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Follow-Up Study of 6-Month Short Course Chemotherapy for Pulmonary Tuberculosis with 2SKHRZ/4HRZ (폐결핵에서 6개월 단기 항결핵 화학요법의 추구검사)

  • Koh, Hyung Ki;Kang, Yun Jung;Lim, Seong Yong;Shin, Jong Wook;Choi, Jae Sun;Yoo, Ji Hoon;Park, In Won;Choi, Byoung Whui;Hue, Sung Ho;Seo, Seung Chun
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.852-861
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    • 1996
  • Background : Many clinicians have experienced the difficulty of decision on termination of antituberculosis chemotherapy after the 6th month due to relapse of disease. There is still controversy in the effect of 2S(K)HRZ/4HRZ 6-month short course chemotherapy including pyrazinamide for 6 months in patiems with pulmonary tuberculosis. And there is no long term follow-up study of 6-month short course chemotherapy for pulmonary tuberculosis in korea. So we had performed the study to find the result of 6-month antituberculosis chemotherapy for 4 years. Method : We studied prospectively the effect of 2S(K)HRZ/4HRZ in one hundred-fifty patients with pulmonary tuberculosis and followed up fifty-nine patients for more than 1 year to 4 years after the completion of 6-month short course therapy. Results : 1) Out of one hundred-fifty patients, seventy-two patients(48%) completed the prescribed 6-month chemotherapy. Sixty-eight patients(45.3%) have experienced premature discontinuation and the most common cause of premature discontinuation was drop-out against advice(thirty-six patients, 24%). Ten patients(6.7%) were treated beyond the 6 months mainly due to irregular treatment. 2) Fifty-nine patients(81.9%) among seventy-two patients with completed treatment have been followed up for more than 1 year and 32 patients(44.4%) for more than 4 years. There was three relapse patients of whom two patients have experienced relapse of pulmonary tuberculosis within 1 year after the termination of chemotherapy. 3) Among one hundred-thirty-four patients who have been assessible for more than two months of chemotherapy, including the patients who experienced within 2 months, there were eighty-two patients(61.2%) who have experienced adverse reactions and the treatment regimen was changed only in thirteen patients(9.7%). The most frequent cause of adverse reactions was arthralgia and/or hyperuricemia, which had occurred in 33 patients(24.6%). Conclusion : In a university hospital in Korea, 6-month shot course chemotherapy of 2S(K)HRZ/4HRZ had unnegligible relapses and premature discontinuation. Therefore, change of the regimen might be carefully considered by drug susceptibility results. Close monitoring of patients, retrial of sputum exam and radiologic evaluation during treatment might be required in the endemic area of drug resistant strains like in Korea. Further study about the effect of 6-month short course chemotherapy including pyrazinamide for 6-month might be needed.

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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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Preselection of Bovine Blastocysts Expressing Exogeneous Gene Following Microinjection (외래유전자를 주입한 소 수정란에서 형질전환가능 수정란의 선발)

  • 공일근
    • Korean Journal of Animal Reproduction
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    • v.21 no.2
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    • pp.167-176
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    • 1997
  • This study was carried out to evaluate the potential for preselection of transgenic embryos prior to transfer into recipient animals. In these experiments, I used a 3.2 kb transgene which contained the neomycin resistance gene (neo) and lac Z gene driven by the $\beta$ actin promoter (iacZ Ineo). Oocytes were aspirated from abattoir ovaries, matured in TCM-199 supplemented with 10% fetal bovine serum (FBS), 5 ${\mu}\textrm{g}$/ml LH, 0.5 ${\mu}\textrm{g}$/ml FSH, 100 unit/ml penicillin, and 100 ${\mu}\textrm{g}$/ml streptomycin for 22 to 24 hrs then inseminated with a sperm suspension of 1 X 10$^6$ sperm/ml containing 5 ${\mu}\textrm{g}$/ml of heparin. At 18-20 hrs after insemination, cumulus cells were removed by vortexing and pronuclei of centrifuged zygotes microinjected with the lacZ/neo construct (3 ng/$\mu$l). All cultures were carried out in CR1aa with transfected BRL monolayers containing 3 mg/ml BSA, 20 $\mu$/ml NEM amino acids and 40 $\mu$I/ml BME amino acids. To identify the appropriate concentration of G418 for selection, non-microinjected zygotes were cultured in the presence of 0, 50, 100 and 200 $\mu$g/ml of G418. After 8 days of culture in these treatments, 44/145 (30.3%), 13/150 (8. 7%), 1/151 (0.7%) and 0/134 (0.0%) devel-oped to the blastocyst stage in 0, 50, 100 and 200 $\mu$g/ml of G418, respectively. A total of 1,127 zygotes were microinjected and placed into culture (without G418) and subsequently 710 (63.0%) cleaved. At 48 hrs post-injection, embryos ($\geq$2-cell) were randomly assigned to control (medium alone) or G418 (100 ${\mu}\textrm{g}$/ml) treatments. A control culture of 740 non-microinjected embryos from the same replicates of embryos were also placed into control medium. After 8 days in culture, 54/343 (15.7%) and 22/367 (6.0 %) of the microinjected embryos developed to the blastocyst stage in control and G418 media, respectively. A total of 151/740 (27.2%) of the non-microinjected embryos placed in the control medium developed to the blastocyst stage. The blastocysts in the control treatment had a mean of 70.7 ${\pm}$ 4.7 cells of which 23.1 ${\pm}$ 2.6 (32.7%) stained for $\beta$-Gal activity. B1astocysts in the G418 treatment had a mean of 48.8${\pm}$7.5 cells of which 40.3 ${\pm}$ 4.1 (82.6%) stained for $\beta$-Gal ac tivity (P<0.05). In the control treatment 26 of 30 (87.0%) blastocysts had some cells with $\beta$-Gal activity while all of the blastocysts in the G418 treatment had some cell with $\beta$-Gal ac tivity (P<0.05). However, ICM colonies in either control or G418 treatments were not expressed any epiblast cell except of trophetoderm celIs. The $\beta$-actin promoter/lacZ gene may not be e expression or silence expression in epiblast cells These results clearly show an enrichment of blastocysts expressing the transgene in the majority of their cells after culture in the presence of G418. The exogeneous gene was not express a and silence in ICM colonies especiallly epiblast cells except of trophectederm cells. Even though the higher rate cell number expressed of exogeneous gene in the G418 treatments, a total cell number was decrease significantly (P<0.05) of which might be also drop of the establishment of ES like-cell colonies and production of transgenic animals. However, futher studies need to determine the viability of these selected embryos and the avability of production of transgenic offspring.

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Analysis on the source characteristics of three earthquakes nearby the Gyeongju area of the South Korea in 1999 (1999년 경주 인근에서 3차례 발생한 지진들의 지진원 특성 분석)

  • Choi, Ho-Seon;Shim, Taek-Mo
    • The Journal of Engineering Geology
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    • v.19 no.4
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    • pp.509-515
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    • 2009
  • Three earthquakes with local magnitude ($M_L$) greater than 3.0 occurred on April 24, June 2 and September 12 in 1999 nearby the Gyeongju area. Redetermined epicenters were located within the radius of 1 km. We carried out waveform inversion analysis to estimate focal mechanism of June 2 event, and P and S wave polarity and their amplitude ratio analysis to estimate focal mechanisms of April 24 and September 12 events. June 2 and September 12 events had similar fault plane solutions each other. The fault plane solution of April 24 event included those of other 2 events, but its distribution range was relatively broad. Focal mechanisms of those events had a strike slip faulting with a small normal component. P-axes of those events were ENE-WSW which were similar to previous studies on the P-axis of the Korean Peninsula. Considering distances between epicenters, similarities of seismic waves and sameness of polarities of seismic data recorded at common seismic stations, these events might occurred at the same fault. The seismic moment of June 2 event was estimated to be $3.9\;{\times}\;10^{14}\;N{\cdot}m$ and this value corresponded to the moment magnitude ($M_W$) 3.7. The moment magnitude estimated by spectral analysis was 3.8, which was similar to that estimated by waveform inversion analysis. The average stress drop was estimated to be 7.5 MPa. Moment magnitudes of April 24 and September 12 events were estimated to be 3.2 and 3.4 by comparing the spectrum of those events recorded at common single seismic station.

Characteristic of Raindrop Size Distribution Using Two-dimensional Video Disdrometer Data in Daegu, Korea (2차원 광학 우적계 자료를 이용한 대구지역 우적크기분포 특성 분석)

  • Bang, Wonbae;Kwon, Soohyun;Lee, GyuWon
    • Journal of the Korean earth science society
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    • v.38 no.7
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    • pp.511-521
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    • 2017
  • This study analyzes Two-dimensional video disdrometer (2DVD) data while summer 2011-2012 in Daegu region and compares with Marshall and Palmer (MP) distribution to find out statistical characteristics and characteristics variability about drop size distribution (DSD) of Daegu region. As the characterize DSD of Daegu region, this study uses single moment parameters such as rainfall intensity (R), reflectivity factor (Z) and double moment parameters such as generalized characteristics number concentration ($N{_0}^{\prime}$) and generalized characteristics diameter ($D{_m}^{\prime}$). Also, this study makes an assumption that DSD function can be expressed as general gamma distribution. The results of analysis show that DSD of Daegu region has ${\log}_{10}N{_0}^{\prime}=2.37$, $D{_m}^{\prime}=1.04mm$, and c =2.37, ${\mu}=0.39$ on average. When the assumption of MP distribution is used, these figures then end up with the different characteristics; ${\log}_{10}N{_0}^{\prime}=2.27$, $D{_m}^{\prime}=0.9mm$, c =1, ${\mu}=1$ on average. The differences indicate liquid water content (LWC) of Daegu distribution is generally larger than MP distribution at equal Z. Second, DSD shape of Daegu distribution is concave upward. Other important facts are the characteristics of Daegu distribution change when Z changes. DSD shape of Daegu region changes concave downward (c =2.05~2.55, ${\mu}=0.33{\sim}0.77$) to cubic function-like shape (c =3.0, ${\mu}=-0.13{\sim}-0.33$) at Z > 45 dBZ. 35 dBZ ${\leq}$ Z > 45 dBZ group of Daegu distribution has characteristics similar to maritime cluster of diverse climate DSD study. However, Z > 45 dBZ group of Daegu distribution has a difference from the cluster.

A Study on the Problem of Organic Image in the 20th Post-paintings (20세기 후기회화에 있어서 유기 이미지의 문제)

  • Park Ji-Sook
    • Journal of Science of Art and Design
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    • v.3
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    • pp.145-177
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    • 2001
  • The artist's interest has been captivated by ecological phenomena in Nature. Her keen captivation has then been focused into plastic art depicting the image of primitive life. The wide sweep of her work encompasses the totality of nature which consists of the human's subconscious power and imagination which she then portrays by organic images. These organic images are in contrast to scientific, mathematical and logical inference and consciousness. This research examines the character of the organic images in modern art by her analysis of some representative works by others. The image is an essential concept in the art which appeared in very different ways and in different perspectives. The image in the artwork appears to be the realistic expression until the early part of the 20th Century. Well into the 20th Century, it began being expressed in various ways such as combined images by imagination which is combined or rejected in the story of artwork. It also began being expressed by transferred images by changed original conditions. It is the main purpose of this research is to study of various expressions of organic images in the artwork of the Post-Modernism era. The character and meaning of organic image painting helps people to approach the human instinct more easily to find out the natural essence. It is also an objective of the organic image to tenderise our human sensibilities, thus helping us to regain vitality and recover our poor humanity in the barren wilderness of modern society. 'Life communion with nature' is a meeting point and common ground for Oriental Philosophy and organic image painting. Through this research, organic image painting is characterised in the four following ways : 1st) Organic image painting seeks regularity and perfection of outer shapes, in contrast to disordered and deformed nature, resulting in organic and biotic formalistic mode of plastic art. 2nd) Organic image painting seeks the formative. 3rd) Organic image painting pursues the priceless dignity of life by researching the formatted arrangement and figure, which contains primitive power of life. 4th) Organic image painting makes crystal clear the power of human and nature, which is a historic and biological phenomenon. This, in turn, exposes the humanistic view of the world from modern society best characterised in lost self-understanding, isolation and materialism. The representative organic image painting artists are Elizabeth Murray, Kusama Yayoi, and Niki do Saint Phalle. Elizabeth Murray used shaped canvas and a round construction of relief works. Kusama Yayoi used Automatistic expressionism originating from the realms of unconsciousness and which is represented by the mass and shape of a water drop. Niki do Saint Phalle shows the transcendence of universal life and anti-life to respect the dignity of life and the eco-friendliness relationship of human and nature in the post-modernism in art history. This is accomplished by surrealistic, symbolic, fantastic and humoristic expression. These three artists' works express the spirit of the organic image in contemporary art. It contains the stream of nature and life to seek not only the state of materialism in the reality, but also the harmonized world of nature and human which has almost lost the important meaning in modern times. Finally, this organic image is the plastic language of the majestic life. It is the romantic idea that the intimacy of nature and the universe and Surrealism, which emphasizes the unconsciousness , is the source of truth and spirit. Also it is influenced by primitive art and abstract art. According to this research, the subject 'Research About Organic Images' is not only an important element in the plastic arts from primitive society to the present, but is also fundamental to an true understanding of Post-Modernism.

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A Study on the Physcial and Mechanical Properties of Hot - Compressed Wood (열압처리(熱壓處理) 목재(木材)의 이학적(理學的) 성질(性質)에 관(關)한 연구(硏究))

  • Park, Young-Kyu;Chung, Dae-Kyo
    • Journal of the Korean Wood Science and Technology
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    • v.15 no.4
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    • pp.45-58
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    • 1987
  • This study was carried out to improve the physical and mechanical properties of Pupulus alba $\times$ glandulosa treated by the heat and compression. The results obtained were as follows. 1. The specific gravity of the wood was conspicuously increased by the lincreasing of pressing level. 2. The shrinkage of the wood was increased. by the increasing of pressing level. The radial shrinkage was 6.41-8.81%, the tangential shrinkage was 8.98-19.81 %, and the longitudinal shrinkage was 1.46-1.91 %. Comparing to the untreated stock, the rate of increase was 48.7-104.4% in radial direction. 1.7-124.4% in tangential direction and 60.4-109.9% in longitudinal direction, respectively. 3. The rate absorption of 30% compressed stock was Similar to that of untreated stock. but the rate of absorption of 40 % or more compressed stock was increased highly. 4. The thickness swelling of the wood was not changed in radial direction at pressing level, but was conspicuously increased in tangential direction under the pressing level of 40% and 50%. 5. The heat and compression treatment affected on the mechanical properties of the wood. The longitudinal compressive strength was increased under the pressing level of up to 40%, but was decreased under the pressing level of 50%. The bending strength was not changed under the compression percentage of up to 30%, but was decreased under the pressing level of 30% or more. And, the absorbed energy in impact bending was increased to 128% under the pressing level of up to 30%, but was decreased under the pressing level of 30% or more. Conclusionly, the mechanical properties of the wood was improved by the heat and compression treatment, but the strength of the wood was decreased under the pressing level of a certain level or more(in this study, pressing level of 30% or more). This was because of the wood deterioration due to the deformation(shrinkage, crack, failure) of wood tissues induced by the heat and compression treatment, the heat analysis of wood components induced by the heating, and the drop of the degree of polymerization.

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The Effects of Aroma Self Massage in Hands on Pain, Depressive Mood and Anxiety in Breast Cancer Patients (유방암 환자의 통증, 우울 및 불안 증상 조절에 아로마 자가 치료의 효과)

  • Sohn, Keun-Joo;Kim, Myung-Ja;Lee, June-Young;Lee, Jae-Bok;Kim, Su-Hyun;Kim, Jong-A;Jung, Hoe-Hyun;Choi, Seung-Wan;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.18-29
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    • 2005
  • Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

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Effect of GA3 Treatment on Bud Formation, Fruit Set, and Enlargement in Ardisia pusilla (GA3에 의한 산호수의 화아형성과 착과 및 비대 증진효과)

  • Kil, Mi-Jung;Huh, Yeun-Joo;Kwon, Young-Soon
    • Horticultural Science & Technology
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    • v.29 no.6
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    • pp.555-560
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    • 2011
  • The objective of this study was carried out to investigate the proper plant growth regulator for increasing the number of flower, fruit set, and to enlarge the size of the berries in Ardisia pusilla. Flower bud formation was used rooted cutting, and fruit set, enlargement, and coloration of fruit were used with two years-old. $GA_3$ concentrations were treated with 0, 100, 200, or $400mg{\cdot}L^{-1}$. Flower bud formation was effective in $400mg{\cdot}L^{-1}$ $GA_3$ and it was 1.8 times greater than control. Plant growth regulators were applied by foliar spray at full bloom stage to increase the fruit set. As a result, $GA_3$ was the most effective for increasing fruit set. Also, auxins of 4-CPA (Tomatotone, Donbu hitech Co., Korea) and dichloprop triethanol amine (Antifall, Bayer Crop Science Co., Ltd., Korea) were effective. When $GA_3$ concentrations of 0.5 and $1.0mg{\cdot}L^{-1}$ were used, fruit set (%) reached to 70% and 77%, respectively. Effectiveness of $GA_3$ was 1.8 times greater than control. Also, auxins, dichloprop triethanol amine increased to about 7-12% during fruit setting, but cytokinin and anti-gibberellin were ineffective. To investigate the fruit enlargement and coloration, $GA_3$ was treated with 0.3, 0.6, and $1.2mg{\cdot}L^{-1}$. Fruit enlargement was achieved to about 15% by $GA_3$ $0.6mg{\cdot}L^{-1}$ when $GA_3$ was treated 3 times at the interval of 1 month per treatment when fruit size was about 2-3mm (after full-blooming two months). But anthocyanin contents for coloration of fruit skin were not significant according to $GA_3$ concentration. The results showed that $GA_3$ enhanced bud formation, fruit set and enlargement of fruit size in Ardisia pusilla.

A Preliminary Study on Emotion, Self-Esteem and Quality of Life in the Patients with Chest Pain (흉통 환자에서의 정서, 자존감 및 삶의 질에 대한 예비 연구)

  • Park, Sook Hyun;Jae, Young Myo;Lee, Dae Su;Jang, Saeheon;Choi, Jin Hyuk;Lee, Han Cheol
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.120-126
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    • 2012
  • Objectives : The objective of this study is to measure and to compare the rate of depression, anxiety, self-es-teem and the quality of life of the patients with chest pain. Based on the result of this study, the necessity of the psychiatric assessment and treatment of the patients with chest pain is emphasized. This study is a preliminary research for a larger scale investigation to be carried out in the future. Methods : Thirty nine patients with chest pain who visited Cardiovascular Division of Dept. of Internal Medicine Pusan National University Hospital and fourty normal control group(NC) were included in this study. The patients were classified into typical chest pain group(TCP, N=19) and atypical chest pain group(ACP, N=20) based on the cause of the pain. The cause was determined by cardiac computed tomography, exercise stress test, coronary angiography, and questionaires by a cardiology specialist. The patients were assessed with Beck Depression Inventory(BDI), State-Trait Anxiety Inventory(STAI), Rosenberg Self-Esteem Scale(RSES) and Korean version of the Smith Klein Beecham 'Quality of Life' scale(KvSBQOL). Results : 1) When the risk factors of cardiac disease is compared, most of the factors(Hypertension, Diabetes, Hyperlipidemia, Cerebral infarction) did not differ significantly among the two chest pain groups, except for the family history, for which TCP group showed higher risk than ACP group did. 2) As for the self-report questionaires scores, BDI score, which indicates the rate of depression, of both ACP group and TCP group was significantly higher than that of NC group in BDI for depression. STAI score, which measures anxiety, was also significantly high in both groups. Especially, STAI score was significantly higher in ACP group than TCP group. 3) In the aspect of self-esteem and quality of life, ACP group scored significantly lower than TCP group and NC group. The scores for TCP group and NC group did not differ significantly. Conclusions : The patients with chest pain showed more depression and anxiety than normal control group, regardless of the cause of the pain. However, TCP group did not show significantly larger drop in self-esteem and quality of life than ACP group did. This result implies that early psychiatric assessment and treatment is needed for the patients with such chest pain, since it is highly likely that the pain would lead to lower quality of life of the patients.

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