• Title/Summary/Keyword: age at onset

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Clinical Study of CT-diagnosed Olivopontocerebellar Atrophies (Olivopontocerebellar Atrophy의 임상상과 전산화단층뇌촬영 소견)

  • Park, Mee-Yeong;O, Khyoung-Yhun;Hah, Jung-Sang;Byun, Yeung-Ju;Park, Choong-Suh
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.87-93
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    • 1988
  • The diagnosis of OPCA could be made clinically with important aid of brain CT scanning, although the definite and conclusive diagnosis only by postmortem pathological determination. We reviewed, clinically and with brain CT examination, 12 cases of patients with OPCA who were admitted to the Yeungnam University Hospital for a recent 5 years. The result were as following. : 1. The distribution of age is from 49 to 72, mainly 50 to 60. Man is more frequent than women at the 4.5 times. 2. The interval period from Sx. onset to diagnosis is 1 year to 6 years. 3. The usual initial Sxs. were dizziness(58%), ataxia(33%), and other less frequent Sxs. were weakness of low extremities, dysarthria, headache and urinary incontinence. The clinical manifestations at the initial diagnosis were cerebellar disturbance(100%), dysarthria(83%), and increased deep tendon reflexes(58%). 4. The results of brain CT finding are like this : ${\cdot}$ the width of cerebellar sulci is more than 1mm, other 4 cases more than 2mm. ${\cdot}$ the width of cerebellar pontine cistern of the patient if usually 3 to 4mm, other 2 cases extended to the 5mm. ${\cdot}$ the A. P and lateral lengths of 4th. ventricle is 4mm and 4 to 8mm respectively. ${\cdot}$ 6 cases of whole patients show coincidentally cerebral atrophy.

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Efficacy of Antiepileptic Drug on the Benign Childhood Epilepsy with Centro-Temporal Spikes (중심-측두엽 극파를 보이는 양성 소아 간질 환자에서 항경련제 투여의 유효성)

  • Oh, Mee Hye;Kim, Soo Young;Seo, Won Hee;Pee, Dae Hun;Choi, Byung Min;Eun, Baik-Lin
    • Clinical and Experimental Pediatrics
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    • v.46 no.9
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    • pp.893-897
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    • 2003
  • Purpose : Benign childhood epilepsy with centrotemporal spikes(BECT) is characterized by an excellent prognosis. Therefore, the necessity for the use of antiepileptic drugs is controversial. The object of this study is to know about the long-term follow-up of BECT, comparing daily treatment with antiepileptic drug(AED) versus no medication. Methods : We retrospectively studied 56 cases of BECTs, examined at Pediatric Neurology Clinic, Korea University Medical Center as reference study time, August 2002. Thirty-eight patients didn't have mediation(group I), while eighteen patients received one or two AED(group II). We evaluated demographics, clinical manifestations at diagnosis, EEG findings and clinical courses in groups I & II. Results : There was no significant differences of sex, age, seizure frequency, seizure type, seizure onset time, family history and EEG findings between group I & II. The reasons to start AED were : parents' anxiety(three cases), frequent seizure(12 cases) and daytime seizure(three cases). There was no evolution of status epilepticus and no difficulty in school performance. Conclusion : AED treatment was of no advantage and long-term prognosis was good regardless of treatment strategy. So it is advisable not to choose AED as the first line of therapy, provided that the patient himself/herself or the family understands the benign nature of BECT.

A Retrospective Study of Oral Tumors in Dogs: 44 cases ($2002{\sim}2007$) (개에서 발생한 구강종양 44례 ($2002{\im}2007$))

  • Park, Shin-Ae;Yi, Na-Young;Jeong, Man-Bok;Kim, Won-Tae;Kim, Se-Eun;Park, Young-Woo;You, Mi-Hyeon;Choi, Min-Cheol;Yoon, Jung-Hee;Kim, Dae-Yong;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.26 no.1
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    • pp.36-40
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    • 2009
  • The purpose of this study was to determine the incidence and therapeutic outcomes of canine oral tumors in Korea. Medical records of dogs presented with oral tumor at the Veterinary Medical Teaching Hospital of Seoul National University from 2002 to 2007 were reviewed. The predominant breeds were Yorkshire terrier (n=14), miniature poodle (n=7), Shih Tzu (n=6), and maltese (n=4), in order. The mean age at onset was $10.0{\pm}3.8$ years. The most common tumor types included fibrous epulis (n=13), malignant melanoma (n=12), acanthomatous epulis (n=4), and squamous cell carcinoma (n=3). Surgical removal was performed in 29 cases; simple excision in 18 cases, partial mandibulectomy in 8 cases, and partial maxillectomy in 3 dogs. Outcomes of surgery were various according to the tumor types. Prognosis of dogs with fibrous epulis and acanthomatous epulis was good and that of dogs with malignant melanoma was poor.

Clinical Characteristics of Panic Disorder with Comorbid Major Depressive Disorder (주요우울장애를 동반한 공황장애 환자군의 임상적 특징)

  • Lee, Sun-Woo;Lee, Kang Soo;Lee, Sang-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.25 no.3
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    • pp.45-52
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    • 2018
  • Objectives The objective of this study was to investigate the differences in sociodemographic and clinical characteristics, temperaments, and quality of life between panic disorder (PD) patients with and without major depressive disorder (PD+MDD and PD-MDD patients, respectively). Methods We compared 411 PD-MDD and 219 PD+MDD patients. All patients who were drug-free for at least 1 month were assessed at initial outpatient visits before the administration of medication. The following instruments were used for assessment: the NEO Personality Inventory-Neuroticism (NEO-N) ; the Temperament and Character Inventory-Harm Avoidance (TCI-HA) ; the State-Trait Anxiety Inventory (STAI) ; the Intolerance of Uncertainty Scale-Short (IUS); the Anxiety Sensitivity Index-Revised (ASI-R); the Beck Depression Inventory (BDI) ; the Beck Anxiety Inventory (BAI); the Penn State Worry Questionnaire (PSWQ) ; the Generalized Anxiety Disorder for 7 item (GAD-7) ; the Albany Panic and Phobia Questionnaire (APPQ) ; the Panic Disorder Severity Scale (PDSS) ; the Early Trauma Inventory Self Report-Short Form (ETISR-SF) ; the Scale for Suicidal Ideation (SSI) ; the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF) ; the Sheehan Disability Scale (SDS) ; and the Short Form health survey (SF-36). Results Compared to the PD-MDD patients, the PD+MDD patients were younger and more likely to be unmarried. They showed higher rates of unemployment, lower levels of education and income, younger age of onset, more previous suicide attempts, a greater incidence of agoraphobia, and more previous treatments. The PD+MDD patients showed significantly higher scores on the NEO-N, the TCI-HA, the STAI, the IUS, the ASI-R, the BDI, the BAI, the PSWQ, the GAD-7, the APPQ, the PDSS, the ETISR-SF, and the SSI. In addition, the PD+MDD patients showed significantly lower quality of life than did the PD-MDD patients. In contrast with previous studies, we observed no significant differences between the two groups in terms of gender, duration until treatment, and psychiatric comorbidities. Conclusions This study showed that the PD+MDD patients have more early trauma experiences, higher levels of anxiety-related temperaments, more severe panic and depressive symptoms, and lower quality of life than the PD-MDD patients.

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Cytokine expression and localization during the development of glomerulosclerosis in FGS mice

  • Park, Sang-Joon;Lee, Sae-Bom;Lee, Young-Ho;Ryu, Si-Yun;Jeong, Kyu-Shik;Lee, Cha-Soo
    • Korean Journal of Veterinary Pathology
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    • v.3 no.1
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    • pp.15-25
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    • 1999
  • To elucidate the mechanism of age-related development in FGS/NgaKIST mice with spontaneous glomerulosclerotic lesion, we examined expression and localization of various cytokine mRNA in the kidney in the progression of diseases. This mouse model is the first to develop spontanously occuring glomerosclerotic lesion in the kidney. In this study, we detected the up-regulation of local cytokine genes such as IL-1$\beta$, IL-2, IL-6, IL-10, TNF-$\alpha$, TGF-$\beta$, and IFN- $\gamma$ in the kidneys. In RT-PCR and Southern blot analysis, we detected gradual expressions of cytokine mRNA of IL-1$\beta$, IL-2, IL-6, IFN- $\gamma$, and TNF $\alpha$ mRNA during the course of disease. Other cytokines including IL -10 and TGF -$\beta$ were found to be appeared the slightly expressed level at 3 to 12 weeks before onset of inflammatory lesion but they are highly expressed at the end-stage of the disease accompaning high proteinurea and wasting. In situ RT-PCR, each cytokine mRNA were specifically localized in a variety of cells including mesangial, endothelial, parietal epithelial, tubular epithelial, arterial muscle cell, and infiltrated inflammatory cells. In addition, TNF - $\alpha$was detected moderately in the visceral and parietal epithelial cell, but weakly in endothelial and mesangial cells, whereas IL-1 $\beta$ and IL -6 were strong in mesangial regions. IL-6 and TNF- $\alpha$ was highly localized in the damaged proximal and collecting tubules. Especially, TGF -$\beta$ mRNA was highly found in mesangial cells within glomerulus and interstitium during the end-stage of this disease.. These results indicate that pro inflammatory cytokines such as IL-1 $\beta$, IL-2, IL-6, and TNF- $\alpha$ were gradually expressed from the early stage of this disease to the end-stage, and that IL-10 and TGF-$\beta$ may be important in the accumulation of extracellular matrix(ECM) within glomerulus and periglomerular fibrosis in the progression of this disease as well as tissue destruction in end-stage of this disease.

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Secondary Traumatic Stress(STS) and related factors of Emergency Medical Technicians (응급구조사의 이차 외상성 스트레스 정도와 관련요인)

  • Choi, Hee-Jeong;Park, Jeong-Mi;Suh, Soon-Rim
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.2
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    • pp.5-15
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    • 2009
  • Purpose : This study was to examine the secondary traumatic stress(STS) and related factors of emergency medical technicians. Methods : This study was conducted among 190 emergency medical technicians, over the age of 25, with the 1st or 2nd grade qualification, who serve at fire stations in U and P city of Korea. The collected data for this study was analyzed using SPSS 12.0. Result : The average character type of A-type personality technicians was 43.25 points and the average of B-type personality technicians was 37.82 points. It suggested that the former was higher than the latter. State anxiety did not show statistically significant difference between A-Type group and B-Type group with the score of 48.51 for A-Type and 47.91 for B-Type. Physical symptoms showed statistically significant difference between the two groups with the higher score of 28.45 for A-type group than that of 28.13 for B-Type group. The level of STS related to the volunteers' job characteristics was found to be low when the volunteers were satisfied with their job and didn't want to transfer to another division. Those on duty who had slept more than seven hours that day had the highest points. The number of points was highest when the frequency for the onset of trauma was between 20~30 times. Furthermore it was found that for most technicians, 71.05%, the period of symptoms lasted for a few weeks at most, and this was where the STS was the lowest, whereas on the other hand the highest STS occurred when the symptoms lasted for a period of up to six months. The findings showed significant correlations with a relation of r=.24 between STS and level of anxiety and r=.45 between STS and physical symptoms. However, no significant correlation was found between the level of anxiety and physical symptoms. Conclusion : The more emergency medical technicians are exposed to accidents, the more serious the STS are. Those with an A-type personality are especially prone to have higher STS. The higher the STS level is, the higher the level of physical states and anxiety is.

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A Study of Soy Isoflavone Supplementation Effect on Bone Mineral Density and Bone Metabolism Markers in Female College Students with Low Bone Mass (이소플라본의 투여가 골질량이 감소된 저체중과 정상체중 여대생의 골밀도 및 골대사 지표에 미치는 영향에 관한 연구)

  • 백수경;승정자
    • Journal of Nutrition and Health
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    • v.36 no.2
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    • pp.154-166
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    • 2003
  • To investigate the effects of isoflavone supplementation on both bone mineral density and hormone variation in premenopausal women who had decreased bone mass, the 24 subjects were divided into two groups: one was the underweight group, consisting of 13 subjects, and the other was the normal weight group consisting of 11 subjects. For each group, we investigated the effects of isoflavone supplementation of 90 mg/day on both bone mineral density and hormone variation during 3 menstrual cycles. Anthropometric measurements, dietary recall, and analyses of blood and urine were assessed from baseline to post-treatment. The results were as follows: The average age of the underweight group was 21.8 years old and that of the normal weight group was 23.2 years old. The comparative results for the two groups at baseline were as follows: Onset of menarche, menstrual cycle, and menstrual length were not significantly different between the groups. Serum protein, total, HDL-, LDL-cholesterol, triglyceride, Ca, P, Mg, Cu, and Zn level were not significantly different between the groups. Serum estradiol, SHBG, LH, and FSH level were also not significantly different between the groups. Lumbar spine BMD by T scores of the underweight group was significantly lower than that of the normal weight group. Serum osteocalcin, urinary DPD, and urinary pH were not significantly different between the groups. The comparative results for the two groups at post-treatment were as follows: From baseline to post-treatment, the intake of energy, nutrients and isoflavone in food did not significantly change in either group. Serum protein, total cholesterol, HDL-, LDL-cholesterol, and triglyceride levels did not significantly change in either group. Serum Ca, Cu, and Zn levels were significantly lower in both groups and serum Mg level significantly decreased only in the underweight group. Serum estradiol levels were significantly lower in both groups, but serum SHBG, LH, and FSH levels did not significantly change in either group. Lumbar spine BMD by T score of the underweight group significantly increased to 15%, but that of the normal weight group did not significantly change. Serum osteocalcin of the underweight group significantly increased to 28%, while that of the normal weight group significantly increased to 40%. Urinary DPD of the normal weight group significantly increased to 12%. The results show that the BMD of the underweight group was lower than that of the normal weight group. Therefore, the underweight group had a disadvantage in obtaining maximum bone mineral density. The results also show that isoflavone supplementation during 3 menstrual cycles was effective in increasing the bone mineral density of the lumbar spine and affected bone metabolism markers in premenopausal underweight women. Therefore, it can be concluded that sufficient intake of isoflavone could be helpful in preventing decreases in bone mass among premenopausal women, especially underweight women.

Microvascular Decompression for Hemifacial Spasm Associated with Vertebrobasilar Artery

  • Kim, Joo-Pyung;Park, Bong-Jin;Choi, Seok-Keun;Rhee, Bong-Arm;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.44 no.3
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    • pp.131-135
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    • 2008
  • Objective : Hemifacial spasm (HFS) is considered as a reversible pathophysiological condition mainly induced by continuous vascular compression of the facial nerve root exit zone (REZ) at the cerebellopontine angle. As an offending vessel, vertebrobasilar artery tends to compress much more heavily than others. The authors analyzed HFS caused by vertebrobasilar artery and described the relationships between microsurgical findings and clinical courses. Methods : Out of 1,798 cases treated with microvascular decompression (MVD) from Jan. 1980 to Dec. 2004. the causative vessels were either vertebral artery or basilar artery in 87 patients. Seventy-nine patients were enrolled in this study. Preoperatively, computed tomography (CT) or brain magnetic resonance (MR) imaging with 3-dimentional short range MR technique was performed and CT was checked immediately or 2-3 days after anesthetic recovery. The authors retrospectively analyzed the clinical features. the compression patterns of the vessels at the time of surgery and treatment outcomes. Results : There were 47 were male and 32 female patients. HFS developed on the left side in 52 cases and on the right side in 27. The mean age of onset was 52.3 years (range 19-60) and the mean duration of symptoms was 10.7 years. Many patients (39 cases; 49.1%) had past history of hypertension. HFS caused only by the vertebral artery was 8 cases although most of the other cases were caused by vertebral artery (VA) in combination with its branching arteries. Most frequently, the VA and the posterior inferior cerebellar artery (PICA) were the simultaneous causative blood vessels comprising 32 cases (40.5%). and in 27 cases (34.2 %) the VA and the anterior inferior cerebellar artery (AICA) were the offenders. Facial symptoms disappeared in 61 cases (77.2%) immediately after the operation and 68 cases (86.1%) showed good outcome after 6 months. Surgical outcome just after the operation was poor in whom the perforators arose from the offending vessels concurrently (p<0.05). Conclusion : In case where the vertebral artery is a cause of HFS, commonly branching arteries associated with main arterial compression on facial REZ requires more definite treatment for proper decompression because of its relatively poor results compared to the condition caused by other vascular compressive origins.

A study on the Occurrence of the Stroke Patients (뇌졸중 환자의 발생특성에 관한 연구)

  • Kim, Han-Soo
    • The Journal of Korean Physical Therapy
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    • v.2 no.1
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    • pp.21-33
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    • 1990
  • The purpose of this study is to investigated the occurrence properties of the cerebrovascular accidents. Clinical observations were done 252 cases, were carried from June, 1989 to May, 1990 at 4 general hospital in Taegu, Korea. The following results have been obtained ; 1. Among the 252 cases of cerebrovascular accidents, males was noted in $51.6\%$ and females in $48.4\%$. The ratio between males and females was 1.1 : 1 in whole groups of cerebrovascular accidents, and in aging distribution, it was showed variety distribution in age groups, fifties, sixties and forties were in order of frequency, particulary, more than half was shelved from 50 to 69. 2. Among the 252 cases of cerebrovascular accidents, cerebral hemorrhage was rioted in $64.3\%$, cerebral infarction in $25.8\%$, cerebral thrombosis in $6.3\%$, subarachnoid hemorrhage in $2.4\%$ and cerebral embolism in $1.2\%$. 3. In distribution of academic career, high school level was noted in $37.7\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$, elementary school level in $30.5\%$, middle school level in $17.1\%$ arid college level in $14.7\%$. 4. In distribution of occupation, office worker was noted in $21.8\%$, housewife in $20.2\%$, the others in $19.1\%$, physical laborer in $18.3\%$ and inoccupation in $18.3\%$. 5. In seasonal distribution, spring was noted in $34.9\%$, winter in $32.5\%$, autumn in $20.3\%$ and summer in $12.3\%$. 6. Among the preceding diseases at the onset of cerebrovascular accidents, hypertension was noted in $51.6\%$, no preceding disease in $20.2\%$, other disease in $10.3\%$ and diabetes mellitus in $9.5\%$ and cardiovalvular disease in $6.0\%$. 7. In systolic blood pressure on admission, 160-199mmHg was noted in $32.2\%$, 200-239mmHg in $23.4\%$, 140-159mmHg in $19.4\%$, below 140mmHg in $16.3\%$, and above 240mmHg in $8.7\%$, While, in diastolic blood pressure, above 130mmHg noted in $24.6\%$, below 90 mmHg in $17.1\%$, 120-129mmHg in $13.1\%$ and was 90-99mmHg in $11.1\%$. 8. In major predisposing factors of patients, emotional stress was noted in $20.2\%$, physical action in $17.9\%$, rest in $16.9\%$, while sleeping in $10.7\%$, drinking in $9.9\%$ and defecation in $7.9\%$. 9. In distribution of affected side, left was noted in $48.4\%$, right in 42.1 and both $9.5\%$. 10. In rates of recurrent cases, first attach was noted in $79.0\%$, 1st recurrence in $17.0\%$, 2nd recurrence in $3.6\%$ and 3rd recurrence in $0.4\%$.

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Surgical Management of Infective Endocarditis Complicated by Embolic Stroke: Early versus Delayed Surgery

  • Kim, Gwan-Sic;Kim, Joon-Bum;Jung, Sung-Ho;Yun, Tae-Jin;Choo, Suk-Jung;Chung, Cheol-Hyun;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.332-337
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    • 2011
  • Background: The optimal timing of surgery for infective endocarditis complicated by embolic stroke is unclear. We compared early versus delayed surgery in these patients. Materials and Methods: Between 1992 and 2007, 56 consecutive patients underwent open cardiac surgery for the treatment of infective endocarditis complicated by acute septic embolic stroke, 34 within 2 weeks (early group) and 22 more than 2 weeks (delayed group) after the onset of stroke. Results: The mean age at time of surgery was $45.7{\pm}14.8$ years. Stroke was ischemic in 42 patients and hemorrhagic in 14. Patients in the early group were more likely to have highly mobile, large (>1 cm in diameter) vegetation and less likely to have hemorrhagic infarction than those in the delayed group. There were two (3.7%) intraoperative deaths, both in the early group and attributed to neurologic aggravation. Among the 54 survivors, 4 (7.1%), that is, 2 in each group, showed neurologic aggravation. During a median follow-up of 61.7 months (range, 0.4~170.4 months), there were 5 late deaths. Overall 5-year neurologic aggravation-free survival rates were $79.1{\pm}7.0%$ in the early group and $90.9{\pm}6.1%$ in the delayed group (p=0.113). Conclusion: Outcomes of early operation for infective endocarditis in stroke patients were similar to those of the conventional approach. Early surgical intervention may be preferable for patients at high risk of life-threatening septic embolism.