• Title/Summary/Keyword: Functional impairment

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Pharmacological Characterization of (10bS)-1,2,3,5,6,10b-hexahydropyrrolo[2,1-a]isoquinoline Oxalate (YSL-3S) as a New ${\alpha}_2$-Adrenoceptor Antagonist

  • Chung, Sung-Hyun;Yook, Ju-Won;Min, Byung-Jun;Lee, Jae-Yeol;Lee, Yong-Sup;Jin, Chang-Bae
    • Archives of Pharmacal Research
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    • v.23 no.4
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    • pp.353-359
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    • 2000
  • ${\alpha}_2$-Adrenoceptor antagonists, which can enhance synaptic norepinephrine levels by blocking feedback inhibition processes, are potentially useful in the treatment of disease states such. as depression, memory impairment, impotence and sexual dysfunction. (10bS)-1,2,3,5,6,10b-Hexahydropyrrolo[2,1-a]isoquinoline oxalate (YSL-3S) was evaluated in several in vitro biological tests to establish its pharmacological profile of activities as an ${\alpha}_2$-adrenoceptor antagonist. Saturation binding assay revealed that$^{3}[H]$rauwolscine bound to the $\alpha$$_2$-adrenoceptors with a Kd value of 6.3$\pm$0.5 nM and a Bmax value of 25l$\pm$39 fmol/mg protein in rat cortical synaptic membranes. Competitive binding assay showed that YSL-3S inhibited the binding of$^3[H]$rauwolscine (1 nM) in a concentration-dependent manner with a Ki value of 98.2$\pm$12.1 nM while it did not inhibit the binding of [$^3$H]cytisine (1.25 nM) to neuronal nicotinic cholinergic receptors. The Ki values of yohimbine, clonidine and norepinephrine for $^3[H]$rauwolscine binding were 15.8$\pm$1.0, 40.1$\pm$5.9 and 40.0$\pm$11.5 nM, respectively. In addition, the binding affinity of YSL-3S for ${\alpha}_2$-adrenoceptors was higher than that of its antipode and the racemic mixture. The functional activity of YSL-3S at the presynaptic ${\alpha}_2$-adrenoceptors was assessed using the prostatic portion of the rat vas deferens. Clonidine inhibited field-stimulated contractions of the vas deference in a dose-dependent manner. The presence of YSL-3S or yohimbine caused a parallel, rightward the dose-response curve of clonidine in a dose-dependent manner, indicating an antagonistic action at the presynaptic ${\alpha}_2$-adrenoceptors. The $pA_2$values of yohimbine and YSL-3S were 7.66$\pm$0.13 and 6.64$\pm$0.18, respectively. The results indicate that YSL-3S acts as a competitive antagonist at presynaptic ${\alpha}_2$ -adrenoceptors with a potency approximately ten times lower than yohimbine, but is devoid of binding affinity for neuronal nicotinic cholinergic receptors.

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The Effect of home education convergence program on arm functions, occupational performance, quality of life, and depression in mastectomy patients with arm function impairment (팔기능 장애가 있는 유방암절제술 환자의 가정치료융합프로그램이 작업수행력, 삶의 질, 우울감에 미치는 효과 연구)

  • Kim, Ko-Un;Oh, Hye-Won
    • Journal of Digital Convergence
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    • v.14 no.9
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    • pp.515-523
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    • 2016
  • This study applied a home therapy convergence program to patients who had undergone mastectomy and examined its effects on their arm functions, occupational performance, quality of life, and depression. The number of subjects was 20. The subjects were those who visited an occupational therapy room as outpatients and received the intervention twice per week, forty minutes per each time, for 12 weeks. In order to look at their arm functions before and after the intervention, K-DASH was employed and their edema was measured with a tape line. In order to examine their occupational performance, quality of life, and depression before and after the intervention, COPM, FACT-B, and BDI, respectively, were utilized. After the intervention, their arm functions significantly increased, but their edema did not significantly decrease, their occupational performance and quality of life significantly improved, and their depression was significantly reduced. Thus, a home education convergence program positively affected mastectomy patients' arm functions, occupational performance, quality of life, and depression.

Postoperative long-term results for the comparison of the symmetry of the upper lip during lip closure according to Millard and Pfeifer

  • Kauffmann, Philipp;Cordesmeyer, Robert;Fouellefack, Gisele Awondzeko;Schminke, Boris;Wiese, Karl-Gunther
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.18.1-18.6
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    • 2018
  • Background: Clefts in newborns are associated with severe morphological and functional impairment. Especially the lip is of importance as if the treatment result is unsatisfactory, it can lead to psychological changes in the patient. Different operative procedures have been developed over the last decades. The aim of the presented study was the comparison of the surgical techniques according to Millard and Pfeifer regarding the temporal development of the postoperative symmetry of the lip height and mouth width. Methods: Digitized photographs of patients from the department of oral and maxillofacial surgery at the University of Göttingen were evaluated from 1979 to 1996. With a video analysis program, the lip height and mouth width were analyzed regarding the symmetry. We demonstrated the symmetry values over a period of 8 years in order to show the influence of growth on postoperative results. Results: The development of the vertical symmetry of the Philtrum and the lip vermillion on the cleft side in comparison to the healthy side behaves differently depending on Pfeifer and Millard. The lip height of the cleft lip was shorter in both techniques than on the healthy side, but Pfeifer's difference was significantly more pronounced. The lip vermillion height on the cleft side was slightly shorter in the Millard group and markedly larger in the Pfeifer group. Both techniques can achieve good symmetry results for the vertical dimension of the lip. According to Pfeifer, the development of the horizontal dimension on the cleft side is bigger within the first 4 years than on the healthy side; according to the Millard technique, the horizontal development is smaller. These differences are greater within the first 6 years and approach between the 6th and 8th year. Conclusions: The Millard technique demonstrates better results concerning the philtrum and vermillion symmetry during growth within the first 6 years. Over the whole study period, growth corrects the philtrum and vermillion symmetry within the Pfeifer group.

THE SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY FINDINGS IN DEVELOPMENTAL LANGUAGE DISORDERS (발달성언어장애아(發達性言語障碍兒)의 단일광자방출전산화단층촬영(單一光子防出電算化斷層撮影) 소견(所見)에 관한 연구)

  • Park, Jin-Seng;Cho, Soo-Churl;Lee, Myung-Chul
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.46-55
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    • 1992
  • The pathophysiology of developmental language disorder is a highly controversial matter. In order to investigate the neural mechanisms involved in developmental language disorders, the authors studied three dimensional regional cerebral blood flow(rCBF) using Tc-99mH-MPAO in 42 children with developmental language disorders. The results are summarized as follows : 1) 61.9% (26/42) of this series revealed decreased perfusion in SPECT. 2) Regions of hypoperfusion were seen in cerebral cortex(47.6%, 20/42), thalamus(33.3%, 14/42), basal ganglia(11.9%, 5/42) and cerebellum(7.1%, 3/42). This study suggests that developmental language disorder could be due to specific functional impairment of the local brain regions which could not detected by conventional investigations such as brain CT or EEG.

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Oxaliplatin-induced Peripheral Neuropathy in Patients with Advanced or Metastatic Gastric Cancer (진행성 또는 전이성 위암 환자에 있어서 Oxaliplatin 투여로 인한 말초신경통증 분석)

  • Park, Ae-Ryoung;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.18-22
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    • 2009
  • Oxaliplatin is a tolerable and effective drug of choice in the treatment of advanced or metastatic gastric cancer. However, it has many dose-limiting neurotoxicities. This study was performed to assess the incidence and types of oxaliplatin-related neurotoxicities. Sixty-four patients receiving oxaliplatin-involved regimen as salvage therapy on metastatic gastric cancer or as the first-line therapy on advanced gastric cancer were evaluated during the period between September 1, 2006 and February 29, 2008. The patients were treated with oxaliplatin 100 $mg/m^2$ and leucovorin 100 $mg/m^2$ simultaneously as 2-hour-lasting infusion on Day-1 followed by 5-FU 1200 $mg/m^2$ as a 22-hour-lasting continuous infusion both on Day-1 and Day-2 by every other week. We developed questionnaires to evaluate patient-recognized neurotoxic symptoms rather than the observer-described events. Surveys were completed at bedside or via telephone interview. Acute and chronic neurotoxicities were graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC, version 3) as well as the Oxaliplatin-specific Neurotoxicity Scale. The Grade-3 neuropathy was reported in 19% of the patients (n=12) and grade-1/2 neuropathy occurred in 70% (n=45). The most common symptom was cold-related dysesthesia (83%) regarded as nociperception by the patients. Some patients (19%) experienced functional impairment affecting activities of daily living such as writing, buttoning, and walking. Even though 74% of the patients (42/57) were prescribed with gabapentin to reduce these peripheral symptoms, it did not appear to derive any benefit from this medication. It is suggested that notify the patients about their oxaliplatin-associated, debilitating symptoms, and educate them any self-care strategy at the initiating phase of the chemotherapy. Moreover, it needs to design the intervention studies regarding the prevention and management of the peripheral neuropathy.

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A Preliminary Study on Method for Evaluation and Diagnosis of Late Luteal Phase Dysphoric Disorder in Women - Focusing on Psychiatric Outpatients - (후기 황체기 불쾌기분 장애의 평가 방법 및 진단에 관한 예비 연구 - 정신과 외래환자를 대상으로 -)

  • Yi, Sang-Kyu;Joe, Sook-Haeng;Kwak, Dong-Il
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.115-125
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    • 1995
  • Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

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Quantitative Ga-67 Scintigraphy in patients with Silicosis: Comparison with Chest X-ray and Pulmonary Function (규폐증에서 Gallium-67 신티그라피의 정량적인 분석: 흉부 X-선과 폐기능검사와의 비교)

  • Shin, Kwang-Hyun;Sohn, Hyung-Sun;Chung, Yong-An
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.4
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    • pp.381-387
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    • 1999
  • Purpose: The International Labor Organization (ILO) has established an international standard for chest X-ray diagnosis of pneumoconiosis since 1980. However, there is a need for improved diagnosis and staging in occupational disease. We evaluated Ga-67 citrate scintigraphy quantitatively and correlated the scintigraphic findings with pulmonary function tests and chest X-ray results. Materials and Methods: Twenty-five patients underwent whole body scintigraphy with additional chest and abdomen images 48 hrs after intravenous injection of 185 MBq of Ga-67 citrate. Ten normal controls were also studied. Regions of interest (ROI) were drawn on the posterior image to measure counts from the liver and lungs (Lung/Liver Ratio). Results: L/L ratio according to the stages of chest X-ray classification were as follows; stage 0 (normal, n=10): $0.3948{\pm}0.0692$, stage 1 (n=10): $0.5763{\pm}0.1537$, stage 2 (n=11), $0.6849{\pm}0.1459$, stage 3 (n=4) $0.9913{\pm}0.0712$. There was a significant correlation between the scintigraphic L/L ratio and the X-ray stage (r=0.618, p<0.05). However, no significant correlation between L/L ratio and pulmonary function tests were observed (p>0.05). Conclusion: Quantitative Ga-67 scintigraphy can be a useful method for staging of silicosis. However, it is not a method to assess pulmonary functional impairment.

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The Effect of Leukoaraiosis on the Severity and Course of Delirium (백질변성이 섬망의 심각도 및 경과에 미치는 영향)

  • Choi, Won-Jung;Seok, Jeong-Ho;Oh, Seung-Taek;Chung, Tae-Sub;Kim, Jae-Jin
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.194-200
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    • 2018
  • Objectives : The significance of leukoaraiosis on brain magnetic resonance imaging (MRI) is uncertain, but it is often seen with vascular risk factors or in the context of cognitive impairment. We aimed to investigate the effect of leukoaraiosis on the severity and course of delirium. Methods : Periventricular hyperintensity and deep white matter hyperintensity on brain MRI were rated in 42 patients with delirium by semiquantative visual rating scale. Correlations between their grades and the scores of Korean version of Delirium Rating Scale-Revised-98 (K-DRS-R-98) were analyzed, and the interaction effects between the groups according to the levels of leukoaraiosis and two evaluation points were also analyzed. Results : The grade of deep white matter hyperintensity in the occipital lobe was positively correlated with the scores on the total, severity items, cognitive items, and non-cognitive items of K-DRS-R-98. The cognitive items scores of K-DRS-R-98 in the low grade group of periventricular hyperintensity showed significantly steeper decrease than the high grade group. Conclusions : A difference in severity or recovery speed of delirium according to the level of leukoaraiosis may result from disruption in brain functional connectivity. Our results have a clinical implication in that the severity and course of delirium can be possibly predicted using the level of leukoaraiosis.

The Definition of Frail Elderly and the Frailty Screening Assessment Tool: A Systematic Review (허약노인의 정의 및 허약 선별 평가도구에 관한 체계적 고찰)

  • Lee, Gyeong A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.3
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    • pp.43-56
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    • 2021
  • Objective : The objective of this study was to present the components of frailty by organizing the definitions of frail elderly and analyzing the tools used to screen them. Methods : This study searched for articles at involved frailty screening assessments in the elderly. Databases including CINAHL, Embase, Medline Complete, and PubMed were searched. The search terms were "assess" AND "frailty" AND "screening" AND ("frail elderly" OR "elderly"). Results : A total of 539 articles were identified by the search and 11 articles were selected. Frailty occurs due to the depressed function of multidimensional factors, and a frail elderly person is defined as one at high risk of health degeneration, functional impairment, and occurrence of disability, and having a high level of threat to life. Seven tools were selected from 11 articles. The most frequently used tool was the frailty phenotype, which was used in five articles (45.4%). The identified components of frailty were physical, activity participation, nutrition, psychological, social, overall health, and age. Conclusion : The results confirmed the definition and components of frailty. This study is expected to contribute to the future development of standardized evaluation tools for screening frail elderly individuals and intervention programs for the management of the frail elderly.

Investigating the Role of Microglia in Maternal Immune Activation in Rodent Models (모체 면역 활성화 유도 설치류 모델에서 미세아교세포의 역할 조사)

  • Hyunju Kim
    • Journal of Life Science
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    • v.33 no.5
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    • pp.429-435
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    • 2023
  • Epidemiological studies suggest that maternal infection, maternal stress, and environmental risk factors during pregnancy increase the risk of brain development abnormalities associated with cognitive impairment in the offspring and increase susceptibility to schizophrenia and autism spectrum disorder. Several animal models have demonstrated that maternal immune activation (MIA) is sufficient to induce abnormal brain development and behavioral defects in the fetus. When polyinosine:polycytodylic acid (poly I:C) or lipopolysaccharide (LPS), which is commonly used in maternal immune activation animal models, was introduced into a pregnant dam, an increase in pro-inflammatory cytokines and microglial activity was observed in the offspring's brain. Microglia are brain-resident immune cells that play a mediating role in the central nervous system, and they are responsible for various functions, such as phagocytosis, synapse formation and branching, and angiogenesis. Several studies have reported that microglia are activated in MIA offspring and influence offspring behavior through interactions with various cytokines. In addition, it has been reported that they play an important role in brain circuits through interactions with neurons and astrocytes. However, there is controversy concerning whether microglia are essential to brain development or lead to behavioral defects, and the exact mechanism remains unknown. Therefore, for the potential diagnosis and treatment of brain developmental disorders, a functional study of microglia should be conducted using MIA animal models.