park, Hyeoun-Ae
    • Asian Oncology Nursing
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    • v.9 no.2
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    • pp.77-85
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    • 2009
  • Purpose: The purpose of this study was to identify symptom cluster experienced by patients with advanced non-small cell lung cancer (NSCLC) on gefitinib treatment. In addition, this study assessed the patterns in severity of the symptom cluster and differences in quality of life (QOL) and function among subgroups by the severity of symptom cluster. Methods: This study was conducted as a secondary analysis of symptoms of 72 patients from a mother study. Factor analysis was used to identify symptom clusters measured with EORTC QLQ-C30 and LC13 symptom related items. Results: Three symptom clusters were identified: cluster 1 was comprised of fatigue, anorexia and dysphagia; cluster 2 of dyspnea, cough and insomnia; and cluster 3 of pain, constipation and nausea/vomiting. These three symptom clusters were improved one week after gefitinib administration. The group with more severe symptom clusters showed significantly lower QOL and function than the group with less severe symptom clusters. Conclusion: Since symptom clusters experienced by the patients with advanced NSCLC influenced on the QOL and function, it is important for nurses to understand and observe their symptom clusters. In addition, there is an necessity to develop nursing interventions to effectively care patients with the symptom clusters.

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Analysis of the Five-Factor Model of Personality in Obsessive-Compulsive Disorder (강박장애 환자에서의 성격 5요인 모델 분석)

  • Huh, Min Jung;Byun, Min Soo;Kim, Sung Nyun;Kim, Euitae;Jang, Joon Hwan;Kwon, Jun Soo
    • Anxiety and mood
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    • v.8 no.2
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    • pp.99-105
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    • 2012
  • Objective : The aim of this study is to evaluate the five-factor model of personality in patients with obsessive-compulsive disorder (OCD) related to obsessive-compulsive symptom severity and the distinct symptom subgroups. Methods : We recruited 95 patients with OCD and 116 normal controls in the study. We used the short version of Revised NEO Personality Inventory and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) for the assessment. Results : Patients with OCD showed significantly higher scores in neuroticism than normal controls. On multiple linear regression analysis, we found that agreeableness and conscientiousness were associated with the total Y-BOCS scores. On subscale analysis, agreeableness and neuroticism were associated with the obsession subscale scores and only conscientiousness was associated with the compulsion subscale scores. Furthermore, we found that patients who have contamination/cleaning or symmetry/ordering/counting/arranging as a main symptom presentation had significantly higher mean scores in conscientiousness than patients who have harm due to injury/violence/aggression as a main symptom presentation. Conclusion : In this study, we found that specific personality factors are associated with the obsessive-compulsive symptom severity. In addition, this is the first study to investigate the relationship between the personality factors in the five-factor model and the distinct symptom subgroups in OCD.

A Study of Social Support Network in the Course of Schizophrenic Patients (정신분열병(精祥分裂病) 환자(患者)의 사회적(社會的) 지지망(支持網) 분석(分析))

  • Han, Chang-Hwan;Kim, Kwang-Jin;Suk, Jae-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.4 no.2
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    • pp.226-244
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    • 1996
  • This study was designed to evaluate the social support network of schizophrenic patients. 64 schizophrenic patients being treated as out-door patient were compared with 30 neurotic control patients. Schizophrenics were divided into positive, subpositive, subnegative and negative subgroups by present symptom and social network of both schizophrenics and control group were evaluated. The results are as follows: 1) Social network of schizophrenics was smaller than that of control group. Size of social network of schizophrenics was 10.6 and that of control group was 23.5. 2) In both kin and nonkin, social network of schizophrenics was smaller than that of control group. Of the kin, schizophrenics were more supported by wife or husband, father, and mother, but were less supported by brother, son and other relatives. 3) There was no difference in the kin or nonkin or total supporters between the four subgroups of schizophrenics. But, subgroup of schizophrenics which was divided as having negative symptom had smaller network than control group in active formal and informal supporters. 4) When divided into 4 support areas, schizophrenics was remarkably less supported in emotional, instrumental and appraisal support area than control group, but there was no difference in the informational support areas. 5) Compared with control group, schizophrenics more often mentioned parent and ten often mentioned nonkin supporter as the one that is most important to him. 6) Schizophrenics had smaller cluster and less leisure activity than control group. Subgroup of schizophrenics who was divided as having negative symptom had less frequency of leisure activity than other subgroups.

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Analysis of Gait Parameters According to the Clinical Features of Parkinson's Disease Using 3-D Motion Analysis System with Electrogoniometer (3차원 전기측각 보행분석기를 이용한 파킨슨씨병 환자의 임상 양상에 따른 보행 분석)

  • Baek, Hye-Jin;Yoon, Joon-Shik;Kim, Sei-Joo;Lee, Gyu-Ho;Koh, Seong-Beom
    • Annals of Clinical Neurophysiology
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    • v.11 no.1
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    • pp.9-15
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    • 2009
  • Background: To investigate the differences of locomotor dynamics between Parkinson's disease (PD) patients with tremor dominant symptom and patients with postural instability dominant symptom. Methods: 66 subjects with PD were classified into two subgroups, tremor-dominant group and postural instability and gait disorder group by Unified Parkinson's disease rating scale (UPDRS). The spatial, temporal and electrodynamic gait parameters were recorded automatically using computerized 3-D motion analysis system with electrogoniometer. Results: There was no significant difference in cadence, pelvic tilt range, hip flexion range, knee flexion range and ankle dorsiflexion range. Postural instability and gait disorder group showed decreased gait velocity, short stride length, decreased range of motion in pelvic obliquity, pelvic rotation and ankle plantar flexion. Conclusions: There was meaningful difference in locomotor dynamics between Parkinson's disease(PD) patients with tremor dominant symptom and patients with postural instability dominant symptom.

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Patterns of Restricted and Repetitive Behaviors in Toddlers and Young Children with Autism Spectrum Disorder

  • Song, Da-Yea;Kim, Dabin;Lee, Hannah J.;Bong, Guiyoung;Han, Jae Hyun;Yoo, Hee Jeong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.33 no.2
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    • pp.35-40
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    • 2022
  • Objectives: Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD. The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods: A total of 313 children with ASD, aged 12-42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results: Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion: Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.

Relations between Clinical Findings and Treatment Results in Patients with Temporomandibular Disorders (측두하악장애환자의 임상양태와 치료결과와의 관계)

  • Hee-Young Oh;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.407-420
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    • 1995
  • This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

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A TOMOGRAPHIC STUDY OF THE CONDYLE POSITION IN TEMPOROMANDIBULAR DISORDERS (단층촬영을 이용한 악관절 기능장애 환자의 과두위에 관한 연구)

  • Choi Sung Youn;Ryu Young Kyu
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.18 no.1
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    • pp.81-136
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    • 1988
  • The aim of this study was to determine whether T.M.J. tomographic examination yielded significant differences in condyle positions among asymptomatic, myalgia, derangement, and arthrosis groups of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows. 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substantial range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P<.05). Also that of left central section existed between derangement and myalgia groups, and that of left medial section existed between derangement and myalgia groups (P<.05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main- symptom sides, and only between derangement and myalgia groups in central section of contra-lateral sides (P<.05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia groups (P<.05). Condyle position in derangement group was more posterior. The distribution of the condyle position of contra-lateral side in patients with unilateral symptoms was similar to that of main-symptom side in each symptomatic group. No significant difference existed between main-symptom and contra-lateral sides. 5. For internal derangement subgroups, condyle position in reducible disc displacement group was more posterior than non-reciprocal and locking groups, but there was no significant difference. 6. From 16 to 25 years, significant difference for mean condyle position of medial section of main-symptom side of each symptomatic group existed between myalgia and derangement groups (P<.05).

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A Comparative Study on the Temporomandibular Joint Sounds before and after Occlusal Splint Therapy Using Electrovibratography (두개하악장애환자의 교합안정장치에 의한 치료후 Sonopak을 이용한 악관절음 변화)

  • Hye-Sook Park;Jong-Hoon Choi;Chang-Seo Park
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.67-78
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    • 1996
  • This study was performed to compare the TMJ sounds by means of vibration-related items by Sonopak such as integral, high integral, above 300/(0-300) ratio, peak amplitude, peak frequency and median frequency before and after occlusa1 splint therapy as well as counselling, physical modalities. For this study 22 patients with craniomandibular disorders (CMDs) were selected and examined by routine diagnostic procedure for CMDs including Transcranial and Panoramic radiographs and were classified into 3 CMDs subgroups : disc displacement with reduction, disc displacement without reduction, and degenerative joint disease. Visual analogue scale (VAS) about joint sound was recorded during treatment period and VAS treatment index (VAS Ti) was calculated from the VAS data and treatment duration. The author evaluated and compared treatment results by several parmeters such as symptom duration, timing of joint sound, parafunctional habits, trauma, and diagnostic classification. The obtained results were as follows : 1. Before the treatment, the highest value of peak amplitude was observed in disc displacement with reduction group and value of median frequency was highest in degenerative joint disease group. In addition the highest values of peak frequency and ratio ware observed in degenerative joint disease group, though they were not significant. Furthermore the lowest value of high integral was observed in disc displacement without reduction group and though it was not significant, value of integral was lowest in that group. 2. Among 3CMDs subgroups disc displacement with reduction group showed the significantly decreased value of high integral and degenerative joint disease group had the significantly decreased value of integral after conservative treatment including occlusal splint therapy. Conclusively conservative treatment including occlusal splint therapy vay be effective in the treatment of CMDs including TMJ sound. 3. Fair prognosis for conservative treatment was observed in acute group under 6 months than chronic group, 6 months over in symptom duration but there was no statistical difference. The result for conservative treatment was observed slightly poor in subjects with bruxism, clenching, unilateral chewing habit and trauma history but there were no statistical differences.

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Morphological and Genetic Characteristics of Colletotrichum gloeosporioides Isolated from Newly Emerging Static-Symptom Anthracnose in Apple

  • Jeon, Yongho;Cheon, Wonsu
    • 한국균학회소식:학술대회논문집
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    • 2014.10a
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    • pp.34-34
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    • 2014
  • Filamentous fungi of the genus Colletotrichum (teleomorph, Glomerella) are considered major plant pathogens worldwide. Cereals, legumes, vegetables, and fruit trees may be seriously affected by this pathogen (1). Colletotrichum species cause typical disease symptoms known as anthracnoses, characterized by sunken necrotic tissue, where orange conidial masses are produced. Anthracnose appears in both developing and mature plant tissues (2). We investigated disease occurrence in apple orchards from 2013 to 2014 in northern Gyeongbuk province, Korea. Typical anthracnose with advanced symptoms was observed in all apple orchards studied. Of late, static fruit spot symptoms are being observed in apple orchards. A small lesion, which does not expand further and remains static until the harvesting season, is observed at the beginning of fruit growth period. In our study, static symptoms, together with the typical symptoms, were observed on apples. The isolated fungus was tested for pathogenicity on cv. 'Fuji apple' (fully ripe fruits, unripe fruits, and cross-section of fruits) by inoculating the fruits with a conidial suspension ($10^5$ conidia/ml). In apple inoculated with typical anthracnose fungus, the anthracnose symptoms progressed, and dark lesions with salmon-colored masses of conidia were observed on fruit, which were also soft and sunken. However, in apple inoculated with fungi causing static symptoms, the size of the spots did not increase. Interestingly, the shape and size of the conidia and the shape of the appressoria of both types of fungi were found to be similar. The conidia of the two types of fungi were straight and cylindrical, with an obtuse apex. The culture and morphological characteristics of the conidia were similar to those of C. gloeosporioides (5). The conidia of C. gloeosporioides germinate and form appressoria in response to chemical signals such as host surface wax and the fruitripening hormone ethylene (3). In this study, the spores started to germinate 4 h after incubation with an ethephon suspension. Then, the germ tubes began to swell, and subsequently, differentiation into appressoria with dark thick walls was completed by 8 h. In advanced symptoms, fungal spores of virtually all the appressoria formed primary hyphae within 16 h. However, in the static-symptom fungus spores, no primary hyphae formed by 16 h. The two types of isolates exhibited different growth rates on medium containing apple pectin, Na polypectate, or glucose as the sole carbon. Static-symptom fungi had a >10% reduction in growth (apple pectin, 14.9%; Na polypectate, 27.7%; glucose, 10.4%). The fungal isolates were also genetically characterized by sequencing. ITS regions of rDNA, chitin synthase 1 (CHS1), actin (ACT), and ${\beta}$-tubulin (${\beta}t$) were amplified from isolates using primer pairs ITS 1 and ITS 4 (4), CHS-79F and CHS-354R, ACT-512F and ACT-783R, and T1 and ${\beta}t2$ (5), respectively. The resulting sequences showed 100% identity with sequences of C. gloeosporioides at KC493156, and the sequence of the ${\beta}$t gene showed 100% identity with C. gloeosporioides at JX009557.1. Therefore, sequence data from the four loci studied proves that the isolated pathogen is C. gloeosporioides. We also performed random amplified polymorphic DNA-PCR, which showed clearly differentiated subgroups of C. gloeosporioides genotypes. The clustering of these groups was highly related to the symptom types of the individual strains.

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