Kim, Shin Hyung;Sun, Jong Min;Yoon, Kyung Bong;Moon, Joo Hwa;An, Jong Rin;Yoon, Duck Mi
The Korean Journal of Pain
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v.28
no.2
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pp.137-143
/
2015
Background: Insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic low back pain (CLBP). In this retrospective study, we have determined risk factors associated with clinical insomnia in CLBP patients in a university hospital in Korea. Methods: Data from four-hundred and eighty one CLBP patients was analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ${\geq}15$). Patients' demographics and pain-related factors were evaluated by logistic regression analysis to identify risk factors of clinical insomnia in CLBP. Results: It was found that 43% of patients reported mild to severe insomnia after the development of back pain. In addition, 20% of patients met the criteria for clinically significant insomnia (ISI score ${\geq}15$). In a stepwise multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain and neuropathic pain components, and high level of depression were strongly associated with clinical insomnia in CLBP. Among these factors, the presence of comorbid musculoskeletal pain other than back pain was the strongest determinant, with the highest odds ratio of 8.074 (95% CI 4.250 to 15.339) for predicting clinical insomnia. Conclusions: Insomnia should be addressed as an integral part of pain management in CLBP patients with these risk factors, especially in patients suffering from CLBP with comorbid musculoskeletal pain.
To assess premenstrual changes in adolescents, a self rating retrospective premenstrual assessment from(PAF) and a prospective daily rating form(DRF) were administered to 230 high school students who reported premenstrual changes. The results were as follows 1) According to typological categories of retrospective premenstrual assessment form, the most commonly reported changes in mood and behavior were major depressive syndrome(40.0%), impulsive syndrome(20.9%). Especially among the subtype of depressive syndrome, hostility feature and withdrawal feature were most frequent. The most commonly reported changes in physical condition were general discomfort(73.5%), fatigue(33.9%). 50.9% of all subjects reported impaired social function. 2) 41.2% of the subjects who met the criteria for typological categories of retrospective premenstrual assessment form were confirmed by prospective daily rating form. 3) According to different criteria of percent change method of assessing symptom change, 38.7% of all subjects had at least one mild premenstrual change and 23.5% had at least one moderate premenstrual change. 4) Using prospective daily rating form, overall psychological changes were confirmed more frequently than physical changes. Of the mild premenstrual changes, 'low energy, tired & weak', 'less or impaired work' were most common changes. Of the moderate premenstrual changes, the most common change was 'low energy, tired & weak'. 5) As attitude toward menstruation, 44.9% of the subjects with confirmed premenstrual changes had more negative attitude(disgusted) toward menstruation. 6) The subjects with confirmed mild or moderate premenstrual changes had only dysphoric mood changes or both physical and dysphoric mood changes, but did not have only physical changes. These results suggest that retrospective reports of premenstrual changes were partially confirmed by daily prospective ratings. A substantial number of adolescents appeared to experience premenstrual changes, and the most common confimed premenstrual change of mild or moderate severity was 'low energy, tired and weak'.
Purpose : To identify factors related to the severity and frequency of hot flush of postmenopausal women who participated in a clinical trial. Methods : A cross-section study of 34 postmenopausal women between 40 and 60 years of age was done. VAS(visual analog scale) was used to evaluate the hot flush degree. Statistical analysis was performed with multiple linear regression analysis. Results : Hot flush VAS was proportional to the percent body fat with 1.467 regression coefficient (p-value= 0.010). It implies that the symptom of hot flush becomes worse as the percent body fat increases. Some hormones also have effects on hot flush. We found that LH might cause increment of hot flush VAS(i.e., the corresponding regression coefficient is 0.912). Sasang constitution was not relevant to the hot flush degree. Hot flush VAS seemed to increase as the vascular aging degree by SA-2000 getting worse, but it was not statistically significant (p-value= 0.594). Conclusion : This study is a part of a prospective clinical trial. For more accurate result, larger-scale cross-section study or clinical trial are necessary.
Park, So-Hyun;Choi, Hee-Yeon;Lim, Weon-Jeong;Moon, Byung-In;Lim, Woo-Sung
Korean Journal of Biological Psychiatry
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v.24
no.4
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pp.204-211
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2017
Objectives In this study, we identified the symptoms of insomnia, anxiety, and depressed mood in newly diagnosed women breast and thyroid cancer patients. Methods The subjects of this study were 1794 women patients who visited the Ewha Womans University Cancer Center for Women. They included 1119 newly diagnosed primary breast cancer patients and 675 newly diagnosed primary thyroid cancer patients. The patients completed the National Cancer Center Psychological Symptom Inventory (NCC-PSI) during their first follow-up visit after surgery, before starting chemotherapy or radiotherapy. The NCC-PSI is composed of the modified distress thermometer (MDT) and the modified impact thermometer (MIT) for insomnia, anxiety, and depressed mood. Results Anxiety severity was found to be greater in breast cancer patients than in thyroid cancer patients. Significant levels of anxiety, depressed mood and insomnia were present in 28, 24.5, and 20.7% in all the subjects, respectively. Moreover, anxiety symptoms, depressed mood and insomnia interfered with the daily lives of 20, 18.4, and 14.2% of all the subjects, respectively. Dealing with anxiety (18.8%) was found to need the most help, followed by dealing with insomnia (8.9%) and depressed mood (8.7%). Conclusions A significant level of distress was found in about 40% of the total subjects. Nearly 30% of newly diagnosed breast cancer patients reported significant anxiety symptoms and interferences with daily living caused by anxiety, which most commonly needed special care. Early assessment and management of psychological distress, especially anxiety, in breast and thyroid cancer treatment are very important to establish integrated cancer care.
In this study, resistance responses were investigated during the interaction of Botrytis fabae with two faba bean cultivars expressing different levels of resistance against this pathogen, Nubaria (resistant) and Giza 40 (susceptible). Disease severity was assessed on leaves using a rating scale from 1 to 9. Accumulation levels of reactive oxygen species (ROS), lipid peroxidation and antioxidant enzymes (superoxide dismutase, catalase and ascorbate peroxidase) were measured in leaf tissues at different times of infection. The expression profiles of two pathogenesis-related proteins (PRPs) encoded by the genes PR-1 and ${\beta}$-1,3-glucanase were also investigated using reverse transcription RT-PCR analysis. The accumulation of these defense responses was induced significantly in both cultivars upon infection with B. fabae compared with un-inoculated controls. The resistant cultivar showed weaker necrotic symptom expression, less ROS accumulation, a lower rate of lipid peroxidation and higher activity of the enzymatic ROS scavenging system compared with susceptible cultivar. Interestingly, ROS accumulated rapidly in the resistant leaf tissues and peaked during the early stages of infection, whereas accumulation was stronger and more intense in the susceptible tissues in later stages. Moreover, the response of the resistant cultivar to infection was earlier and stronger, exhibiting high transcript accumulation of the PR genes. These results indicated that the induction of oxidant/antioxidant responses and the accumulation of PRPs are part of the faba bean defense mechanism against the necrotrophic fungus B. fabae with a different intensity and timing of induction, depending on the resistance levels.
Purpose: The purpose of this study was to develop a motivation-enhanced self-management (MESM) intervention for irritable bowel syndrome (IBS) and to evaluate its effects on female college students with IBS. Methods: The program was constructed to reflect the conceptual framework of the self-determination theory including autonomous motivation enhancement strategy through the satisfaction of psychological needs. The experimental group (n= 24) participated in the all eight weekly MESM sessions, and the control group (n= 25) received one hour education of IBS. Primary outcome measures were the IBS symptom severity scale (IBS-SSS) and the IBS specific quality of life (IBS-QOL), and assessed at the baseline and at eight and 16 weeks after the allocation. Others were autonomous motivation, self-determined behavior, and psychological distress assessed at the baseline and at eight weeks. Results: The experimental group showed improvement in the IBS-SSS (p< .001) at 16 weeks compared to the control group. They showed markedly more improvement in the IBS QOL (p= .008), but the magnitude of this difference decreased at 16 weeks. The experimental group showed improvements in autonomous motivation (p= .035), self-determined behavior (p= .023), and psychological distress (p= .044) compared to the control group. Conclusion: Study results suggest that the MESM intervention for female college students may effectively improve the IBS-SSS and the QOL.
Hur, Junseok W.;Hur, Junho K.;Kwon, Taek-Hyun;Park, Youn Kwan;Chung, Hung Seob;Kim, Joo Han
Journal of Korean Neurosurgical Society
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v.52
no.3
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pp.215-220
/
2012
Objective : There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods : Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results : RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion : RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.
Objective: This study investigated the therapeutic possibility of natural therapy in atopy-camp for children with atopic dermatitis. Methods: 30 children (19 boys and 11 girls, median age 11.5 years, ranging from 9 to 15) participated in natural environment-based activities in a camp-village located in Geumsan-gun for five days. Assessment of symptom change was conducted by self-reporting numeric scale (NRS) for pruritus and sleeping difficulty, investigator global assessment (IGA), eczema area and severity index (EASI score), serum histamine and IgE concentration before and after the camp period. Statistical significance was analyzed by paired t-test. Results: NRS for pruritus ($4.7{\pm}2.0$ into $4.3{\pm}2.1$), sleeping difficulty ($3.1{\pm}2.1$ into $2.9{\pm}2.0$), and serum histamine concentration ($4.27{\pm}7.39$ mol / L into $3.21{\pm}6.08$ mol / L) showed positive changes but didn't reach statistical significance (p > 0.05). IGA ($3.8{\pm}0.9$ into $4.13{\pm}1.0$), while EASI score ($10.8{\pm}9.7$ into $9.1{\pm}9.2$) and IgE ($408{\pm}320$ IU / mL into $385{\pm}3.8$ IU / mL) were significantly improved (p < 0.01). Conclusions: In spite of the limitation of the clinical trial protocol, this study may provide the possibility of natural environment-based therapy for children with atopic dermatitis.
Kim, Ki-Hoon;Cho, Hyung-Jun;Lee, Jin-Yong;Cho, Baek-Gun
The Journal of Pediatrics of Korean Medicine
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v.18
no.1
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pp.153-163
/
2004
Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.
Epstein-Barr virus (EBV) infection can be presented with various clinical manifestations and different levels of severity when infected. Infectious mononucleosis, which is most commonly caused by EBV infection in children and adolescents, is a clinical syndrome characterized by fatigue, malaise, fever, sore throat, and generalized lymphadenopathy. But rarely, patients with infectious mononucleosis may present with gastrointestinal symptoms and complicated by gastritis, splenic infarction, and splenic rupture. We encountered a 16-year-old girl who presented with fever, fatigue, and epigastric pain. Splenic infarction and EBV-associated gastritis were diagnosed by using esophagogastroduodenoscopy and abdominal computed tomography. Endoscopy revealed a generalized hyperemic nodular lesion in the stomach, and the biopsy findings were chronic gastritis with erosion and positive in situ hybridization for EBV. As splenic infarction and acute gastritis are rare in infectious mononucleosis and are prone to be overlooked, we must consider these complications when an infectious mononucleosis patient presents with gastrointestinal symptom.
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