• Title/Summary/Keyword: intolerance

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L1-2 Disc Herniations : Clinical Characteristics and Surgical Results

  • Lee, Sang-Ho;Choi, Seok-Min
    • Journal of Korean Neurosurgical Society
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    • v.38 no.3
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    • pp.196-201
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    • 2005
  • Objective : Among upper lumbar disc herniations, L1-2 disc herniations are especially rare. We present the specific clinical features of L1-2 disc herniation and compared results of different surgical options. Methods : The authors undertook a retrospective single institution review of the patients who underwent surgery for L1-2 disc herniation. Thirty patients who underwent surgery for isolated L1-2 disc herniations were included. Results : Buttock pain was more frequent than anterior or anterolateral thigh pain. Standing and/or walking intolerance was more common than sitting intolerance. The straight leg raising test was positive only in 15 patients [50%]. Iliopsoas weakness was more frequent than quadriceps weakness. Percutaneous discectomy group demonstrated worse outcome than laminectomy group or lateral retroperitoneal approach group. Conclusion : Standing and/or walking intolerance, positive femoral nerve stretch test, and iliopsoas weakness can be useful clues to the diagnosis of L1-2 disc herniation. Posterior approach using partial laminectomy and medial facetectomy or minimally invasive lateral retroperitoneal approach seems like a better surgical option for L1-2 disc herniation than percutaneous endoscopic discectomy.

The Relationship between Intolerance of Uncertainty and Relationship Addiction: The Mediating Effect of Experiential Avoidance (미혼남녀의 불확실성에 대한 인내력 부족과 관계중독의 관계에 관한 연구: 경험회피의 매개효과)

  • Gayeon Kim;Jeoungyun Park
    • Korean Journal of Culture and Social Issue
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    • v.30 no.2
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    • pp.221-238
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    • 2024
  • The purpose of this study was to explore the effects of intolerance of uncertainty and experiential avoidance on relationship addiction and to investigate the mediating effect of experiential avoidance in the relationship between intolerance of uncertainty and relationship addiction among unmarried adults. For this purpose, an online survey was conducted on unmarried adults aged 20 to 29 who are currently engaged in opposite-sex romantic relationships, and a total of 302 data were used for analysis.. The collected data were analyzed using SPSS 29.0 and PROCESS MACRO v4.2. The main results of this study are as follows. First, intolerance of uncertainty and experiential avoidance had significant effects on relationship addiction. Second, experiential avoidance had a significant mediating effect between intolerance of uncertainty and relationship addiction tendencies. This study identified individual psychological factors that induce relationship addiction. Based on the research results, this study suggests directions for counseling interventions to reduce relationship addiction tendencies and promote healthier relationship patterns among unmarried adults.

Development and Validation of Questionnaire for Chronic Fatigue Syndrome (CFS) Diagnosis Based on Systemic Exertion Intolerance Disease (SEID) Criteria (전신성 활동불능증(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군(Chronic Fatigue Syndrome) 진단 설문지 개발 및 신뢰도 평가)

  • Lim, Eun-jin;Son, Chang-gue;Jang, Eun-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.293-305
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    • 2020
  • Purpose: This study aimed to develop a questionnaire for the diagnosis of chronic fatigue syndrome (CFS) designed based on the systematic exertion intolerance disorder (SEID) criteria, and to validate the reliability of the questionnaire. Methods: A literature search on questionnaires for CFS diagnosis was conducted to develop a SEID questionnaire (SEID-Q27), followed by a pilot survey to identify the reliability of the questionnaire. Adults (Daejeon university personnel) with a Chalder fatigue scale (CFQ) score ≥15 were invited for the survey. We commenced the survey in November 2019 with a two weeks of interval for the test and retest method. The reliability of the questionnaire was investigated in three angles: 1. Cronbach's α, 2. correlations (r) of the questions, numerical rating scale (NRS), and visual analog scale (VAS), and 3. kappa (k) analysis. Results: Among the total 275 adults registered, 55 (20%) participants with a CFQ score ≥15 were invited, and 31 (11%) [15 male, 16 female] completed the questionnaire. The total Cronbach's α was 0.944 for the test and 0.949 for the retest. The reliability (r) of questions by CFQ score (≥15, ≥18, ≥20) ranged from 0.533-0.928 (p <0.05), and the r score of the NRS and VAS were the highest in CFQ scores ≥20, at 0.933 (p<0.001). The agreement rate of the SEID-Q27 between the test and retest was 87% (kappa k=0.743). Conclusions: The SEID-Q27 seems to be reliable. Further studies are needed to measure the validity of the tool and the cutoff point.

Validity Study of the Systemic Exertion Intolerance Disease Questionnaire (SEID-Q27) for Chronic Fatigue Syndrome (CFS) Diagnosis (SEID(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군 진단 설문지(SEID-Q27) 타당도 연구)

  • Lim, Eun-jin;Son, Chang-gue;Jang, Eun-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1015-1029
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    • 2020
  • Purpose: This study assessed the validity of a questionnaire (SEID-Q27) for diagnosis of chronic fatigue syndrome (CFS), designed based on the systematic exertion intolerance disorder (SEID) criteria. Methods: Two groups of participants were recruited: 1. a non-CFS control group: adult university personnel with a Chalder fatigue scale (CFQ) score ≥15, and 2. a CFS patient group: patients from an online CFS community diagnosed with CFS (diagnostic code of G93.3) with the symptoms present. The survey ran from September to October, 2020. The validity of the questionnaire was investigated by factor analysis and receiver operator characteristic (ROC) analysis. Results: Among the 35 adults surveyed, 30 (86%) participants had CFQ scores ≥15 (15 males and 15 females) and 5 (14%) had a CFS diagnosis (2 males and 3 females). The total mean score was significantly different between the two groups (CFS: 6.8±2.2 vs. control: 4.4±2.4, p<0.05). The area under the curve (AUC) was 0.827. With a cut-off point 62, the sensitivity was 60%, specificity 97%, and the discriminant ability of the survey was 79%. Conclusions: The SEID -Q27 appears to be a useful instrument for the diagnosis of CFS using SEID criteria. However, further large-scale studies are needed with greater numbers of participants.

Enteral nutrition in mechanically ventilated patients after organophosphate poisoning

  • Sang U Bark;Jeong Mi Moon;Byeng Jo Chun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.22 no.1
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    • pp.1-9
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    • 2024
  • Purpose: Nutritional therapy is a crucial component of therapy for critically ill patients, but there is a lack of nutritional support guidelines for organophosphate (OP) poisoning, likely due to the gastrointestinal effects of atropine, the main antidote for OP. This study investigated whether enteral nutrition (EN) during atropinization is acceptable for mechanically ventilated patients after OP poisoning. Methods: This retrospective study classified 82 patients with OP poisoning according to whether they were fed during atropinization while on mechanical ventilation (MV). Data on the baseline characteristics, nutritional support, and clinical outcomes were compared. Univariate and multivariate regression models were constructed to analyze the associations between atropine administration for OP poisoning and feeding intolerance-related EN after adjustment for risk factors. Results: Eighty-two patients received EN after 72 hours on MV, and 40 of them simultaneously received 2 mg/hr atropine for the first 120 hours after EN initiation. The overall incidence of feeding intolerance was 57.3% during the first 12 days after EN initiation and did not differ according to atropine administration. Appropriate atropinization during EN in regression model 1 and the dosage of atropine administered during EN and the duration of EN during atropinization in model 2 were not associated with feeding intolerance in patients on MV after OP poisoning. Conclusion: Appropriate atropinization is not associated with feeding intolerance after EN provision in patients on MV after OP poisoning. This study will help establish nutritional guidelines for OP poisoning patients. More research on nutritional support is needed to validate our results.

Feeding Introlerance Due to Allergic Enterocolitis in Very Low Birth Weight Infants (극소 저체중 출생아에서 식이 불내성을 임상적 특징으로 하는 알레르기성 장염)

  • Ko, Yu-Mi;Kim, Jin-Kyu;Ahn, So-Yoon;Yoo, Hye-Soo;Jeon, Ga-Won;Kim, Eun-Sun;Chang, Yun-Sil;Park, Won-Soon
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.204-210
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    • 2011
  • Purpose: Feeding intolerance is common in very low birth weight infants(VLBWI); however, research on the etiology is limited. We investigated the incidence of allergic enterocolitis (AEC) as a cause of feeding intolerance and present the clinical characteristics of VLBWIs. Methods: The medical records of VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center between January 2009 and July 2010 were retrospectively analyzed. AEC was defined as patients who had feeding intolerance with eosinophila and who responded to hypoallergenic feeding intervention. Feeding intolerance symptoms included blood tinged stools, abdominal distension, residual feeding and regurgitation. Eosinophilia was defined as an eosinophil count ${\geq}$700 cells/$mm^3$. Patients with feeding intolerance were divided into the AEC or non-AEC group. Results: Of the 181 patients, 161 (88.9%) had a feeding intolerance, and 119 (65.7%) had eosinophilia. Seventeen infants were diagnosed with AEC. No difference in mean gestational age, birth weight, antibiotics duration, TPN duration, hospitalization, or symptom onset day was observed between patients with AEC and non-AEC patients. The percentage of eosinophilia was significantly higher in patients with AEC than in non-AEC patients. Two patients (12%) improved with restricted breast milk, 10 patients (59%) with extensively hydrolyzed formula and five patients (29%) with free amino acid-based formula. Conclusion: Our results suggest that AEC should be considered in VLBWIs who have clinical features of feeding intolerance and eosinophilia. An aggressive increase in feeding would be possible through feeding intervention in VLBWIs with feeding intolerance.

Minireview for Chronic Fatigue Syndrome and its Medical Attention recently

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.40 no.4
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    • pp.84-90
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    • 2019
  • Objectives: Chronic fatigue syndrome (CFS) is a debilitating illness impairing seriously quality of life, while CFS would be an optimized target disorder of Korean medicine. This study aims to present the recent information especially in aspect of medical policy and new diagnosis criteria for CFS. Methods: The literature survey was conducted using the terms of "chronic fatigue syndrome", "myalgic encephalomyelitis" and "fibromyalgia" in PubMed database and Google database in its entirety from January 2011 to February 2019. The in-depth review was made focusing on the changes in policy and medical perspective for CFS. Results: Recently large medical attentions and researches for CFS have been existed worldwide. By supporting of USA government, IOM made a report which leaded to a turning point in clinical practices and research in 2015. This report recommended a new name of CFS to systemic exertion intolerance disease (SEID), and new diagnostic criteria focusing on post-exertional malaise, unrefreshing sleep, cognitive impairment and orthostatic intolerance. The medical perspective also was changed into "a serious, chronic, complex, systemic disease" from a psychological-like disorder, and then UAS and EU governments sharply increased the research grants. Conclusions: This study provided practitioners in Korean medicine (KM) a core information about the recent changes in CFS-related perspectives. This review would be helpful for KM-derived researches or therapeutics development for CFS.

Myeloma-associated Amyloidosis Presenting as Orthostatic Intolerance (기립불능증으로 발현한 다발골수종과 연관된 아밀로이드증)

  • Jeong, Heejeong;Nam, Wonsik;Son, Seungnam;Kim, Soo-Kyung;Kang, Heeyoung;Choi, Nack-Cheon;Kwon, Oh-Young;Lim, ByeongHoon;Park, Ki-Jong
    • Annals of Clinical Neurophysiology
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    • v.17 no.1
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    • pp.24-27
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    • 2015
  • Amyloidosis is a systemic disorder associated with clonal plasma cell dyscrasia. Nephrotic syndrome, congestive heart failure, autonomic and peripheral neuropathy is often associated features in amyloidosis. Early diagnosis is most important because of different prognosis by stage. The diagnosis can be delayed since symptoms of amyloidosis may vary or nonspecific. We describe a patient of myeloma-associated amyloidosis, who showed orthostatic intolerance as the first symptom of the disease.

Orthostatic Intolerance Ambulation in Patients Using Patient Controlled Analgesia

  • Park, Kwang Ok;Lee, Yoon Young
    • The Korean Journal of Pain
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    • v.26 no.3
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    • pp.277-285
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    • 2013
  • Background: Opioid analgesics are widely used to reduce postoperative pain and to enhance post-operative recovery. However, orthostatic intolerance (OI) induced by opioid containing intravenous patient controlled analgesia (IPCA) may hinder postoperative recovery. This study investigated factors that affect OI in patients receiving IPCA for postoperative pain control. Methods: OI was instantly evaluated at the time of first ambulation in 175 patients taking opioid containing IPCA after open and laparoscopic subtotal gastrectomies. Patients were classified as having OI if they experienced dizziness, nausea/vomiting, blurred vision, headache, somnolence and syncope. Factors contributing to OI were assessed with logistic regression analysis. Results: Out of 175 patients, 61 (52.6%) male and 44 (74.6%) female patients experienced OI at the time of first ambulation. The frequency of OI related symptoms were dizziness (97, 55.4%), nausea (46, 26.3%), headache (9, 5.1%), blurred vision (3, 1.7%) and vomiting (2, 1.1%). Significant risk factors for OI were gender (P=0.002) and total amount of opioids administered (P=0.033). Conclusions: The incidence of OI is significantly higher in male than in female patients and is influenced by the opioid dose.

Effects of Massage Therapy on Feeding Intolerance and Physical Growth in Premature Infants (마사지요법이 미숙아의 수유불내성과 신체성장에 미치는 효과)

  • Seo, Hyun Young;Kim, Young Hae;Kim, Sung-Ju
    • Child Health Nursing Research
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    • v.22 no.4
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    • pp.355-362
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    • 2016
  • Purpose: The purpose of this study was to identify effects of Massage therapy on feeding intolerance and physical growth in premature infants. Methods: This study was conducted in the NICU of U university hospital, from June to December 2014. A quasi experimental design was used. A total of 60 premature infants were randomly assigned into two groups of 30 infants each. Infants of control group were given conventional treatment, while infants of experimental group given conventional treatment plus massage therapy. Massage therapy was performed for 15 minutes, 60 min before feeding, 3 times per day for 21 times over 7 days. The number of feedings withheld for feeding intolerance, number of gastric residuals, number of fecal excretions and physical growth variables (weight, height) were measured. Results: After the intervention, number of fecal excretions and weight gain in the experimental group were significantly higher than that of the control group. Also, number of gastric residuals in the experimental group was lower than that of the control group. Conclusion: Massage therapy laid the basis for nursing intervention to promote feeding tolerance and physical growth in premature infants.