Background: An adequate large-scale pediatric cohort based on nationwide administrative data is lacking in Korea. Purpose: This study aimed to differentiate patients with VVS by autonomic dysfunction severity using the composite autonomic severity score (CASS) and compare the clinical manifestations and prognosis between patient subgroups. Methods: We retrospectively reviewed the medical records of 66 VVS patients divided into 3 groups by CASS. To compare the differences between these groups, we analyzed VVS type, triggers, prodromal symptoms, management of syncope, and prognosis between patients with mild versus moderate autonomic dysfunction. Results: Of our 66 patients with VVS, 41 had mild autonomic dysfunction (62.1%) and 25 had moderate autonomic dysfunction (37.9%). We found no significant intergroup differences in age, sex, inducible factor (P=0.172), prodromal symptoms, laboratory findings, head-up tilt test, type of syncope, or prognosis (P=0.154). Conclusion: We found no evidence that autonomic dysfunction degree is affected by VVS characteristics, test findings, parameters, or prognosis; therefore, no further evaluations are needed to classify autonomic dysfunction severity.
Objectives: We intended to identify factors related to the severity of hot flush of climacteric women from an East-West medical point of view. Methods: We surveyed 446 climacteric women who had received Korean oriental medical questionnaires about clinical symptom patterns and health medical examinations at Kyung-Hee University Medical Center over 1 year, from June 2007 to May 2008. Then, we compared hot flush with clinical symptom pattern and health medical examination result. Results: As the severity of hot flush increased, hypnagogic disorder in sleep pattern, abdominal gaseous distention in digestion pattern, tenesmus in evacuation pattern, yellow or reddish urine in voiding pattern, spontaneous sweating in sweating pattern, chest oppression in psychologic pattern, not-pulling-bedclothes in cold-heat pattern and mouth dryness in craniocervical symptom increased (p<0.05). In relation to digestion pattern, the severity of hot flush showed statistical significance according to prevalence of gastritis diagnosed by gastroscopy and upper GI series(p<0.01). In relation to voiding pattern, the severity of hot flush showed statistical significance according to prevalence of urine protein diagnosed by urinalysis (p<0.05). In relation to sweating, psychologic & cold-heat pattern, triiodothyronine (T3) increase and thyroid stimulating hormone (TSH) decrease were significantly correlated as the severity of hot flush increased (p<0.01). Conclusions: The result showed that hot flush of climacteric women had to be considered in respect of digestion disorder related to gastritis and sweating psychologic cold-heat disorder related to thyroid hormone.
Lee, Tae-Rim;Hwang, Sun-Hwee;Seo, Kyoung Won;Song, Kun Ho
Journal of Veterinary Clinics
/
v.37
no.6
/
pp.311-316
/
2020
Biomarkers used in dogs with heartworm disease include N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI), which are associated with damage to the myocardium. Pulmonary hypertension is one of the clinical signs of canine heartworm disease. The purpose of this study is to investigate the change in the concentration of each biomarker, severity of pulmonary hypertension and the correlation between biomarkers according to the severity of clinical signs. Five healthy dogs and 10 heartworm-infected dogs were recruited for the study. The heartworm-infected group was classified based on the history, clinical signs, and blood assay, thoracic radiography, and echocardiography after confirming the infection according to the results of the commercial ELISA kit (SNAP test, IDEXX Laboratories, Maine, USA). NT-proBNP was higher in the severely infected group than the control group (p < 0.05); cTnI was also higher in the severely infected group than the control group (p < 0.05). The pressure gradient of pulmonary hypertension was higher in the severe group than the mild group (p < 0.05). The severity of pulmonary hypertension was correlated with NT-proBNP (r = 0.818, p < 0.01), cTnI (r = 0.894, p < 0.01). When the correlation of the two serum values for each group was examined, a correlation was not found in the mild group (r = 0.707, p = 0.182), but a correlation was found in the severe group (r = 0.9, p < 0.05). NT-proBNP and cTnI were significantly increased and correlated with severe clinical signs. Pulmonary hypertension was significant higher in the severe group than in the mild group (p < 0.05). Evaluation of blood biomarker concentration and severity of pulmonary hypertension and referring to each correlation between these indicators may be helpful to assess the severity of the heartworm disease.
Objectives: This study was conducted to establish the study form of atopic dermatitis in oriental medicine, to find out the effect of herbal medicine and to compare Bangpungtongsungsan group with symptom-complexes prescription group. Methods: We gave scores(1-3) to the 37 outpatients who visited the dept. of Ophthalmotolaryngology & Dermatosurgery of the Kyunghee Oriental Medical Center from June 1,2000 to September 30, 2000. According to transformed the G. Rajka, T. Langeland and Jon M. Hanifin standard. We checked the Eosinophil count, IgE and the scores (intensity: the degree of itching, course: the degree of itching during a year, extent: erythema, lichenification, scaling. dryness, erosion' oozing). After herbal treatment for 6 weeks, we checked the above factors again in the same way. In treatment, we divided the patients into Bangpungtongsungsan group and Symptom-complexes group for cross-comparison. Results: There were 19 patients we could check by score and 14 patients by laboratory. 1. In the 14 lab cases, the number of abnormal value of Eosinophil count and IgE was decreased but it was not significant. 2. In the 19 cases by score, clinical severity of the intensity of itching, lichenification, scaling' dryness was significantly decreased between the before- and after-herbal treatment periods (P<0.01, P<0.01, P<0.05). 3. In 19 cases, clinical severity of erythema, erosion. oozing was decreased after herbal treatment but it was not significant(p>0.05). 4. In point of total score, clinical severity of atopic dermatitis was significantly decreased after herbal treatment(p<0.01). 5. There was no significant difference between Bangpungtongsungsan group and Symptom-complexes group(P<0.05). Conclusions: Although more study is needed, these results indicate that herbal treatment is effective on atopic dermatitis.
Purpose: There is considerable variability in rates of hospitalization for patients with community-acquired pneumonia (CAP) in part because of physicians' uncertainty in assessing the severity of illness at presentation. The purpose of the study was to examine the current treatment patterns and factors influencing the Pneumonia Severity Index (PSI) and clinical outcomes in the patient with CAP. Method: The retrospective data collection of the patients with CAP was conducted and the data were reviewed. The collected data included demographic, clinical, laboratory and microbiological medical information. All patients were stratified into three risk groups according to PSI: low risk (PSI score I-II), moderate risk (III) and high risk (IV-V) groups. The examined treatment patterns were the appropriateness of admissions, category of antibiotics used. The prognostic factors associated with PSI and clinical outcomes were examined. Results: One hundred and six patients' medical data were reviewed. The overall appropriateness of admissions was low presenting many of patients were admitted or intensely treated in the hospital despite of lower risk of prognosis and treated with intravenous antibiotics instead of oral fluoroquinolones. Primary pneumonia pathogens were Klebsiella pneumoniae (27%) and Streptococcus pneumoniae (21.6%). Mean LOS was 8.5 days and was significantly longer (10.0days) (p<0.001) in high risk group. The patients with age >65 (p<0.001), diabetes mellitus (p<0.001), mental alteration (p<0.001), and/or $PaO_2$ <60 mmHg (p<0.001) had a tendency to have higher PSI. The prognostic factors associated with longer LOS were age >65 years (p=0.008), mental status alteration (p<0.001), dyspnea (p=0.002) and PSI score (p=0.001). The prognostic factors associated with mortality were congestive heart failure (p=0.038), systolic blood pressure <90 mmHg (p=0.002) and arterial pH <7.35 (p=0.013). Conclusion: Most of patients were found to over-utilize medical service according to appropriateness of admissions. The elderly, mentally altered patients with low $PaO_2$ had higher PSI score with increased risk of LOS. The mortality could be increased in the patient with disease state of congestive heart failure, high blood pressure, and/or acidosis.
Objectives: Cold Hypersensitivity of Hands and Feet (CHHF) has been diagnosed objectively by Digital Infrared Thermal Imaging (DITI) and has been known to be associated with autonomic nervous system (ANS), which can be assessed by Heart Rate Variability (HRV). This study evaluated the correlation between severity of CHHF and HRV variables.Methods: We studied 155 non-menopausal women with CHHF who visited Kyung Hee University Hospital at Gangdong from 01 October 2013 to 30 April 2016. We measured DITI and HRV of each patient. We used DITI to calculate the severity of CHHF with thermal difference between upper arm (L4, 俠白穴) and palm (P8, 勞宮穴) of both hands and anterior thigh (ST32, 伏兎穴) and dorsum of foot (LI3, 太衝穴) of both feet. The correlation between severity of CHHF and HRV variables were analyzed.Results: In time domain analysis, there was significantly positive correlation between the severity of CHHF and both SDNN and RMSSD. In frequency domain analysis, there was significantly positive correlation between the severity of CHHF and TP, HF and HF Norm while there was significantly negative correlation between the severity of CHHF and LF Norm as well as between the severity of cold hypersensitivity of both hands and LF/HF ratio.Conclusions: The more severe CHHF is, the more increased the function of parasympathetic nerve system (PNS) and relatively decreased the function of sympathetic nerve system (SNS) is. Also, it has known that cold hypersensitivity could be caused by deficiency syndrome and qi deficiency has the same ANS tendency as CHHF. Therefore, in practical fields, this result can be helpful in planning treatment and deciding prognosis in respect of deficiency syndrome.
Background/Aims: Adverse drug reaction (ADR) is an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product. The present study was conducted in order to monitor the frequency and severity of ADR during antimicrobial therapy of septicemia. Methods: A prospective, observational, and noncomparative study was conducted over a period of 6 months on patients of septicemia admitted at a university hospital. Naranjo algorithm scale was used for causality assessment. Severity assessment was done by Hartwig severity scale. Results: ADRs in selected hospitalized patients of septicemia was found to be in 26.5% of the study population. During the study period, 12 ADRs were confirmed occurring in 9, out of 34 admitted patients. Pediatric patients experienced maximum ADRs, 44.4%. Females experienced a significantly higher incidence of ADRs, 66.7%. According to Naranjo's probability scale, 8.3% of ADRs were found to be definite, 58.3% as probable, and 33.3% as possible. A higher proportion of these ADRs, 66.7% were preventable in nature. Severity assessment showed that more than half of ADRs were moderate. Teicoplanin was found to be the commonest antimicrobial agent associated with ADRs, followed by gemifloxacin and ofloxacin. Conclusions: The incidence and severity of ADRs observed in the present study was substantially high indicating the need of extra vigilant during the antimicrobial therapy of septicemia.
Background: Inflammatory diseases can increase the prevalence of anemia. Recent studies confirmed that the prevalence of anemia is increased by atopic dermatitis (AD), a chronic inflammatory disease. Therefore, we aimed to elucidate the correlation between AD severity and prevalence of anemia. Methods: We used data of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2016). We included pediatric patients (<18 years) with AD diagnosis who were prescribed medications for AD. We applied a propensity score method with inverse probability of treatment weighting (IPTW) adjusting for differences in prevalence of confounders and performed IPTW logistic regression to evaluate associations between the anemia and severity of AD. Results: In total, 91,501 patients (mild AD: 47,054 patients; moderate-to-severe AD: 44,447 patients) <18 years who were prescribed drugs for AD were analyzed. Analysis of the probability of patients with mild AD and prevalence of anemia as a reference revealed an odds ratio (OR) of 1.159 (95% CI, 1.109-1.212; p<0.001) in moderate-to-severe AD patients, indicating a correlation between anemia prevalence and AD severity. Subgroup analysis according to gender, age group, and type of health insurance revealed there was an association between AD severity and anemia except in patients equal or older than 7 years. Conclusion: The prevalence of anemia increased with AD severity despite adjusting for confounding factors. Our results support the hypothesis that AD can cause anemia, and anemia prevalence could be increased in severe AD patients. Further studies are needed to establish a pathological basis.
PURPOSE. The purpose of this study was to assess the prevalence and extent of clinical attachment loss of periodontal tissue and to find out variables related to clinical attachment loss (CAL) in Korean adults older than 40 years of age. MATERIALS AND METHODS. Data were collected from 2,519 subjects who were part of a cohort study conducted in Ansan city by Korea University Medical School for Korean Genome project. Age, sex, smoking, drinking, fast glucose, blood pressure, obesity and total cholesterol levels were examined. The oral examination included probing pocket depth, gingival recession and CAL of Ramford's teeth. The severity of periodontitis was classified based on the mean value of CAL. The relationship between each risk factor and the severity of CAL was independently estimated using the chi-square test, the test or one-way ANOVA. Multiple regression analysis was used to determine the significance of each factor in the periodontal disease. RESULTS. The prevalences of clinical attachment between 1 and 3 mm, between 3 and < 5 mm, and ${\geq}$ 5 mm were 80.27%, 16.75% and < 1%, respectively. Although the univariate analysis showed age, gender, smoking, fasting glucose, blood pressure and total cholesterol levels were significantly related to the severity of CAL, multiple regression analysis indicated that age (P < .0001), gender (P < .0001) and smoking (P < .05) were only significantly related. CONCLUSION. Older age, male gender and smoking were significant risk factor for the increase of CAL, and these may be useful indicators of periodontitis high-risk groups.
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