• Title/Summary/Keyword: 임상요인들

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Quantitative Electroencephalogram Markers for Predicting Cerebral Amyloid Pathology in Non-Demented Older Individuals With Depression: A Preliminary Study (비치매 노인 우울증 환자에서 대뇌 아밀로이드 병리 예측을 위한 정량화 뇌파 지표: 예비연구)

  • Park, Seon Young;Chae, Soohyun;Park, Jinsick;Lee, Dong Young;Park, Jee Eun
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.78-85
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    • 2021
  • Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

A Comparative Study on the Mental Health of Adolescents Residing in Child Care Institutions (Orphanages) and Youth Shelters (아동양육시설과 청소년 쉼터에 거주중인 청소년들의 정신건강 수준 비교)

  • Yeonwoo Joun;Cheolgyu Shin;Hyunjeong Kim;Keun Oh;Heeyoung Seo;Jonggook Lee;Je Jung Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.2
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    • pp.125-133
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    • 2023
  • Objectives : This study aims to compare the mental health of adolescents living in child care institutions (orphanages) and youth shelters, to provide basic data for appropriate psychiatric interventions for each facilities. Methods : The sample consisted of 157 adolescents in child care institutions and 31 adolescents in Youth Shelters who completed the Korean version of the Youth Self Report (K-YSR). We compared the K-YSR scores between the two groups and also examined factors related to suicidality. Results : Adolescents in youth shelters were older and had higher rates of drinking (p<0.001), smoking (p<0.001), and "abnormal sleep" (p=0.007) than adolescents in child care institutions. They also showed higher 'suicidality' (p=0.004) and K-YSR scores. On the other hand, adolescents in child care institutions have lower 'suicidality', but they have higher 'suicidality' when they have 'abnormal sleep' (OR 4.194; p=0.006), 'abnormal diet' (OR 2.503; p=0.010), and 'concerns about weight gain' (OR 2.503; p=0.010). Additionally, 17.6% of participants in the study showed 'suicidality'. The 'suicidality' group had a higher overall K-YSR score than the non-suicidal group, and had higher 'abnormal sleep' (OR 3.766; p=0.014) and 'concern about weight gain' (OR 2.864; p=0.032). Conclusions : Adolescents in youth shelters appear to have more serious clinical difficulties than adolescents in child care institutions, so prompt psychiatric intervention is needed. Additionally, it is necessary to consider mental health assessments including suicidality when adolescents in child care institutions complain of sleep, eating, or weight gain problems.

A Long Term Follow Up Two Cases of Lesch-Nyhan Syndrome Pink Diaper (Lesch-Nyhan 증후군 장기 추적관찰: 분홍 기저귀)

  • Jae Young Kim;Wung Joo Song;Bong-Ok Kim;Harvey L. Levy;Sook Za Kim
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.24 no.1
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    • pp.26-36
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    • 2024
  • Lesch-Nyhan syndrome (LNS) is an Clinical symptoms can range from mild to severe depending on residual enzyme activity and genetic mutations. In Korea, 27 cases of LNS have been reported. We report the results of an 11-year comparative follow-up of two cases of children who visited because of pink diapers, one who died from LNS with no residual enzymes and one case with partial residual enzymes. Case 1: During follow-up, seizures, developmental delay, and regression were observed. The boy experienced insomnia and severe constipation. He exhibited self-mutilating behavior, a grand mal seizure, scoliosis with severe spasticity, truncal hypotonia, choreoathetoid movement, and ataxia. After prolonged emaciation, staghorn calculi, and recurrent pneumonia, the patient died suddenly at the age of 11 years. Genetic testing revealed a hemizygous HPRT1 variant (c.151C>T (p.Arg51Ter)). Uric acid level was 10.5 mg/dL (normal range: ~3.5-7.9) and HPRT activity 0.02 nmol/hr/spot (10-23.8 nmol/hr/spot). Case 2: During follow-up, the patient remained underweight. He has normal intelligence attending primary school. Self-mutilation symptoms were not observed. Regular renal ultrasonography did not reveal urolithiasis. The patient had a hemizygous HPRT1 variant (c.35A>C (p.Asp12Ala)). Uric acid level and HPRT activity were 11 mg/dL and 0.56 nmol/hr/spot. Pink diapers after the neonatal period and severe protein aversion, neurological problems, and kidney stones, differentiation for LNS is necessary. When suspected, serum uric acid levels, HPRT enzyme activity, and molecular biological tests may be helpful in predicting the prognosis of LNS.

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Analysis of Neurological Complications on Antegrade Versus Retrograde Cerebral Perfusion in the Surgical Treatment of Aortic Dissection (대동맥 박리에서 전방성 뇌 관류와 역행성 뇌 관류의 신경학적 분석)

  • Park Il;Kim Kyu Tae;Lee Jong Tae;Chang Bong Hyun;Lee Eung Bae;Cho Joon Yong
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.489-495
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    • 2005
  • In the surgical treatment of aortic dissection, aortic arch replacement under total circulatory arrest is often performed after careful inspection to determine the severity of disease progression. Under circulatory arrest, antegrade or retrograde cerebral perfusion is required for brain protection. Recently, antegrade cerebral perfusion has been used more, because of the limitation of retrograde cerebral perfusion. This study is to compare these two methods especially in the respect to neurological complications. Material and Method: Forty patients with aortic dissection involving aortic arch from May 2000 to May 2004 were enrolled in this study, and the methods of operation, clinical recovery, and neurological complications were retrospectively reviewed. Result: In the ACP (antegrade cerebral perfusion) group, axillary artery cannulation was performed in 10 out of 15 cases. In the RCP (retrograde cerebral perfusion) group, femoral artery Cannulation was performed in 24 out of 25 cases. The average esophageal and rectal temperature under total circulatory arrest was $17.2^{\circ}C\;and\;22.8^{\circ}C$ in the group A, and $16.0^{\circ}C\;and\;19.7^{\circ}C$ in the group B, respectively. Higher temperature in the ACP group may have brought the shorter operation and cardiopulmonary bypass time. However, the length of period for postoperative clinical recovery and admission duration did not show any statistically significant differences. Eleven out of the total 15 cases in the ACP group and thirteen out of the total 25 cases in the RCP group showed neurological complication but did not show statistically significant difference. In each group, there were 5 cases with permanent neurological complications. All 5 cases in the ACP group showed some improvements that enabled routine exercise. However all 5 cases in RCP group did not show significant improvements. Conclusion: The Antegrade, cerebral perfusion, which maintains orthordromic circulation, brings moderate degree of hypothermia and, therefore, shortens the operation time and cardiopulmonary bypass time. We concluded that Antegrade cerebral perfusion is safe and can be used widely under total circulatory arrest.

A Clinical Study of Corrosive Esophagitis (식도부식증에 대한 임상적 고찰)

  • 조진규;차창일;조중생;최춘기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.7-8
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    • 1981
  • Authors observed clinically 34 cases of the corrosive esophagitis caused by various corrosive agents at Kyung Hee University Hospital from Aug. 1978 to Dec. 1980. The results obtained were as follows; 1. Among the 34 patients, male was 19 (55.9%) and female 15(44.1%). Most frequently found age was 3rd decade. 2. 18 cases(52.9%) came to the hospital within 24 hours after ingestion of the agents, and 13 cases(38.2%) within 2 to 7 days. 3. Seasonal distribution showed most frequently in spring(35.3%). 4. The moment of the accident was suicidal attempt in 27 cases(79.4%) and misdrinking in 7 cases(20.6%). 5. Acetic acid was a most commonly used agent, showing 23 cases(67.6%), lye and insecticides were next in order. 6. Common chief complaints were swallowing difficulty and sore throat. 7. The average hospital days was 14.8 days. 8. Esophagogram was performed between 3 to 7 days after ingestion in 13 cases(38.2 %), findings were constrictions on the 1st narrowing portion in 4 cases(30.8%) and within normal limits in 3 cases(23.1%). 9. Esophagoscopy was performed in 31 cases(91.2%) between 2 to 7 days after ingestion, which revealed edema and coating on entrance of the esophagus in 9 cases (29.0 %). Diffuse edema on entire length of the esophagus and within normal limits were next in order. 10. Laboratory results were as follows: Anemia was in 1 cases(2.9%), leukocytosis. in 21 cases (61.8%), increase ESR in 9 cases (26.5%), markedly increased BUN and creatinine in 3 cases (8.8%), and hypokalemia in 1 cases(2.9%). Proteinuria in 10 cases(29.4%) hematuria in 4 cases(l1.8%), and coca cola urine in 3 cases (8.8%). 11. Associated diseases were 3 cases(8.8%) of cancer, 1 cases (2.9%) of diabetes mellitus, and 1 cases(2.9%) of manic depressive illness. 12. Various treatment was given: Esophageal and gastric washing in 23 cases(67.6%) for the emergent treatment, antibiotics in 32 cases(94.1%), steroids in 30 cases(88.2%), bougienation in 5 cases(14.7%), hemodialysis in 1 case(2.9%), and partial esophagectomy with gastrostomy and gastroileal anastomosis in 1 cases(2.9%). 13. Serious complications were observed in 9 cases (26.5%), consisted of 6 cases(17.6%) of esophageal stricture, 1 cases(2.9%), of aute renal failure, 1 cases (2.9%) of pneu momediastinum with pneumonia, and 1 cases (2.9%) of pneumonia.

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The Standing Crops and Soil-borne Microfungal Flora of Phyllostachys reticulata in Korea (한국산(韓國産) 왕대나무의 현존량(現存量)과 토양(土壤) 미세균류상(微細菌類相))

  • Kim, Kwan-Soo
    • The Korean Journal of Mycology
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    • v.7 no.2
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    • pp.91-116
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    • 1979
  • This paper is to investigate the standing crops and microfungal flora in soil in Phyllostachys reticulata forests in both the Yesan area (A) and the Kwangsan area (B). The stand density of the bamboo revealed 17,250 shoots per ha in area A, and in area B 14,780 shoots which were 16.1% less in number than area A. In respect to the environmental factors between the two areas, the mean temperature during the growth period was $1.5{\sim}2^{\circ}C$ higher in area B than in area A, soil tempeature also was $1{\sim}2^{\circ}C$ higher in area B, and the total quantities of nitrogen, phosphoric acid and organic compounds contained in the soil of area B were also slightly higher than those of area A. In area B the quantities of dried leaf matter, humus, and vegetation in the bamboo forest were also larger than in area A. In addition, five more species of microfungi which playa role in the decomposition of the various organic materials in the bamboo forests were identified in area B: Mortierella elongata, Mucor circinelloides, Aspergillus japonicus, Penicillium waksmani and Trichoderma lignorum. The atmospheric temperature in the inner portions of the bamboo forests was lower than the outside temperature, but the humidity was higher. The rates of relative illuminance were measured in area A at 4.19%, and in area B at 2.7%. These values revealed that the photosynthetic acitivity in the lower part of the bamboo was lost but it was considered that lower illuminance increased the microfungal activities in the vicinity of the surface soil. Since the productive structure of the bamboo showed that the maximum amount of photosynthesis was located in the upper portion of the bamboo in area B, it was considered to be an effective structure in maintaining the high productivity of the bamboo. The allometric relation between $D^2H$ and dry weight of stems(Ws), branches(Wb) and leaves(Wl) of the bamboo in area A were appoximated by log Ws=0.5262 log $D^2H$+1.9546; log Wb=0.6288 log $D^2H$+1.5723; log Wl=0.5181 log $D^2H$+1.8732, and those of the bamboo in area B were approximated by log Ws=0.5433 log $D^2H$+1.8610; log Wb=0.1630 log $D^2H$+2.3475; log Wl=0.4509 log $D^2H$+2.0041. From the above, the standing crops in area A were measured thus: Ws was 1,128. 83kg; Wb, 689.05kg; Wl, 926.69kg and Wl, 2,744.57kg per 10a. In area B, Ws was 1,206. 66kg; Wb, 679.92kg; Wl, 1,112.51kg and Wt, 2.999kg per l0a. Significant differences from the result of t-test were for $D^2H$ Ws, Wl and Wt between areas A and B. But no significant difference was found for Wb. In order to record as completely as possible the microfungal flora of the areas, every possible means was tried, and 158 strains of fungi were isolated, and of these, the microfungi of 55 species were identified. The dominant species were Trichoderma viride, Penicillium janthinellum, P. commune, Aspergillus oryzae, A. niger, A. gigantus, A. fumigatus, Mortierella ramaniana, var. anguliFPora, Mucor hiemalis and Zygorhynchus moelleri. According to the above results, it was revealed that optimum soil, the increases of soil materials, more species of soil microfungi, and the atmospheric temperature during the growth period have made the bamboo flourish and bring more species and larger quantities of vegetation in the bamboo forests. The correlation between the standing crops and environmental factors in the bamboo forest is considered to be a complicated relationship of all the factors, but the stand density is thought to be the most important factor involved.

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