• Title/Summary/Keyword: age at onset

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Clinical Characteristics of Panic Disorder Patients in Korean University Hospital : A Multi-Center, Retrospective Study (국내 대학병원 공황장애 환자들의 임상적 특징에 대한 연구 : 다기관, 후향적 연구)

  • Oh, Jae-Young;Lee, Jae-Hon;Han, Sang-Woo;Chee, Ik-Seung;Koo, Bon Hoon;Woo, Jong Min;Yang, Jong-Chul;Gim, Min-Sook;Lee, Sang Hyuk;Heo, Jung-Yoon;Yu, Bum-Hee
    • Anxiety and mood
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    • v.10 no.1
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    • pp.11-16
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    • 2014
  • Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.

Relationship between Lower -Limb Joint Angle and Muscle Activity due to Saddle Height during Cycle Pedaling (사이클 페달링 시 안장높이에 따른 하지관절 각도와 근육활성화의 상관관계)

  • Seo, Jeong-Woo;Choi, Jin-Seung;Kang, Dong-Won;Bae, Jae-Hyuk;Tack, Gye-Rae
    • Korean Journal of Applied Biomechanics
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    • v.22 no.3
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    • pp.357-363
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    • 2012
  • The purpose of this study was to investigate the effects of different saddle heights on lower-limb joint angle and muscle activity. Six elite cyclists(age: $32.2{\pm}5.2years$, height: $171.0{\pm}3.5cm$, weight: $79.7{\pm}5.6kg$, cycle career: $13{\pm}6.2years$) participated in three min. submaximal(90 rpm) pedaling tests with the same load and cadence based on saddle heights where subject's saddle height was determined by his knee flexion angle when the pedal crank was at the 6 o'clock position. Joint angles(hip, knee, ankle joints) and the activity of lower limb muscles(biceps femoris(BF), vastus lateralis(VL), tibialis anterior(TA) and gastrocnemius medial(GM)) were compared by measuring 3D motion and electromyography(EMG) data. Results showed that there were significant differences in minimum hip & knee joint angle and range of motion of hip and knee joint between saddle heights. Onset timing and integrated EMG of only BF among 4 muscles were significantly different between saddle heights. Especially there was a negative relationship between minimum hip joint angle and onset timing of BF in most subject, which means that onset timing of BF became fast as the degree of bending of the hip joint became larger by saddle height. Optimal pedaling will be possible through increased amount of muscle activation due to the appropriate burst onset timing by proper pedaling posture with adjusted saddle height.

Initial Motor Unit Discharge Pattern in Patients with Stroke (뇌졸중 환자에서 운동단위의 초기 방전 양상)

  • Lee, Sang-Moo;Bae, Jae-Chun
    • Annals of Clinical Neurophysiology
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    • v.4 no.1
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    • pp.12-15
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    • 2002
  • Background : Changes in firing pattern and in the recruitment order of single motor unit(MU) have been claimed to be characteristic of central motor lesions, and a reduced firing rate was found in upper motor neuron lesions. But these findings have been rarely studied before in Korea, so we studied initial MU recruitment pattern in stroke patients with hemiparesis. Methods : We studied six patients(3 men and 3 women) whose mean age was $60.6{\pm}7.4$ years. A mean $20.6{\pm}16.2$ months had elapsed since the stroke. To compare the initial MU activation patterns in proximal and distal segments of paretic limb with their contalateral unaffected counterparts, we studied the onset and recruitment intervals in biceps brachii(BB) and first dorsal interossei(FDI) muscles in paretic and healthy arms. In a single muscle we examined from 5 to 10 individual MUs. And in a single motor unit, both the onset interval and the recruitment interval was examined. Results : The mean onset interval in paretic limb was significantly(p<0.05) longer than unaffected limb at proximal and distal location: BB $118.5{\pm}17.8$ msec vs $96.1{\pm}8.3$ msec(n=58); FDI $125.8{\pm}16.7$ msec vs $101.5{\pm}17.2$ msec(n=38). The mean recruitment interval in paretic limb was also significantly(p<0.05) longer than unaffected limb: BB $87.7{\pm}14.9$ msec vs $73.4{\pm}11.5$ msec(n=53); FDI $96.3{\pm}16.4$ msec vs $87.7{\pm}14.1$ msec(n=38). Conclusion : The first recruited MU had a lower baseline firing rate and the second recruited motor unit potential appeared earlier in paretic than in healthy muscles. And these findings may explain one of the reasons for paresis in patients with stroke.

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Gender Differences in Delay Seeking Treatment and Related Experiences in Patients with Acute Myocardial Infarction (급성심근경색증 환자의 성별에 따른 치료추구지연과 관련 경험의 비교)

  • Won, Mi-Suk;Shin, Nah-Mee;Kim, Eunsook
    • Korean Journal of Adult Nursing
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    • v.28 no.4
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    • pp.459-469
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    • 2016
  • Purpose: This comparative descriptive study was to identify gender differences in delay seeking treatment and related experiences in patients with acute myocardial infarction (AMI). Methods: Ninety-seven participants were recruited from a tertiary hospital. Results: Mean age of 47 women was $71.5{\pm}13.3$ while that of men was $55.0{\pm}10.9$ (p<.001). More women lived alone and were jobless, less educated, and poorer than men. Men were likely to be 'current smokers' and drink alcohol, however viewed themselves healthier than women (p=.030). Women's hospital stay was $9.23{\pm}21.04$ days while men's was $4.86{\pm}2.72$ days (p=.014). More women had been diagnosed with hypertension (p=.040). Women appeared to report significantly less pain ($6.46{\pm}3.1$) than men ($8.44{\pm}1.8$). More men described their pain as sudden onset (p=.015) and chest pain as major symptom (p=.034) than women. More women were found alone upon onset of symptoms (p=.023) and had important reasons for delay seeking treatment (p=.021) than men. Median time from onset of symptoms to seeking medical service was 1.5 hours for men and 5.1 hours for women (p=.003). Median time taken from onset of symptoms to hospital for therapy was 3.5 hours for men and 9.1 hours for women (p=.019). Conclusion: This study findings that women reported less pain and delayed in seeking treatment, suggest needs for strategies targeting women at risk of AMI.

Sleep Onset Insomnia and Depression Discourage Patients from Using Positive Airway Pressure

  • Park, Yun Kyung;Joo, Eun Yeon
    • Journal of Sleep Medicine
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    • v.15 no.2
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    • pp.55-61
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    • 2018
  • Objectives: Despite the accumulating evidence of the effectiveness of positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) syndrome, adherence to PAP therapy is not high. Several factors reportedly affect PAP adherence; however, it remains unclear whether patients' symptoms were detrimental to adherence rate. This study is aimed at investigating the relationship between insomnia symptoms and adherence. Methods: Retrospective analyses were performed in 359 patients with OSA (mean age $58.4{\pm}13.2$ years; females, n=80). Logistic regression analyses were performed between PAP adherence with clinical factors and questionnaires, such as Epworth Sleepiness Scale, Insomnia Severity Index, and Beck Depression Inventory (BDI). Results: PAP adherence was defined as the use of PAP for ${\geq}4h$ per night on 70% of nights during 30 consecutive days. The median follow-up time was 55 days (interquartile range, 30-119 days), and 54.3% showed poor adherence. Non-adherent patients showed more severe sleep onset insomnia, higher BDI, and higher nadir oxygen saturation ($SaO_2$). Patients with good adherence had higher apnea-hypopnea index, oxygen desaturation index, and respiratory arousal to total arousal ratio. Sleep onset insomnia [odds ratio (OR)=1.792, p=0.012], BDI (OR = 1.055, p=0.026), and nadir $SaO_2$ (OR=1.043, p=0.040) were independently associated with PAP non-adherence. Conclusions: Not the severity of insomnia but sleep onset insomnia was associated with PAP adherence, as well as depressive mood. It suggests that different interventions for reducing insomnia and depressive mood are needed to increase PAP adherence in patients with OSA.

Restoration of the Broken Lumbopelvic-hip Neuromuscular Chain and Coordinated Synergistic Activation in Low Back Pain

  • Park, Haeun;Park, Chanhee;You, Joshua (Sung) Hyun
    • Physical Therapy Korea
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    • v.29 no.3
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    • pp.215-224
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    • 2022
  • Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

Influencing factor on the prognosis of arthrocentesis

  • Kim, Yoon Ho;Jeong, Tae Min;Pang, Kang Mi;Song, Seung Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.4
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    • pp.155-159
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    • 2014
  • Objectives: The purpose of this article is to evaluate factors influencing prognosis of arthrocentesis in patients with temporomandibular joint (TMJ) disorder. Materials and Methods: The subjects included 145 patients treated with arthrocentesis at the Dental Center of Ajou University Hospital from 2011 to 2013 for the purpose of recovering mouth opening limitation (MOL) and pain relief. Prognosis of arthrocentesis was evaluated 1 month after the operation. Improvement on MOL was defined as an increase from below 30 mm (MOL ${\leq}30mm$) to above 40 mm (MOL ${\geq}40mm$), and pain relief was defined as when a group with TMJ pain with a visual analog scale (VAS) score of 4 or more (VAS ${\geq}4$) decreased to a score of 3 or more. The success of arthrocentesis was determined when either mouth opening improved or pain relief was fulfilled. To determine the factors influencing the success of arthrocentesis, the patients were classified by age, gender, diagnosis group (the anterior disc displacement without reduction group, the anterior disc displacement with reduction group, or other TMJ disorders group), time of onset and oral habits (clenching, bruxism) to investigate the correlations between these factors and prognosis. Results: One hundred twenty out of 145 patients who underwent arthrocentesis (83.4%) were found to be successful. Among the influencing factors mentioned above, age, diagnosis and time of onset had no statistically significant correlation with the success of arthrocentesis. However, a group of patients in their fifties showed a lower success rate (ANOVA P=0.053) and the success rate of the group with oral habits was 71% (Pearson's chi-square test P=0.035). Conclusion: From this study, we find that factors influencing the success of arthrocentesis include age and oral habits. We also conclude that arthrocentesis is effective in treating mouth opening symptoms and for pain relief.

The Clinical Analysis of 104 Sanhupung Patients that visited at an Oriental Medicine Hospital. (일개 한의대 부속 한방병원에 산후풍으로 내원한 환자 104례에 대한 실태 분석)

  • Jang, Se-Ran;Park, Young-Sun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.3
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    • pp.192-204
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    • 2010
  • Purpose: Sanhupung's pathological conditions is different from non-postpartum's disease. So it is important to analyze Sanhupung's construction, onset factors and Oriental theraphy. Methods: We studied 104 Sanhupung women visiting $\bigcirc\bigcirc$ hospital form January 2008 to December 2009. We analyzed the general characteristics, kinds of symptoms and Oriental theraphy's present condition. Also We compared patients' age, the number of live births and delivery month to the National Statistical Office's results. Results: 1. Patients over the age of 30, who have one child and who gave birth in September(14.42%) and in Summer(43.26%) occupied the highest percentage. But delivery method was not correlated with Sanhupung. 2. Musculo-skeletal symptoms(42.13%) were the most common symptoms. Wrist, waist, knees(59.59%) were the most common pain areas and the other pain symptoms (40.21%) appeared a significant portion of cases respectively. 3. In the 21~30days after delivery, the most patients visited. The number of patients admitted within 30 days after delivery or within 90 days was small comparing with Sanhupung onset. Patients treated within 10 days(47.12%) and treated only herb medicine(54.90%) were the most common. And the patients responded satisfacion or over were 88.46%. Conclusion: Patients' age, the number of born babies, delivery time were correlated with Sanhupung symptoms, but the method of delivery was not associated. And musculo-skeletal symptoms were the most common symptoms. Sanhupung patient's treatment period and methods were limited.

Effects of 20% Aluminum Chloride in Axillary Hyperhidrosis not Accompanying Osmidrosis

  • Kim, Seok-Won;Lee, Seung-Myung
    • Journal of Korean Neurosurgical Society
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    • v.37 no.4
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    • pp.272-274
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    • 2005
  • Objective: Surgical treatment of focal axillary hyperhidrosis is often unsatisfactory because of compensatory hyperhidrosis. The purpose of this study is to evalute the effect of decreased sweating production using 20% aluminum chloride on axillary hyperhidrosis. Methods: From February to December, 2002, 10 patients (mean age 25.2 male 2, female 8) with clinical diagnosis of axillary hyperhidrosis were treated by 20% aluminum chloride solution. Until the desired degree of symptom relief was obtained, they were educated to apply every day and thereafter, the agent would be applied as often as is necessary. We analyzed patient's satisfaction and application time at onset of desired dryness, application interval to maintain the relief of symptom and side effects. Results: Aluminum chloride solution was effective in treatment of axillary hyperhidrosis showing excellent result in 60% of patients and good in 40%. Application time at onset of desired dryness ranged from 1 to 6 days(mean 3 days). Application interval to maintain the relief of symptom ranged from 5 to 45 days(mean 12 days). There were no significant complications but just mild irritation and miliaria in seven patients. Conclusion: 20% aluminum chloride solution is the simple, safe and less expensive method for initial treatment for axillary hyperhidrosis not accompanying osmidrosis.

Minimal Change Nephrotic Syndrome Presented with Acute Renal Failure in a Child (급성 신부전증을 동반한 미세변화 신증후군 1례)

  • Park Soo-Jun;Rho Kwang-Sik;Lee Gu-Hyun;Kim Pyung-Kil;Jeong Hyeon-Joo
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.79-81
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    • 1997
  • Minimal change nephrotic syndrome is characterized by proteinuria, hypoproteinemia, edema, and hyperlipidemia. Children with onset of nephrotic syndrome between the age of 1 and 8 year are likely to have steroid response to minimal chage disease, but we experienced one case of minimal change disease which failed to respond to steroid therapy at beginning and subsequently developed acute renal failure. It was seen in a 5 year-old male child that presented with edema and gross hematuria. Peritoneal dialysis was performed for acute renal failure for 11 days. Patient was completely recorvered from acute renal failure and renal biopsy was done at 27th day after onset of disease which revealed typical picture of minimal change disease complicated by acute tubular necrosis. We beleive this case is very unusual and it may be the first case in the literature in terms of pediatric cases.

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