• Title/Summary/Keyword: 자가증상보고

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The Result of the Surgical Treatment for Non-small Cell Lung Cancer (비소세포성 폐암의 외과적 치료에 대한 성적)

  • Park, Jin-Gyu;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.30 no.9
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    • pp.899-907
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    • 1997
  • Recently, primary lung cancer has increased markedly in incidence & prevalence in korea. Prom July 1979 to June 1996, 183 patients were diagnosed and operated for primary non-small cell lung cancer, and evaluated clinically. 1. There were 164 males and 19 females(M:P=8.6: 1), and the peak incidence of age was 50th and 60th decade of life(73.7%). 2. Most of symptoms were respiratory, whitch were cough(44.8%), chest pain(30.1%), dyspnea(20.8%), hemoptysis or blood tinged sputum(19.7%), sputum(15.3%), and asymptomatic cases were 12.0%. 3. Histopathologically, sguamous cell carcinoma was 68.9%, adenocarcinoma 19.7%, bronchioloalveol r cell carcinoma 2.2%, adenosguamous cell carcinoma 1.6%, and large cell carcinoma 7.7%. 4. In the operation, pneumonectomy was 41.0%, lobectomy 42.1%, bilobectomy 13.1%, stagmentectomy or wedge resection 1.6%, and explore tharacotomy 2.2%, and the overall resectability was 97.8%. 5. Postoperative complications were developed in 31.9%, and operative mortality was 1.6%. 6. In postoperative stagings, stage I was 38.3%, stage H 14.8%, stage llla 31.1%, and stage IIIb 15.8%. 7. The overall cumulative survival rates were 1 year 77.8%, 3 year 42.7%, and 5 year 39.5%. The 5 year survival rate according to stage were stage 153.0%, stage H 46.5%, stage I[la 28.2%, and stage IIIb 13.8%(p<0.05), according to operation method were lobectomy 45.0%, and pneumonectomy 30.3%(p<0.05), and according to mediastinal involvement were Nl 32.0%, and N2 11.1%(p<0.05). The 5 year survival rate according to histologic type were squamous cell carcinoma 43.1%, adenocarcinoma 23.3%, and large cell carcinoma 30.3 (p>0.05).

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Association of Leukotriene C4 Synthase Gene Polymorphism with Clinical Response to Montelukast in Childhood Asthma (소아 천식환자에서 Leukotriene C4 Synthase 유전자 다형태와 Montelukast의 임상적 효과와의 연관성)

  • Shin, Kyung Sue;Kim, Youn Woo
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.766-771
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    • 2005
  • Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.

Differential Relations of Depression, Anxiety and Sleep Disturbances by Gender in Young Adolescents (청소년에서 우울 및 불안 증상과 수면 곤란의 성별에 따른 차별적 관련성)

  • Kim, Eun-Jin;Kang, Su-Gyeong;Moon, Myeong-Sung;Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Psychosomatic Medicine
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    • v.18 no.2
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    • pp.62-71
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    • 2010
  • Objectives : The aim of the study was to investigate the prevalence by gender and to evaluate associations of depression, anxiety and sleep disturbances in a large sample of adolescents from the general population. Methods : 1422 subjects, aged 14 years students were recruited in the seven middle-school of the local community. The self-report questionnaire(Children's Depression Inventory : CDI, Beck Anxiety Inventory : BAI and Pittsburgh Sleep Quality Index : PSQI) was used for screening depression, anxiety and sleep disturbances in adolescent. CDI, BAI, and PSQI score was categorized into the following quartiles : $\leq$21, 22-25, 26-28, and $\geq$29 ; $\leq$21, 22-26, 27-31, and $\geq$32 ; $\geq$5, <5. The cut-off score is that CDI is 22, BAI is 22 and PSQI is 5. The result was analyzed using the independent t-test, the chi-square test and logistic regression analyses. Results : The mean CDI score($12.52{\pm}8.32$ vs. $10.39{\pm}7.52$ ; p=0.003), BAI($7.77{\pm}7.93$ vs. $9.84{\pm}9.04$ ; p<0.001) and PSQI($4.57{\pm}2.67$ vs. $3.64{\pm}2.30$ ; p=0.013) of girls were significantly higher than for boys. But, boys in the fourth quartile of CDI(CDI$\geq$29) and BAI(BAI$\geq$32) were at significantly elevated risk for sleep disturbances more than for girls after adjustment for sex, history of psychiatric treatment(CDI odd ratio, 14.66 ; 95% CI, 4.17-51.53, BAI odd ratio, 32.99 ; 95% CI, 4.26-255.39). Conclusion : The results suggest that high CDI, BAI score appears to increase the risk for developing sleep disturbances in boys more than girls.

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Effects of Minor Stressful Events on Sleep in College Students (대학생에서 스트레스가 수면에 미치는 영향)

  • Kang, Seung-Gul;Yoon, Ho-Kyoung;Ham, Byung-Joo;Choi, Yun-Kyeung;Kim, Seung-Hyun;Joe, Sook-Haeng;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.48-55
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    • 2002
  • Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

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Prevalence of Arthritis and Health Behavior Related Risk Factors of the Older Residents in Andong Rural Area (안동 농촌지역 중년 및 노인 주민의 관절염 유병율과 건강습관 관련 위험요인 분석)

  • Lee, Hye-Sang;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.9
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    • pp.1187-1194
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    • 2009
  • This study was performed to estimate the prevalence and the risk factors of arthritis in Andong rural area in 2003. The subjects were 1,462 people (544 males, 818 females) aged 45 years and over. The arthritis group was composed of 322 people (72 males, 250 females), diagnosed by doctor or self-diagnosed by the symptoms. Prevalence of arthritis was higher in female (27.2%) compared to male (13.2%). Mean age of arthritis group was significantly higher than that of normal group (male 66.2 vs 62.8, female 62.6 vs 60.1, p<0.001). The anthropometric measurements, such as % body fat, body mass index (BMI), and waist circumference, and the biochemical measurements, such as plasma triglyceride and total cholesterol level, were significantly higher only in female (not in male) arthritis group than those in normal group. Health related lifestyle factors, such as smoking, alcohol drinking, and exercise, were not different between both groups. The risk factors for arthritis were analyzed using the multiple logistic regression method and expressed as odds ratio (OR). The results showed that female compared to male (OR=1.983), over 65 years compared to 45$\sim$64 years (male OR=2.769 and female OR=1.461), and obese female subjects (not for male) by % body fat ($\geq$32% OR=2.035) or BMI ($\geq$25 kg/$m^2$ OR=1.556) showed significantly higher risk factors for arthritis. Regarding nutrient intakes, higher intakes of fat (OR=1.443), calcium (OR=1.503), iron (OR=1.518) and vitamin A (OR=1.390) in female seemed to be risk factors. In contrast to female, higher intakes of vitamin A (OR=0.526) and riboflavin (OR=0.582) seemed to decrease the risk for arthritis in male. This study revealed that the prevalence of arthritis was significantly higher in female and aged individuals. Also, in order to decrease the prevalence and/or prevention of arthritis, female should prevent overfatness and decrease some nutrient intakes, while male should increase their intakes.

Clinical Manifestation and Treatment Outcome of Lupus Nephritis in Children (소아 루프스 신염의 임상양상 및 치료결과)

  • Park Jee-Min;Shin Jae-Il;Kim Pyung-Kil;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.155-168
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    • 2002
  • Purpose; Systemic lupus erythematosus(SLE) is an autoimmune disease with multi-system involvement and renal damage is a major cause of morbidity and mortality in children. Renal involvement is more common and severe in children than in adults. Therefore, renal biopsy plays a crucial role in planning effective therapy. In this study, we investigated the clinical and pathological findings of lupus nephritis in children to aid clinical care of the disease. Methods: The clinical and pathological data of 40 patients who were diagnosed as SLE with renal involvement in Shinchon Severance Hospital from Jan. 1990 to Sep. 2002 were analyzed retrospectively. Results: The ratio of male to female patients was 1:3 and the median age at diagnosis was 12.1(2-18) years old. FANA(95.0%), anti-ds DNA antibody(87.5%), malar rash(80.0%) were the most common findings among the classification criteria by ARA. Microscopic hematuria with proteinuria(75.0%), nephrotic syndrome(55.0%), and microscopic hematuria alone(15.0%) were the most common renal presentations in the respective order at diagnosis. There were 27 cases with WHO class IV lupus nephritis confirmed by renal biopsy and 3 cases with pathological changes of WHO class type. Different treatment modalities were carried out : prednisolone only in 5 cases, prednisol-one+azat-hioprine in 9 cases, prednisolone+azathioprine+intravenous cyclophosphamide in 14 cases, prednisolone+cyclosporine A+intravenous cyclophosphamide in 12 cases, plasma exchange in 9 cases and intravenous gamma-globulin in 2 cases. The average follow-up period was $51.8{\pm}40.5$ months. During $51.8{\pm}40.5$ months. During follow-up, 4 patients expired. The risk factors associated with mortality were male, WHO class IV and acute renal failure at diagnosis. Conclusion: Renal involvement was noted in 63.5% of childhood SLE, and 67.5% of renal lesion was WHO class IV lupus nephritis which is known to be associated with a poor prognosis. Therefore aggressive treatment employing immunosuppressant during the early stages of disease could be helpful in improving long-term prognosis. But careful attention should be given to optimize the treatment due to unique problems associated with growth, psychosocial development and gonadal toxicity, especially in children.

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Changes in Subjective Symptom, Tear Film Stabilization and Blinking Rates when Wearing RGP Lenses with Different Polishing Conditions for Certain Period of Time (연마상태가 다른 RGP렌즈의 일정기간 착용 시 렌즈착용자의 자각적 증상, 눈물막 안정 및 순목횟수 변화)

  • Park, Mijung;Kim, Hyo Gyum;Bae, Jun Seob;Park, Jung Ju;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.1
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    • pp.31-42
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    • 2014
  • Purpose: The present study was conducted to investigate the effect of the physical properties of RGP lens induced by lens polishing on the actual wearer's subjective comfort, the tear film break-up time and the blinking rate as a follow-up study that revealed the relationship between the lens physical properties during lens manufacturing and lens wearer's factors. Methods: RGP lenses made from the three different polishing conditions (25, 50 and 100 seconds) were applied on 28 eyes of 17 subjects, aged 20 to 29 years, without any known disease and surgical history in the eyes. While the subjects were asked to wear the RGP lenses longer than a week, the questionnaire for the comfortability was administered everyday. Subjective and objective tear break-up time and blinking rate of the wearers were further measured. Results: The wearer's subjective comfortability showed some difference in the type of discomfort and satisfaction score according to the polishing status when wearing RGP lenses made from different polishing conditions longer than a week, and a bigger difference in satisfaction score induced by polishing condition was especially shown in experienced RGP lens wearer rather than un-experienced wearer. In the case of RGP lens wearer compared with the ones without the wearing experience, as the wearing time increased subjective and objective tear break-up time were increased and the blinking rate was decreased. However, subjective and objective tear break-up time were tended to decrease with even longer wearing time when wearing the RGP lens made from the polishment for 100 seconds. Conclusions: These results confirmed that the optimization of physical properties of the lens may not give the same effect on the wearer's subjective and objective symptoms and other factors when actual wearing. From the results, it can suggest that the success rate of RGP lens wear may be changed by physiological factors such as the stabilization of wearer's tear film, comfortability and lens wearing experience when wearing RGP lens based on 'The manufacturing standard for soft contact lens/hard contact lens' provided by Korea Food and Drug Administration.

The Normal Predicted Value of Peak Expiratory Flow(PEF) Measured by the Peak Flow Meter and Correlation Between PEF and Other Ventilatory Parameters (Peak Flow Meter로 측정한 최대호기류속도(PEF)의 추정정상치 및 가타 환기기능검사와의 상관관계)

  • Kim, Min-Chul;Kwon, Kee-Buem;Yim, Dong-Hyun;Song, Chang-Seuk;Jung, Yong-Seuk;Jang, Tae-Won;Yeu, Ho-Dae;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1000-1011
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    • 1998
  • Background: For the diagnosis or evaluation of airway obstruction in bronchial asthma and chronic obstructive lung disorders, various parameters derived from the forced expiratory volume curve and maximal expiratory flow volume curve have been used. Recently the peak expiratory flow(PEF) measured by the peak flow meter is widely used because of its simplicity and convenience. But there were still no data of the predicted normal values measured by the peak flow meter in Korea. This study was to obtain the predicted normal value of PEF and to know the accuracy of this value to predict $FEV_1$. Method: The measurements of PEF by the MiniWright peak flow meter and several parameters derived from the forced expiratory volume and maximal expiratory flow volume curves by the Microspiro HI 501(Chest Co.) were done in 129 men and 125 women without previous history of the respiratory diseases. The predicted normal values of parameters according to the age and the height were obtained, and the regression equation of $FEV_1$ by PEF was calculated. Results: The predicted normal values of PEF(L/min) were -2.45$\times$Age(year) +1.36 $\times$ Height(cm)+427 in men, and -0.96 $\times$ Age (year) + 2.01 $\times$ Height (cm) + 129 in women. FEFmax derived from the maximal expiratory flow volume curve was less than by 125 L/min in men and 118 L/min in women respectively compared to PEF. $FEV_1$(ml) predicted by PEF was 5.98 $\times$ PEF(L/min) + 303 in men, and 4.61 $\times$ PEF(L/min) + 291 in women respectively. Conclusion : The predicted normal value of PEF measured by the peak flow meter was calculated and it could be used as a standard value of PEF while taking care of patients with airway obstruction. $FEV_1$, the gold standard of ventilatory function, could be predicted by PEF to a certain extent.

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Plasma Levels of Cytokines in Patients with Postpartum Depression (산후우울증 환자에서 혈장 Cytokine의 농도변화에 대한 전향적 연구)

  • Lee, Younjung;Kim, Yong-Ku;Kim, Kye-Hyun;Lee, Bun-Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.177-184
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    • 2020
  • Objectives : Postpartum depression is known to occur in 10-15% of mothers. The concentration of cytokine varies depending on stress, depression, pregnancy and general medical conditions. We hypothesized that the concentration of cytokines may be related to reproduction and childbirth, and that women with postpartum depression would show alterations in cytokines levels. Methods : A total of 104 pregnant women were selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups perinatal non-depression controls (n=61), postpartum depression-recovery (n=18), and postpartum depression (n=25). Results : The plasma concentration of TGF-β1, IGF-1 was higher in the pregnant group than in non-pregnant controls (TGF-β1 ; p<0.01, IGF-1 ; p=0.026). At 24 weeks of pregnancy and 6 weeks of delivery, there were no significant differences in the plasma concentration of TGF-β1, IGF-1, β-NGF, IL-2, IL-4, IL-6, IFN-γ, TNF-α between the three groups. There was no statistically significant difference in all three groups during the course of depression in pregnant women. Conclusions : This study found significant difference in plasma cytokines concentrations between non-pregnant controls and perinatal non-depression controls.

Peak Expiratory Flow(PEF) Measured by Peak Flow Meter and Correlation Between PEF and Other Ventilatory Parameters in Healthy Children (정상 소아에서 최고호기유량계(peak flow meter)로 측정한 최고호기유량(PEF)와 기타 환기기능검사와의 상관관계)

  • Oak, Chul-Ho;Sohn, Kai-Hag;Park, Ki-Ryong;Cho, Hyun-Myung;Jang, Tae-Won;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.3
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    • pp.248-259
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    • 2001
  • Background : In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of $FEV_1$ in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of $FEV_1$ especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and $FEV_1$ in healthy children. Method : PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children(age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of $FEV_1$ by PEF were derived. Results : 1. The regression equation for PEF(L/min) was: $12.6{\times}$age(year)+$3.4{\times}$height(cm)-263($R^2=0.85$) in boys, and $6{\times}$age(year)+$3.9{\times}$height(cm)-293($R^2=0.82$) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for $FEV_1$(ml) by PEF(L/min) was:$7{\times}$PEF-550($R^2=0.82$) in boys, and $5.8{\times}$PEF-146 ($R^2=0.81$) in girls, respectively. Conclusion : This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for $FEV_1$, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.

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