• Title/Summary/Keyword: diagnostic scale

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Cardiac Injury due to Thoracic Trauma (흉부외상에 의한 심장손상)

  • Kim, Han-Yong;Kim, Myoung-Young;Park, Jae-Hong;Chei, Chang-Seck;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.831-836
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    • 2007
  • Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.

The Relationship between Premenstrual Changes and Degree of Stress Perception (월경전기변화와 스트레스의 지각 정도간의 상관관계)

  • Kim, Hoe-Kyoung;Joe, Sook-Haeng;Sin, Dong-Kyun
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.61-71
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    • 1999
  • Objective : The purpose of this study was to assess the relationship between the premenstrual changes and stress perception in women with premenstrual changes($PMC^+$)(n=32) and those without premenstrual changes($PMC^-$)(n=62) by using prospective method. Method : The women who were older than 30 years of age and healthy were asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle to assess the changes of psychological and physical symptoms across the menstrual cycle. They also completed 5-point likert scale to assess the perception of stress. Percent changes method was used to assess changes between follicular phase and luteal phase. Results : 1) No significant differences were found in demographic factors(age, education, marriage, employment) and risk factors(onset ages of menarche, regularities of premenstrual changes, duration of menstruation, cycle length, amount of menstruation, dysmenorrhea) between women with and without premenstrual changes. 2) There was a significant difference in mean luteal phase stress score between women with($1.92\pm0.63$) and without premenstrual changes($1.51\pm0.42$)(p<0.05). However no difference was found in mean follicular phase stress score between two groups($PMC^+$ : $1.67\pm0.43$, $PMC^-$ : $1.33\pm0.39$). 3) We divided women having premenstrual changes into two groups, higher stress group(stress score > 1.75(median)) and the lower stress group(stress score <1.75(median)). The higher stress group reported more luteal psychological symptoms than did the lower stress group(df=1, F=13.362, p<0.001). However, the groups did not differ in physical symptoms. Conclusion : In women with premenstrual changes, luteal stress score was higher than follicular stress score and this result suggested tha the perception of stress was related to psychological symptoms but not physical symptoms. These findings suggested that premenstrual change is associated with the stress level, and that it is important to manage the stress which is focused on the management of psychological symptom in the treamtment of prementrual syndrome.

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Interaction between Pain Aspect and Sleep Quality in Patients with Temporomandibular Disorder (측두하악장애 환자에서의 통증양상과 수면과의 관계)

  • Tae, Il-Ho;Kim, Seong-Taek;Ahn, Hyung-Joon;Kwon, Jeong-Seung;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.33 no.2
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    • pp.205-218
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    • 2008
  • Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.

Present Conditions of Mental Health Care in Rural Areas: Community Mental Health Program of Public Health Center (농촌지역 정신보건관리실태: 보건소 지역사회정신보건사업)

  • Lee, Weon-Young;Kim, Dong-Moon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.1-14
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    • 2003
  • Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

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The Development of Beekeeping Farm Management and Marketing Standard Diagnostic Checklist (양봉농가 표준 경영과 마케팅 진단표 개발)

  • Lee, Cheol-Whi;Song, Jeon-Eui;Jang, Hyun-Dong;Choi, Chil-Gu;Kim, Woong;Choi, Jae-Hyuk;Huh, Moo-Yul;Kwon, Se-Hyug;Hwang, Su-Yeon
    • Journal of Distribution Science
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    • v.13 no.10
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    • pp.115-122
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    • 2015
  • Purpose - This study was conducted to develop a beekeeping farm management standard checklist. This is essential to increase the competitive power of beekeeping farmers. Checklists in relation to crops and livestock were established by the Rural Development Administration in the 2000s. To date, 60 checklists have been created by crop and livestock experts. However, other farmers outside the 60 checklists are increasing. Therefore, extra development is required for these farmers. This study was conducted to meet farmers' requirements. The special farming dealt with in this study is beekeeping. Such checklists were not developed due to the small number of beekeeping farmers. However, these days, a number of such farmers are emerging. Research design, data, and methodology - Many related experts participated in this study. This study was conducted in four stages. First, a basic outline of beekeeping was created by surveying many kinds of beekeeping experts. The draft of the beekeeping checklist was created by a secondary advisory council. This draft was then sent to 14 beekeeping experts to confirm whether or not it was suitable as a management checklist. For collecting the experts' opinions, a direct visit survey was done through an arranged questionnaire. Additionally, a basic management checklist blueprint was reviewed by many experts. In the third stage, a Delphi survey method was utilized with a special Delphi questionnaire. In this stage, experts who participated in the first and second stages were excluded. As there were uncertain answers among them, a second Delphi survey was done. As a result of this survey, all answers were agreed among them. Results - From the results of this survey, four subjects in the management accomplishment index were determined. These are farming scale, average product per beehive, the sale price of honey (1kg), and the number of bee plates in the beehive. In the case of the management checklist content, five items were determined. These are beekeeping farming facilities, the environment around the farm land and general management, the product management of the beekeeping harvest, the management of the disease and pest, and farming management. This checklist will be utilized for beekeeping farmers to implement in a management situation. Conclusions - These days, the number of beekeeping farmers is increasing. The management checklist for beekeeping farmers will be used to improve their farming situation and marketing. Beekeeping farmers can understand their management by reviewing their checklist. After checking, the situation of management can be analyzed. Farmers can supplement weaknesses with expert advice. This checklist will be used by agricultural technique extension workers for farming management consulting. This checklist has to be complemented by a change in the management of the environment. This checklist will be delivered to beekeeping farmers after a verification survey is done. The result of the checklist score will be utilized for a benchmarking service to be implemented for beekeeping farmers to utilize.

Sedimentological Characteristics of Surface Sediments in the Southwestern Sea off Cheju Island, Korea (제주도 서남해역의 해저퇴적물 특성)

  • Youn, Jeung-Su;Kim, Soung-Bok;Koh, Gi-Won
    • 한국해양학회지
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    • v.24 no.3
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    • pp.132-147
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    • 1989
  • A total of 83 surface sediments and 55 sea water samples, collected from the southwestern sea of Cheju Island, were analyzed in order to understand their textural characteristics, geochemical composition and the clay mineralogical features. The sediments were subdivided into ten textural classes, namely clayey sand, slightly gravelly muddy sand, sandy clay, clay and mud. The coarse and fine-grained mixed sediments are distributed in the northern part and around the Island, whereas the fine-grained deposits are mainly distributed in the central and southern parts of the study area; small scale mud patches are distributed in the southwestern and northern parts of Cheju Island. The high concentration of total suspended matter in study area gradually increase toward the southwestern and northwestern offshore area. The concentration of geochemical elements is as follow: the content of Mn, Al, Zn, Cr, Cu and Sn increase toward the southern part which is covered mainly with fine-grained deoposits, whereas the content of Ca, Mg and Ag is higher in the northern area; the elements such as Ni, Na, Fe and Pb are more concentrated relatively in muddy deposits rather than in sandy sediments. The light minerals such as Na-Ca feldspars show a high content around the Socotra Rock, toward the Soheugsan and Cheju Islands, but the K-feldspars are relatively high around the Cheju Island. It was noticed that the provenance of these sediments is partly influenced by the geological characteristics near the island. X-ray diffractogram for clay minerals from the southeastern mud patch and around the Soheugsan Island shows the diagnostic calcite peak indicating that the greater part of these clay fraction may have been derived from present and ancient Hwangho River. The high concentration of smectite in the northern part near the Cheju and around the Soheugsan Islands, eastern side of Socotra Rock probably result from supplies smectite altered from volcanic materials distributed in the Cheju Island and Socotra Rock, whereas the samples near the Chuja and northern parts of the Cheju Island contain weak calcite peak and high concentration of kaolinite and chlorite which is closely related to the geolgical characteristics on the adjacenting land area.

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Diagnosis of Pigs Producing PSE Meat using DNA Analysis (DNA검사기법을 이용한 PSE 돈육 생산 돼지 진단)

  • Chung Eui-Ryong;Chung Ku-Young
    • Food Science of Animal Resources
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    • v.24 no.4
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    • pp.349-354
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    • 2004
  • Stress-susceptible pigs have been known as the porcine stress syndrome (PSS), swine PSS, also known as malignant hyperthermia (MH), is characterized as sudden death and production of poor meat quality such as PSE (pale, soft and exudative) meat after slaughtering. PSS and PSE meat cause major economic losses in the pig industry. A point mutation in the gene coding for the ryanodine receptor (RYR1) in porcine skeletal muscle, also known calcium (Ca$^{2+}$) release channel, has been associated with swine PSS and halothane sensitivity. We used the PCR-RFLP(restriction fragment length polymorphism) and PCR-SSCP (single strand conformation polymorphism) methods to detect the PSS gene mutation (C1843T) in the RYR1 gene and to estimate genotype frequencies of PSS gene in Korean pig breed populations. In PCR-RFLP and SSCP analyses, three genotypes of homozygous normal (N/M), heterozygous carrier (N/n) and homozygous recessive mutant (n/n) were detected using agarose or polyacrylamide gel electrophoresis, respectively. The proportions of normal, carrier and PSS pigs were 57.1, 35.7 and 7.1% for Landrace, 82.5, 15.8 and 1.7% far L. Yorkshire, 95.2, 4.8 and 0.0% for Duroc and 72.0, 22.7 and 5.3% for Crossbreed. Consequently, DNA-based diagnosis for the identification of stress-susceptible pigs of PSS and pigs producing PSE meat is a powerful technique. Especially, PCR-SSCP method may be useful as a rapid, sensitive and inexpensive test for the large-scale screening of PSS genotypes and pigs with PSE meat in the pork industry.y.

Psychophysiologic Response in Patients with Panic Disorder (공황장애환자의 정신생리적 반응)

  • Chung, Sang-Keun;Cho, Kwang-Hyun;Jung, Ae-Ja;Park, Tae-Won;Hwang, Ik-Keun
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.52-58
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    • 2001
  • Objectives: An Increased level of psychophysiologic arousal and diminished physiologic flexibility would be observed in patients with panic disorder compared with a normal control group. We investigated the differences of psychophysiologic response between patients with panic disorder and normal control to examine this hypothesis. Methods: Ten Korean patients with panic disorder who met the diagnostic criteria of DSM-IV were compared with 10 normal healthy subjects. In psychological assessment, levels of anxiety and depression were evaluated by State-Trait Anxiety Inventory, Beck's Depression Inventory and Hamilton Rating Scale For Anxiety and Depression. Heart rate, respiration rate, electrodermal response, and electromyographic activity were measured by biofeedback system (J & J I-330 model) to determine psychophysiologic responses on autonomic nervous system. Stressful tasks included mental arithmetic, video game, hyperventilation, and talking about a stressful event. Psychophysiologic responses were measured according to the following procedures : baseline(3 min)-mental arithmetic (3 min)-rest (3 min)-video game (3 min)-rest (3 min)-hyperventilation (3 min)-rest (3 min)-talking about a stressful event (3 min). Results: The baseline level of anxiety and depression, electrodermal response (p=.017), electromyographic activity (p=.047) and heart rate (p=.049) of patients with panic disorder were significantly higher than those of the normal subject group. In electrodermal response, patient group had significantly higher startle response than the control group during hyperventilation (p=.001). Startle and recovery responses of heart rate in the patient group were significantly lower than responses in the control group during mental arithmetic (p=.007, p=.002). In electrodermal response of the patient group, startle response was significantly higher than recovery response during mental arithmetic (p=.000) and video game task (p=.021). Recovery response was significantly higher than startle response in respiratory response during hyperventilation. Conclusion: The results showed that patients with panic disorder had higher autonomic arousal than the control group, but the physiologic flexibility was variable. We suggest that it is helpful for treatment of panic disorder to decrease the level of autonomic arousal and to recover the physiologic flexibility in certain stressful event.

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STUDY ON THE RELATIONSHIP BETWEEN ONTOGENY OF SEROTONIN SYSTEM AND PSYCHOPATHOLOGY IN CONDUCT DISORDER (행동장애에 있어서 Serotonin계의 개체발생적인 과정과 정신병리와의 상호관계에 관한 연구)

  • Shin, Sun-Woong;Shin, Min-Sup;Hwang, Jun-Won;Kim, Boong-Nyun;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.112-122
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    • 2003
  • Objectives:Considerable data indicate that diminished serotonergic activity is related to aggressive behavior. In order to understand the biological etiology in conduct disorder, we studied the relationships of plasma serotonin and 5-HIAA levels in conduct disorders to measures of aggression, violation of rules and oppositional defiant behavior. Methods:Subjects were selected from inpatients and outpatients department of the Division of Child and Adolescent Psychiatry of Seoul National University Hospital. 41 conduct disorders(18 childhoodonset type, 23 adolescent-onset type) and 23 normal controls were included in this study. For the assessment of aggression, rule violation and oppositional behavior, parents completed the rating scale for conduct disorder and oppositional behavior based on the DSM-IV diagnostic criteria. Plasma serotonin and 5-HIAA levels were determined by HPLC with electrochemical detection. Results:1) Plasma 5-HT and 5-HIAA levels were not significantly different among childhood-onset conduct disorder, adolescent-onset conduct disorder and normal control subjects. 2) No significant correlations were found between plasma 5-HT levels and aggression or rule violation. 3) Plasma 5-HT levels showed significant positive correlations with oppositional behavior both in childhood-onset conduct disorder and adolescent-onset conduct disorder. 4) Age-related changes were not found in plasma 5-HT and 5-HIAA levles. Conclusion:Our findings do not support the hypothesis that dysregulation of serotonergic function may be associated with aggresson. Instead, our data suggest that serotonergic function is more closely related with oppositional behavior than aggression.

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Prognostic Factors in Postpsychotic Depressive Disorder of Schizophrenia (정신분열증의 정신증 후 우울장애의 예측인자)

  • Kim, Jin-Sung;Lee, Jong-Bum;Seo, Wan-Seok;Koo, Bon-Hoon;Bae, Dae-Seok;Kim, Yi-Youg;Kim, Jung-Youp
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.150-165
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    • 2005
  • Purpose: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. Materials and Methods: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. Results: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20(25.0%) for the BDI, 16(20.0%) for the ZDS, 18(22.5%) for the CDSS and 6(7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. Conclusion: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.

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