• Title/Summary/Keyword: 스트레스 증상

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Retrospective Cohort Study on the Administration of Sedative for Delirium in Terminally Ill Cancer Patients and Survival Time (말기암환자의 섬망으로 인한 진정제 투약과 생존기간에 관한 후향적 코호트 연구)

  • Park, Hyoung Sook;Kim, Dae Sook;Bae, Eun Hee;Kim, Jung Rim;Seo, Jung Hwa;Yun, Jung Mi
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.119-126
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    • 2016
  • Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

Survey on the Using Frequency of Processed Foods and Dietician' Perception against Management of Food Service at Food Service Institutions (집단급식소의 가공식품 이용 실태 및 급식관리에 대한 영양사의 인식에 대한 조사)

  • Soh, Gowan-Soon;Kim, Yong-Suk;Shin, Dong-Hwa
    • Journal of Food Hygiene and Safety
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    • v.22 no.1
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    • pp.29-36
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    • 2007
  • The using frequency of processed foods and dietician's perception against management of food service at 98 food service institutions located in Jeollabuk-Do were surveyed. Food service institutions included 13 hospitals,38 schools,40 enterprises, and 7 others. Single menu (75.5%) with two (33.7%) or three (57.1%) side dish was offered. In addition, the offering ratio of boiled water and spring water was 37.8 and 32.7%, respectively. The processed foods with high using frequency were kochujang (1.19), sesame oil (1.22), and doenjang (1.30), but that of leek, onion, Chinese cabbage, and radish were 4.95, 4.62, 4.60, and 4.26, respectively. Dietician's major affairs in all type of food service institutions were cooking (64.3%), purchase (48.0%), and personnel managements (39.8%). Dieticians, however, had a low perception against safety and nutrition management. Therefore, in order to prevent the outbreak of food-borne diseases, we estimated that the education and the conversion of dietician' perception against safety and nutrition management were needed.

The Analysis and Study of First Visit Outpatients in Oral Medicine (구강내과에 내원한 신환에 관한 분석 연구)

  • Ko, Myung-Yun;Heo, Jun-Young;Ok, Su-Min;Kim, Kyung-Hee;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.38 no.2
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    • pp.137-142
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    • 2013
  • Oral Medicine includes temporomandibular disorder, orofacial pains such as neuropathic pain, soft tissue diseases, halitosis, laser treatment, snoring, sleep apnea and identification through forensic dentistry etc. Such diseases are relatively common and cause great inconvenience and pain to the patients, as well as incur fatal health scare at times. In terms of oral medicine, the number of orofacial patients is growing due to a change in the life style and an increased stress as time goes in contemporary society and the demand of areas requiring oral medical professionalism, such as soft tissue lesions, snoring and sleep apnea, forensic dentistry evaluation and others are rapidly ascending. Consequently, among the areas in dental science, the calls for the expertism in oral medicine and its role are mounting. Analyzing the distribution according to disease entity, symptoms, duration of disease, and the prehistory courses of new patients visiting the department of oral medicine in a year provides information of the role and the relative importance of oral medicine in prospect and enables effective diagnosis and treatments for the patients. Therefore, in the present study, by analyzing new patients visiting the oral medicine clinic in our dental hospital for a year and by evaluating the role and the professionalism in future oral medicine, the authors concluded the followings: 1. It was founded that new patients to oral medicine mainly had temporomandibular disorders, soft tissue diseases, and neuropathic pains. 2. The number of patients with temporomandibular disorder appeared to be the highest percentage and the order within this was the patients with combined disorders, muscle disorder, and internal derangement of joint disc. 3. The number of patients with xerostomia appeared to be the highest percentage within soft tissue disease, followed by lichen planus and recurrent apthous ulcers. 4. The number of patients with burning mouth syndrome appeared to be the highest percentage within neuropathic pain.

Potential Role of Hedgehog Signaling in Radiation-induced Liver Fibrosis (방사선에 의한 간섬유증에서 헤지호그의 잠재적 역할)

  • Wang, Sihyung;Jung, Youngmi
    • Journal of Life Science
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    • v.23 no.5
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    • pp.710-720
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    • 2013
  • Radiotherapy is commonly used in treating many kinds of cancers which cannot be cured by other therapeutic strategies. However, radiotherapy also induces the damages on the normal tissues. Radiation-induced fibrosis is frequently observed in the patients undergoing radiotherapy, and becomes a major obstacle in the treatment of intrahepatic cancer. Hedgehog (Hh) that is an essential in the liver formation during embryogenesis is not detected in the healthy liver, but activated and modulates the repair process in damaged livers in adult. The expression of Hh increases with the degree of liver damage, regulating the proliferation of hepatic progenitors and hepatic stellate cells (HSC). In addition, Hh induces epithelial-to-mesencymal transition (EMT) and activation of myofibroblasts. In the irradiated livers, up-regulated expression of Hh signaling was associated with proliferation of progenitors, EMT induction, and increased fibrosis. Female-specific expression of Hh leaded to the expansion of progenitors and the accumulation of collagen in the irradiated livers of female mice, indicating that gender disparity in Hh expression may be related with radiation-susceptibility in female. Hence, Hh signaling becomes a novel object of studies for fibrogenesis induced by radiation. However, the absence of the established experimental animal models showing the similar physiopathology with human liver diseases and fibrosis-favorable microenvironment hamper the studies for the radiation-induced fibrosis, providing a few descriptive results. Therefore, further research on the association of Hh with radiation-induced fibrosis can identify the cell and tissue-specific effects of Hh and provides the basic knowledge for underlying mechanisms, contributing to developing therapies for preventing the radiation-induced fibrosis.

An Analytical Study of the Relationship between Climacteric Symptoms and the Stress of Life Events (갱년기 증상과 생활스트레스의 관계에 관한 연구)

  • Im Eun-Ok
    • Journal of Korean Public Health Nursing
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    • v.8 no.2
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    • pp.1-34
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    • 1994
  • This study has been done in order to analyze the relationship between climacteric symptoms and the stress of life events. For the purpose of this study. objectives set up were as followings. : 1. Climacteric symptoms complained by middle aged women are studied. 2. The stress of life events experienced by middle aged women is studied. 3. The relationship between climacteric symptoms and the stress of life events is studied. 4. The relationship between climacteric symptoms and general characteristics is studied. and the relationship between the stress of life events and general characteristics is also studied. The sample size of this study was 462 cases. The subjects were middle-aged women. who were from 40 to 60 years old and resided in Seoul. Data were collected by using questionnaires which consisted of 122 questions from Jan. 1 to Feb. 7 in 1992. The questionnaires include questions about general characteristics. climacteric symptoms and life events. The measurement scales for this study were adopted from the climacteric symptoms scale developed by Chi. Sung-Ai and the measurement scale of stress related to life events devised by Lee. Pyoung Sook. The analysis of data collected was done by using SPSS-pc package. Firstly. general characteristics were analyzed by using descriptive statistical methods. Secondly. climacteric symptoms were analyzed by using descriptive statistical methods. the analysis of variance and correlation analysis. Thirdly. the stress of life events was studied by using descriptive statistical methods. the analysis of variance. and tests of independence. The results of this study are as followings. 1. General characteristics of the respondents are as followings: The average age is 49. 13. and the age group from 46 to 50 has $30.5\%$ in the respondents. Christianity is the major religion $(42.6\%)$. and the respondents with a high school diploma are $(43.1\%)$ of the respondents. $60\%$ of all respondents are housewives. and $90.5\%$ are married. The average number of children is 2.71. and the average number of family is 4.24 Monthly income of $39.1\%$ of the respondents is from l,010,000 Won to 2,000,000 Won. The premenopausal group is $4.9\%$. and $45.5\%$ of all respondents are satisfied with marrital life. $43.3\%$ of all feel happy. and $13.9\%$ feel economic frustration. $27.9\%$ of respondents are satisfied with sexual life. and $45\%$ of all report that the amount of recreational activities are more needed. 2. The average score of climacteric symptoms is 1. 8461 (The maximum score is 5.0). The symptoms complained frequently are nervousness. muscle-ache. fatigue. headache and knee-ache. Climacteric symptoms are significantly different in menopausal states. age groups. the number of children, marrital satisfaction. the feeling of life. self-reported health states and sexual satisfaction. 3. The life events occurred frequently were 'discord with husband', 'children's important exams', 'separation from husband related to works' and 'vacation'. When life events are analyzed by factors. the most frequently mentioned factor is 'marrital life'. The stress of life events is significantly different in a few general characteristics (age. the number of children, the number of family, monthly income, menopausal status, the feeling of life. self-reported health states, economic satisfaction). 4. The score of climacteric symptoms complained is significantly different according to the stress of life events (p<0.051, Especially, the difference is the widest in psychological symptoms according to the factor of 'couple. marrital life' among stressful life events. In Summary, climacteric symptoms complained by middle-aged women are related to the amount of the stress of life events. Whether life events are positive of negative is not important. Yet. climacteric symptoms and stressful life events are deeply related to general characteristics. so we can not insist strongly that one be directly related to the other.

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Association Between Chronotype, Sleep Quality and Resilience as Well as Anxiety Among Medical Students (의과대학 학생들의 일주기 유형과 수면의 질 및 회복탄력성과 불안 증상의 관련성)

  • Jeein Kim;Bong-Jo Kim;Chul-Soon Lee;Boseok Cha;So-Jin Lee;Dongyun Lee;Jiyeong Seo;Jae-Won Choi;Young-Ji Lee;Eunji Lim
    • Sleep Medicine and Psychophysiology
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    • v.29 no.1
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    • pp.21-28
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    • 2022
  • Objectives: Our study aimed to investigate the relationship between the anxiety at first year and chronotype and sleep quality at third year in medical students. We also investigated the association between sleep quality, chronotype, depression and resilience at third year. Methods: Fifty two medical students (36 males, 69%, aged 21 ± 0.93) in first year, and forty four medical students (31 males, 70.5%, aged 23.05 ± 0.99) at third year answered Beck Depression Inventory 2, Beck anxiety inventory, Insomnia severity index-K, Composite scale of morningness and Conner-Davidson Resilience scale-10. Multiple linear regression analysises were performed to identify predictors of chronotype, sleep quality and resilience. Results: Higher anxiety (β = -0.434, p = 0.006) at first year was significant predictor of eveningness at third year, while lower anxiety score (β = 0.606, p < 0.001) at first year was significant predictor of sleep quality at third year. Lower sleep quality (β = -0.314, p = 0.042) and eveningness (β = 0.315, p = 0.041) were associated with low resilience at third year. Also, Lesser depression (β = -0.717, p < 0.001) was associated with higher resilience at third year. Conclusion: Our study showed that higher anxiety in first year had significantly related with eveningness and poor sleep quality at third year. In addition, higher sleep quality, morningness and less depression had significantly associated with better resilience at third year.

Association Between Temporomandibular Disorders and Cervical Muscle Pressure Pain (측두하악장애와 경부근육 압통 간의 상관성)

  • Im, Yeong-Gwan;Kim, Jae-Hyeong;Kim, Byung-Gook
    • Journal of Oral Medicine and Pain
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    • v.33 no.4
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    • pp.339-352
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    • 2008
  • Aims: The aims of this study were to identify the association between cervical muscle pain and TMD by pressure pain response, and to find cervical muscles showing moderate to severe pressure pain that are correlated with masticatory muscle pain. Methods: Patients(n=129, female 65.9%, mean age 28.8 years) answered a TMD questionnaire asking about headache, neck pain, emotional stress, sleep disturbance, parafunction habits, and pain intensity. A clinical examination of the masticatory system was performed. Of the neck muscles, (1) the upper sternocleidomastoid, (2) the middle sternocleidomastoid, (3) the upper trapezius, (4) the splenius capitis, (5) the semispinalis capitis, (6) the scalene medius, and (7) the levator scapulae muscles were examined by palpation. Pressure pain or tenderness of all palpation sites was scored from 0 to 3 according to the pain response. The variables of sum of pressure pain scores were calculated from pressure pain scores and were used for statistical analyses. Results: Eighty patients(62.0%) answered that they suffer from neck pain in the TMD questionnaire. More than 40% of sternocleidomastoid and upper trapezius examination sites showed moderate to severe tenderness in the cervical muscles, and 36% of middle masseter in the masticatory muscles. For the 129 patients, the sum of cervical muscle pain scores(mean=12.88, SD=8.06) and the sum of TMD pain scores(mean=5.36, SD=5.10) were moderately correlated($\rho$ = 0.502, P < 0.001). The sum of TMD pain scores tends to increase as the sum of cervical muscle pain scores increases(Y = 0.395${\cdot}$X, $R^2$ = 0.659, P < 0.001). In the patients with masticatory muscle disorders, the sum of sternocleidomastoid and upper trapezius pain scores(mean = 8.67, SD = 4.95) and the sum of temporalis and masseter pain scores(mean = 3.37, SD = 3.56) showed moderate correlation($\rho$ = 0.375, P < 0.001). Those two variables were in a proportionate relationship(Y = 0.359${\cdot}$X, $R^2$ = 0.538, P < 0.001). In a partial correlation analysis of the sum of unilateral pain scores, the sum of right cervical muscle pain scores and the sum of left cervical muscle pain scores showed the highest correlation(r = 0.802, P < 0.001). The sum of right TMD pain scores and the sum of left TMD pain scores were moderately correlated(r = 0.481, P < 0.001). For the twenty patients with unilateral TMD pain, the partial correlation coefficient between the sum of ipsilateral cervical muscle pain scores and the sum of contralateral cervical muscle pain scores was the largest(r = 0.597, P = 0.009). A partial correlation between the sum of primary TMD side pain scores and the sum of ipsilateral cervical muscle pain scores was 0.564(P = 0.015). Conclusions: TMD is associated with cervical muscle pain on condition of pressure pain response to palpation. Of the cervical muscles, sternocleidomastoid and upper trapezius frequently exhibit moderate to severe pressure pain, and they are closely related to the masticatory muscle pain. The characteristic of symmetric involvement of pain is prominent in cervical muscles; however, TMD can affect the level of cervical muscle pain to modify its symmetric nature.

Effect of Geijibokryunghwan and each constituent herb on inhibition of platelet aggregation (계지복령환(桂枝茯笭丸) 및 그 구성약물(構成藥物)의 혈소판응집억제(血小板凝集抑制)에 관(關)한 연구(硏究))

  • Kim, Jong-Goo;Park, Sun-Dong;Park, Won-Hwan
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.115-129
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    • 2000
  • The cause that the increase of animality fat intakes, under exercise, fatness, adding the stress, advanced age etc., the occurrence rate of the circulation system disease has been increased. And the thrombosis importantly came to the front as the risk factor of these circulation system's disease. Nowadays, the ischemic disease has especially discussed, for example the angina or myocardial infarction, originated in thrombosis that came from the platelet aggregation. In the western medicine, as the cure and prevention, using the aspirin or ticlopidine for platelet aggregation suppressant. But in the , the curing method must be used properly according to the pectoralgia or heartache's kind, state, grade. The platelet do not attache to the normal hemangioendothelial cell. But when it stimulated by endothelium peronia and so on, it attache to the injury endothelium or rise aggregation between the platelet. On this time, it secrete the platelet aggregation inducer as like ADP, thromboxane A2 from the inside of platelet. So it has first defensive function through the aggregation augment that prevent the celerity consumption of blood. But the activation of abnormal platelet occur the platelet grume and thrombogenesis. So it bring up the occlusive angiosis, so to speak, cardiovascular disease, cerebrovascular disease, arterial sclerosis. In oriental medicine, the thrombosis in the category of blood stasis and this blood stasis present the generalise or local blood circulation disturbance that generated by all kinds of pathological fact or blood stream retention accompanying with a series of syndrome. As the syndrome, stabbing pain fixed at certain region, squamous and dry skin, fullness and pain of the chest and hypochondrium, firmness and fullness of the lower abdomen, black stool, dark purple tongue or with ecchymoses and petechiae etc.. has been created. And it becomes the pathopoiesis cause that the convulsion and palpitation, severe palpitatiion, tympanites, the symtom complex with a mass or swelling in the abdomen, insanity, stricken by wind etc.. Moreover, it used the drugs for invigorating blood circulation and eliminating blood stasis or drugs for removing blood stasis for all kinds of syndrome through the blood stasis. And the drugs for activating the blood circulation, such as Salviae Radix, Angelicae Sinensis Radix, Persicae Semen, Achyranthis Radix, Cnidii Rhizoma, Carthami Flos are used for that. And it is used to the herbs of insects that has strong effect about the disintergrating blood stasis such as Hirudo, Scolopendrae Corpus, Buthus, Lumbricus etc.. On this study, It used Geijibokryunghwan(GBH) and the consisting herbs to investigate the influence of platelet aggregation about drugs that used to improvement various symptoms created by the thrombosis in oriental medicine. GBH formula has as formula recorded in the , action of 'eleminating the evil and not impairment of healthy energy' and 'promoting the flow of QI and cold and heat, so used for the expel blood stasis herbs from the ancient. Therefore we investigated the restraint effect of GBH and the consisting herbs about the platelet agregation induced to the ADP, AA or collagen. The conclusion is following. 1. When it added the aggregation inducer after that it added GBH and individual consisting herbs in the PRP, GBH showed the (+) inhibition effect on the platelet aggregation and it showed the (+) inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis. 2. It showed the (+), (+,++) inhibition effect on the platelet aggregation in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc. 3. In the aggregation inhibition activating on the difference of density, GBH showed strong inhibition effect to the aggregation state induced to collagen, and it showed the inhibition effect in the individual consisting herbs as like Paeoniae Radix and Moutan Cortex Radicis about the aggregation induced by the collagen. 4. It showed the strong inhibition effect about the aggregation induced by the collagen in Paeoniae Radix Hoelen, Paeoniae Radix Moutan Cortex Radicis, Hoelen Moutan Cortex Radicis etc Like this, as confirm GBH and the individual consisting herb's inhibition effect of platelet aggregation, We considerated that GBH and the individual consisting herbs have practical applicational value of clinical trial in the thrombosis caused by platelet aggregation.

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.