• Title/Summary/Keyword: symptom score

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Analysis of High-Resolution Manometry Results in LPRD Patients who do not Response to PPI Medication (양자펌프 억제제에 반응을 보이지 않은 인후두 역류질환 환자에서 고해상도 식도 내압검사의 분석)

  • Lee, Chang-Hee;Lee, Hyun-Sub;Jin, Sung-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.2
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    • pp.151-155
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    • 2011
  • Background and Objectives : Laryngopharyngeal reflux disease (LPRD) originates from regurgitation of gastric contents to the laryngopharynx, and it is relatively common disease in otolaryngology. Proton-pump inhibitor (PPI) medication is frequently using treatment method in present time, but controversies exist regarding treatment for it. High-resolution manometry (HRM) system is a newly developed device that using 36 channels and pressure topography plotting program, checking the function and status of esophagus. The aim of this study was to evaluate clinical usefulness of HRM in LPRD patients who do not response to PPI medication. Subjects and Method : From July 2009 to July 2010, a total of 99 patients who were suspected LPRD according to symptoms (Reflux Symptom Index >13) and laryngoscopic findings (Reflux Finding Score >7) were retrospectively enrolled in this study. Patients were consisted of 31 men and 68 women, the mean age was 51.8 years, the mean BMI was 22.46. Patients have taken PPI medication for 2 months, after medication, they performed HRM. Comparative analysis was performed with results of the difference in symptoms. Results : In 99 patients, 37 patients (37.4%) show not improvement of LPRD symptoms after PPI medication. Among them, 18 patients (48.6%) showed abnormal findings that were classified as Peristaltic dysfunction (38.9%), Diffuse esophageal spasm (11.1%), Relaxation impairment of LES (11.1%), Achalasia (5.6%), Hypotensive LES (11.1%), Relaxation impairment of UES (11.1%), Nutcracker esophagus (5.6%), Decreased resting pressure (5.6%). Other 62 patients (62.6%) show improvement of LPRD symptoms, 23 patients (37.1%) showed abnormal findings. Most common finding was Peristaltic dysfunction (43.4%) More prevalent abnormal findings of HRM were found in patients who revealed no response to PPI medication (48.6% vs. 37.1%), but it does not reach the statistical significance. Conclusion : Although statistical significances is not showed, the difference observed in the frequency of HRM abnormal finding between response and no response for PPI medication. It has been estimated that HRM may be used to determine differential diagnosis in patients with LPRD. Further studies in lager population containing normal controls will be needed to prove clinical usefulness.

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Effect of Moxibustion at Junggeuk(CV3), Singwol(CV8) on Women's Urinary Incontinence and Quality of Life (중극(中極), 신궐(神厥) 뜸요법이 여성의 요실금과 삶의 질에 미치는 효과)

  • Lee, Eun-Sook;Kim, Yi-Soon;Lee, Jeong-Won;Oh, Mi-Jung;Kim, Gyeong-Cheol
    • Korean Journal of Acupuncture
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    • v.30 no.3
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    • pp.193-200
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    • 2013
  • Objectives : This study is to examine the effects of moxibustion at Junggeuk(CV3), Singwol(CV8) on women's urinary incontinence and quality of life. The study is a research based on the non-equivalent control group pretest-posttest design. Methods : The subjects of the study were 45 women who were using either of 2 health clinics located in Ulsan. They were sampled in accordance with predetermined standards and then divided into the experimental and control groups, respectively consisting of 22 and 23 members. In treating those women through moxibustion, this researcher applied 2 sheets of 'shingigu' to each of the women on 40 min, per time basis. This experiment was conducted 6 times in total for 2 weeks on every two day basis. Data from all of the measurements were statistically processed and analyzed using SPSS/WIN 12.0. Demographic characteristics of the subjects were examined and indicated in frequency and percentage. The homogeneity test of the two groups was conducted using $x^2$-test, Fisher's exact test, t-test and Mann-Whitney U Test. Hypotheses set for the study were verified through t-test and Mann-Whitney U Test. Results : The experimental group who take moxibustion will be lower in the severeness of urinary incontinence than the control group who do not was supported(p<0.001). 2. The experimental group who take moxibustion will be higher in score for life quality than the control group who do not was supported(U=42.00, p<0.001). Conclusions : These findings suggest that moxibustion can be an effective intervention for women having urinary incontinence because it treats the symptom with no adverse effect and it is non-invasive and easily applicable.

Clinical Features according to the Frequency of Acute Exacerbation in COPD

  • Lee, Seung-Jun;Lee, Seung-Hun;Kim, Yu-Eun;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Kim, Jin-Hyun;You, Jin-Jong;Yoon, Chul-Ho;Lee, Jong-Deog;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.4
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    • pp.367-373
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    • 2012
  • Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010, were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients' medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [$FEV_1$], 45% vs. 65.3%, p=0.001; $FEV_1$/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p<0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.

Effects of Adenophorae Radix(AR) on Atopic Dermatitis(AD) Induced by DNCB in Mice (사삼이 DNCB로 유발된 생쥐의 아토피 피부염에 미치는 영향)

  • Lim, Kyeong-Min;Ko, Hong-Je;Choi, Jung-Hwa;Park, Soo-Yeon;Kim, Jong-Han;Jung, Min?Yeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.31-45
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    • 2017
  • Objectives : Adenophorae Radix(AR) is the dried root of Adenphora triphylla var. japonica HARA. AR has the efficacy of clarifying lung, emitting pus, expelling wind, stopping pruitus and so on. Recently, various studies are being done about anti-oxidative, immunomodulatory and anti-inflammatory effects of AR. So, we expected AR has an availability that can improve symptoms of atopic dermatitis(AD). Methods : In this study, we measured body weight, weight of ear, thickness of ear skin and dorsum skin, symptom score, reproduction rate of splenocytes in vivo and in vitro of mouse with AD induced by DNCB. We experimented with five groups of 9 mice, such as normal group, control group, AR spread(ARS) group, AR feeding(ARF) group, AR spread&feeding(ARSF) group. Results : Control group of body weight significantly reduced and APSF group significantly increased in the first and second week. In weight of ear and thickness of ear skin and dorsum skin, control group significantly increased and ARSF group significantly decreased. In macrophotography viewpoint of dorsal skin, ARS group, ARF group and ARSF group decreased severe pigmented skin lesion, erythema and desquamation as compared with control group. Especially ARSF group showed significant drop. ARS group, ARF group and ARSF group compared to control group were improved in histopathology observation. In vitro and in vivo, treatment group of AR increased proliferation rate of splenocytes, specially in vitro significantly. Conclusions : This experiment indicates Adenophorae Radix extracts is effective on AD induced by DNCB in mice.

The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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Cognition and Attitudes toward Psychological Problems among Middle Managers in Small and Medium-sized Workplaces (정신질환에 대한 중소규모 사업장 중간관리자의 인식 및 태도)

  • Yang, Sun Im;Yim, Hyeon Woo;Jo, Sun-Jin;Ji, Yu Na;Jung, Hye-Sun;Kim, Bo Kyoung;Lee, Kang-Sook;Lee, Won Chul
    • Korean Journal of Occupational Health Nursing
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    • v.17 no.1
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    • pp.23-33
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    • 2008
  • Purpose: The purpose of the study was to identify attitudes of middle managers toward employees with psychological problems and to determine factors affecting their attitudes. Methods: A questionnaire with Community Attitudes Toward Mentally Ill (CAMI) scales was administered to 161 middle managers working in small and medium-sized enterprises based in Seoul and Gyeonggi Province. Results: There are four separate subscales on the CAMI. Mean score for authoritarianism was $35.0{\pm}4.4$, benevolence $23.0{\pm}4.8$, social restrictiveness $32.3{\pm}4.9$ and community mental health ideology $27.2{\pm}5.1$ According to multiple regression analysis, middle managers with no experience of learning mental illness through mass media or higher levels of depression symptom were more authoritative and less benevolent towards employees with psychological problems. The experience of meeting a patient with mental problem contribute to positive attitudes toward people with mental illnesses in social restrictiveness subscale and community mental health ideology subscale among CAMI. Conclusion: This study suggests that experience of having patients with mental problems and information on psychological problems will have great influence on attitudes of middle managers toward employees with psychological problems. It might be important to help middle manager manage their depression because their depression also affects their attitudes toward employees with psychological problems.

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Efficacy and Safety of Electroacupuncture and Acupuncture in Postmenopausal Women with Overactive Bladder; a Pilot Study of Randomized Clinical Controlled Trial (폐경 여성의 과민성 방광에 대한 전침 치료와 침 치료의 유효성과 안전성 평가 ; 무작위 대조군 예비 임상시험)

  • Nam, Eun-Young;Jung, Seung-Hyun;Bae, In-Suk;Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.1
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    • pp.84-98
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    • 2018
  • Objectives: The purpose of this pilot study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture and electroacupuncture in treating overactive bladder (OAB) in menopause women. We tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing OAB symptoms and improving disease-specific quality of life. We also tried to determine the appropriate treatment duration of OAB, with safety of performing acupuncture and electroacupuncture treatment. Methods: This study was a randomized clinical trial. 7 menopause women were randomly assigned to a electroacupuncture group (EA group) (n=4) or acupuncture group (AC group) (n=3) and received electroacupuncture or acupuncture treatment twice a week (16 sessions) in 8 weeks, and follow up assessment was performed after the end of treatment. Overactive Bladder Symptom Score (OABSS), 3-day bladder diary, and King's Health Questionnaire (KHQ) were performed 4 times (at baseline (visit 0), the middle of treatment (visit 8), after the end of treatment (visit 16), and at 4 weeks of follow-up (visit 17)) and analyzed. 2 subjects were dropped out, and finally 5 subjects completed the study. Statistical analysis was performed using SPSS 18.0 for window program. Results: There was an significant improvement in night-time frequency after the treatment (visit 17) in PP (Per-protocol) group analysis (p=0.042). In additional ITT (Inter-to-treat) group analysis, the OABSS (p=0.042) and night-time frequency (p=p=0.017) were improved significantly after the treatment (visit 17). But there was no significant difference of KHQ before and after the treatment. Also there was no significant difference between EA and AC group after the treatment (visit 16, 17). Conclusions: The results of this pilot study suggested that it was feasible to recruit subjects and perform the study procedures, after reconstructing several details of study protocol in performing further clinical trial.

An Index of Visual Function in Patients with Cataract - Pilot study - (백내장 환자의 시기능지표 - 사전 연구를 중심으로 -)

  • Kang, Hyung-Gon;Park, Eun-Cheol;Choi, Yoon Jung;Kim, Han Joong;Hong, Young Jai;Cho, Woo Hyun;Sohn, Myongsei;Lim, Seung Jeong
    • Quality Improvement in Health Care
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    • v.5 no.1
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    • pp.128-138
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    • 1998
  • Background : There is increased recognition that rigorous approach to functional assessment will complement the assessment of clinical status. This study is to develop the appropriate visual function index in Korean patients with cataracts by the assessment of the reliability, validity of visual function indexes including VF-14. Methods : An prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 1-2 days before cataract surgery. Results : We used following measures : 7 visual function indexes, global measures of patients' trouble and satisfaction with vision, and best-corrected visual acuity(VA) in each eye. 7 visual function indexes showed a high internal consistency reliability (Cronbach's alpha coefficients ${\geq}$ 0.86). The better visual acuity(operated eye, better eye), the higher patient satisfaction with vision, the lower symptom score, the lower patient trouble with vision was correlated with preoperative visual function index scores. Among 7 indexes, VF-12 with the exclusion of 2 items drivings from VF-14 is a high Cronbach's alpha coefficient and correlation coefficient and the highest $R^2$. Conclusion : We conclude that VF-12 is reliable and valid in Korea. So we suggest that in Korea, all items of VF-14, the visual function index, which is in use internationally, ought to be surveyed and VF-12 which has been excluded by 2 items of drivings from VF-14 ought to be used for analysis.

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The Effectiveness of Vision Therapy for Symptomatic Accommodative Infacility in Children (증상을 호소하는 조절난이 어린이를 대상으로 한 비전세라피의 효과)

  • Shin, Hoy Sun
    • Journal of Korean Ophthalmic Optics Society
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    • v.14 no.3
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    • pp.75-81
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    • 2009
  • Purpose: The purpose of this controlled study was to determine the effectiveness of vision therapy for accommodative infacility in children. Methods: 10 children 9 to 13 years of age with symptomatic accommodative infacility were divided into a treatment group (n=6) and a contol group (n=4). The treatment group received 12 weeks of vision therapy while the control group received nothing. Results: The visual symptom assessed by COVD-QOL score for the treatment group showed both statistically and clinically significant reduction from 27.50${\pm}$5.68 to 12.00${\pm}$7.24 (p<0.01). Also, there were statistically and clinically significant improvement in the clinical measures of monocular accommodative facility of right eye (from 0.67${\pm}$1.03 cpm to 15.42${\pm}$4.85 cpm; p<0.001) and binocular accommodative facility (from 0.33${\pm}$0.82 cpm to 13.92${\pm}$3.58 cpm; p<0.001). In contrast, there were no significant improvement in symptoms and in the clinical measures of monocular and binocular accommodative facility for the control group (p>0.05). Conclusion: Vision therapy is an effective mode of treatment in eliminating symptoms and improving accommodative facility in children with accommodative infacility.

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The Relationship between Habitual Patient-Reported Symptoms and Signs in the Soft Contact Lens Wearers (소프트 콘택트렌즈 착용자에서 평상시 나타난 증상에 관한 연구)

  • Lee, Koon-Ja;Buyn, Jang-Won;Mun, Mi-Young;Leem, Hyun-Sung
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.3
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    • pp.19-28
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    • 2008
  • Purpose: To understand symptoms and signs in soft contact lens wearers the authors evaluate the attribution of the tear test to the contact lens related symptoms and signs. Methods: Sixty-two healthy soft contact lens wearers (23.95${\pm}$4.38 years old, 18.60${\pm}$16.92 months of prior lens wear) were participated in this study. 3 kinds of tear test and McMonnies' questionnaire test were performed for the soft contact lens wearers and subjective symptoms and objective signs were graded using CCLRU scales during the study period. Results: In this surveys, we found ocular dryness, redness and tiredness are the most common frequent and severe symptoms in soft contact lens wearers. Frequency of the ocular dryness, redness and tiredness are associated with grittiness, burning sensation and foreign body sensation respectively, and severity of the photophobia, foreign body sensation are associated with unstable vision and grittiness and which are associated with score of McMonnies' Questionnaire. Conjunctival redness and limbal redness are major signs but those are not need to be clinical care and rarely occurred corneal and conjunctival staining which are associated with tear break-up-time statistically. Conclusions: Dryness, redness and tiredness are primary common symptoms in Korean soft contact lens wearers. The frequency of those symptoms are increased with the period of soft contact lens wear and those are associated with other symptoms but have no relationship with signs.

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