• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.2
• /
• pp.191-199
• /
• 2016

Objectives : Despite the increased popularity of highly caffeinated beverages, there is little research examining psychiatric adverse effects. The purpose of this study was to investigate the relationships among pattern of highly caffeinated beverage intake and depressive symptom, suicidal ideation, suicidal plan, suicidal attempt in Korean adolescents. Methods : The data was obtained from the 2014 Korean Youth's Risk Behavior Web-based Study by Korea Centers for Disease Control & Prevention. All participants conducted web-based questionnaire survey. Chisquare test and multiple logistic regression analysis were performed to determine the association among highly caffeinated beverage intake pattern, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt adjusting for differences in age, gender, academic achievement, socioeconomic status. Results : A total of 71,638 participants were enrolled in this study. Depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more frequent in the group with presence of highly caffeinated beverage intake within 1 week than in non-drinker group(p<0.01). Highly caffeinated beverage intake was significantly associated with suicidal attempt(OR=1.99 ; 95% CI, 1.77-2.22). In addition, depressive symptom, suicidal ideation, suicidal plan and suicidal attempt were significantly more common in the group with heavy-drinker who exceed recommended daily intake dose of caffeine than in the group with light-drinker(p<0.01). Heavy drinking of caffeinated beverage was significantly associated with suicidal attempt(OR=4.05 ; 95% CI, 3.02-5.43). Conclusions : We found that highly caffeinated beverage intake was related to more frequent depressive symptom, suicidal ideation, plan, attempt in adolescents. Also, caffeine intake which exceed recommended daily intake dose identified the predictor of suicidal attempt. Our result suggested that clinicians need to be aware of the possible psychiatric adverse effects of highly caffeinated beverage in vulnerable population including young adolescents.

• Journal of Yeungnam Medical Science
• /
• v.20 no.1
• /
• pp.62-70
• /
• 2003

Background: Most of all studies about the relation between the health risk and obesity are based on the European and American data. The purpose of this study is to examine the relation between adiposity and risk factors for cardiovacular disease (CVD) in normal weight individuals. Materials and Methods: Normal weight subjects with a body mass index (BMI) between 18.5 and $23kg/m^2$ (76 subjects) and overweight subjects with a BMI between 23 and $25kg/m^2$ (53 subjects) were retained for this study. Normal weight subjects were divided into three group of each adiposity variable, then three group and the overweight group were evaluated for the presence of CVD risk factors and analyze the correlation coefficients between adiposity variables and risk factors controlled for age in normal weight, overweight groups. Using logistic regression analysis, the odds ratio (OR) for the prevalence of risk factors for each group of adiposity variables and the overweight group was estimated relative to the first group in normal weight subjects. Results: Systolic BP, diastolic BP, LDL cholestrol, HDL cholesterol, triglycerides in normal weight subjects were significantly correlated with all adiposity variables (P<0.01). Third group (3.7 for %fat and 4.7 for fat mass)of adiposity variables in the normal weight group and the overweight group (6.6 for %fat and 11.5 for fat mass) tended to have higher ORs compared to first group for risk factor variables. Conclusion: Normal weight subjects with elevated adiposity had higher prevalence of risk factors than normal weights subjects with less adiposity. Measuring of adiposity added additional information of cardiovascular disease risk factors in normal weight subjects.

• Journal of Digital Convergence
• /
• v.15 no.2
• /
• pp.493-501
• /
• 2017

This study aimed to present cosmetic countermeasures for preventing fast aging process in the middle age and accepting healthy aging both physically and mentally by investigating the perception of aging according to the health condition, lifestyle and psychological condition targeting mid-aged women in 40s to 50s residing in Seoul and Gyeonggi-do Province. The data collection period was from July 25 to Sept 1, 2015. The data was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression. It was shown that as the age was higher, the menopause ratio was higher, drinking, exercise volume and hours of sleep were reduced and the stress and psychological pressure were higher. According to the menopausal status, the status of facial aging showed a significant difference (${\chi}^2=39.692^{***}$, p<.001), and it also showed a difference according to the status of leisure (hobby) activity (${\chi}^2=22.470^{***}$, p<.01). Also, as higher the age and closer to the menopause in items including the progress of aging, anxiety about aging and improvement efforts, more negative perception was shown, indicating that it is necessary to prepare cosmetic countermeasures for mid-aged women in like a second puberty 40s to 50s although aging and menopause around 50s are very natural. If a beauty alternative is provided, it will help them to have a successful retirement.

• Journal of Korean Academy of Nursing
• /
• v.4 no.3
• /
• pp.33-56
• /
• 1974

간호를 장래의 전문직으로 택하려고 공부하는 간호학생들은 완전한 성인으로서의 발달 과정중 후기 성년기에 속한다. 이시기는 자아를 발견하고 인간이 무엇을 믿으며 인간의 가치가 무엇인가를 추구하는 중요한 시기이다. 다시 말해서 어른과 어린이의 과도기에 서서 자신의 이상적 가치와 기성사회의 기존 가치를 잘 융화시켜 독립된 인간으로서 성숙하려는 노력의 시기이다. 그러므로 성년기의 갈등은 인생의 어느 시기보다도 그 정도가 심하게 나타난다. 간호학생들은 이상의 일반적인 성년기 발달의 요구 외에도 간호대학이라는 특수한 배움의 여건 때문에 좀 더 심각한 문제에 대두된다. 특히 소아과 간호대학이라는 실습환경은 여러 가지 복잡한 병실 사정으로 많은 긴장감을 주는 학습경험이다. 어린이의 간호에는 그들의 발달과정에 따른 다양한 역활이 요구된다. 또한 병원이라는 낯선 환경과 어머니를 떨어져야하는 두려움으로 불안한 어린이와 그 어린이의 불안과 두려움으로 인해 우울과 죄의식에 있는 어머니의 간호는 여러 면에서 성년기 학생들에게 긴장감을 일으키게 하는 요인이 된다. 본 연구의 문헌조사는 주로 미국 문헌에 나타난 간호 대학생들의 성년기 성숙을 위한 발달의 요구와, 소아병실의 복잡한 여건으로 발생되는 긴장감을 다루고 있다. 문헌을 기초로 하여 저자는 긴장감을 주는 간호활동을 크게 다섯 부군으로 묶었다. 1. 어린이 환자의 신체적 간호, 2. 어린이 환자나 부모와의 원만한 대화와 상호관계를 위한 간호활동 3. 소아병실에서 요구되는 다양한 간호원의 역활 4. 어린이나 부모의 간호에 대한 의뢰심 5. 간호의 가치나 이상적 간호. 연구방법으로는 49개의 폐쇄식 질문 항목을 가진 질문지를 사용하였다. 질문 항목들은 문헌연구에서 소아과 간호학 실습시 학생들이 긴장감을 느낀다고 밝혀진 내용들이 다. 학생들은 자신의 경험을 "긴장감이 없었다. ""긴장감이 있었다. ""심한 긴장감이 있었다. ""실습 중 경험이 없었다. "의 사항 중 택일을 하게 되어 있다. 연구대상으로는 모 대학교 간호대학 학생으로 산부인과 간호학 실습을 마친 후 소아과 간호학 실습 8주를 완료한 4학년 학생 42명이었다. 자료분석의 결과는 대부분의 학생들에게 소아과 간호학 실습은 긴장감을 주는 경험이 있다고 나타났다. 다음은 연구결과 주목할만한 몇 가지 사항들이다. 1. 어린이 환자의 신체적 간호는 성년기 학생들에게 긴장감을 주는 실습 경험이었다. 특별히 심하게 긴장감을 주었던 간호활동은 어린이환자의 상태가 중한 경우로, 장기간 앓는 아이, 선천성 기형이 있는 아이, 회복이 불가능하여 죽게될 아이나 사망하는 경우의 어린이 간호였다. 이 결과는 간호학의 기본과정 즉, 기초간호학이나 내 외과 간호학 실습만으로 소아과 간호학 실습을 위한 충분한 준비가 되지 못한다는 것을 뜻 할 수도 있다. 한편, 문헌연구에서 밝힌바와 같이 어리고 연약해 보이는 어린이들의 신체조건이 학생들의 간호활동을 어렵게 하는 경우도 될 수 있겠다. 2. 간호학생들의 어린이 환자와의 대화나 원만한 인간관계에서의 긴장감은 이 연구결과로 평가나 제언이 힘들다. 조사결과에서 학생들은 주로 어린이의 상태가 좋지 않은 경우에 심한 긴장감을 가졌고 일반적인 간호의 경우에는 별로 긴장감이 없었다. 이것은 질병의 상태나 화제, 이야기 할 때의 상황에 따라 긴장감의 여부가 달라질 수 있다는 결론이 되겠다. 3. 소아병실에서의 다양한 역활을 수행하는 것은 비교적 긴장감이 많이 생기는 간호활동으로 나타났다. 그러나 재미있는 사실은 학생들이 간호원으로서의 전문가적인 입장에서, 환자나 보호자를 가르칠때는 별로 문제가 없었으나 어린이 기르는 방법이나 어린이 이해면에서 좀 더 잘 안다고 생각되는 어머니가 지켜 볼때의 어린이 간호에는 긴장감을 가진다는 사실이다. 이것은 Jewett의 연구에서 밝힌바와는 상반되는 결과다. 그의 연구에서 학설들은 부모나 어머니들에 의해 전문가로서 인정받고 기대되는 경우가 제일 어려운 경험이 있다고 밝혔다. 4. 어린이 환자나 그들 부모의 간호에 대한 의뢰심은 학생들에게 심한 긴장감을 주는 경험이 있다. 특히 신체적 간호에 대해 의뢰하는 경우에는 더 심한 긴장감을 준다고 표현한다. 일반적으로 부모가 병실에 상주하는 경우에는 그들의 의뢰심이 심하며 이것은 학생들에게 감당하기 힘든 긴장과 어려움을 주게된다. 왜냐하면 성년기의 학생들은 그들 자신이 먼저 타인에게서 이해받기를 원하며 또 관용을 베풀어주기를 원하는데 그것을 남에게 주어야 하는 입장은 학생들을 긴장되게 하는 실습활동인 것이다. 5. 학생들은 그들이 배운 간호의 이상이나 가치가 실습지에서의 여러 경우와 맞지 않는 것을 보았을 때 극심한 긴장감을 갖는다고 밝혔다. 의사나 병원 행정의 사실이 자신의 이상과 맞지 않는다는 것보다는 간호원의 간호업무의 차이에서 더 비판적인 반응을 보였다. 대부분의 성년기 학생들은 그들의 이상적인 간호원상을 그들의 선배나 실무 간호원 중에서 찾으려는 시기에 그들의 간호활동이 이론과 다른 점이나 학생 자신의 소아과 간호의 가치와 다른 것을 보았을 때는 심한 반감과 긴장감을 갖게된다. 이 문제는 어린 사람이 윗 어른과 함께 동료의식을 갖고 일하기 어려운 한국적 사회구조 때문에 더 심하게 긴장감을 주는 경험인지도 모른다. 선배 간호원의 전문인으로서의 권위와 어린이 환자 보호자의 어른으로서의 권위 사이에서 자신의 이상과 가치의 추구는 용이하지 않으며 내적 갈등은 어쩔수 없는 일 일 것이다. 6. 대부분 높은 백분율의 긴장 반응은 죽음이나 환자의 사망에 관련된 간호활동 항목에서 나타났다. 이 연구의 대상 학생들은 2, 3학년에서 죽음에 대한 강의를 들었지만 이 연구 결과에 의하면 충분한 학습 경험이 주어진 것 같지 않다. 어떠한 경우의 죽음에라도 어린이 환자나 그 보호자들의 심리를 잘 이해하고 반응을 잘 관찰해서 적절한 간호를 해 줄 수 있는 다양한 방법의 학습 경험이 필요하다고 보겠다. 7. 학생들의 긴장도가 어린이 간호에 더 심한가, 보호자 간호에 더 심한가를 알기 위한 비교 결과는 비교적 비슷한 정도로 나타났다. 8. 학생들의 소아과 간호학 실습시의 긴장도는 과거의 병실 실습기간의 장, 단이나 가정에서의 어린인 간호의 경험과는 별 연관성이 없었다. 연구의 대상자가 적기 때문에 단정을 하기는 힘이 들지만 소아과 간호학 실습이 다른 병실의 실습과는 분리되어서 완전히 다르게 다루어 져야만 하며 간호교육자들의 주의 깊은 관심과 노력이 필요한 실습교육이 라 하겠다. 이상의 전반적인 고찰에 의하면 한국 성년기 간호학생들의 소아과 간호학 실습은 미국의 경우와 마찬가지로 긴장감을 주는 경험이다. 문화배경의 다른 점은 무시하고라도 Davis와 Oleson이 결론한 바와 같이 "간호대 학생은 어디를 막론하고 다 같은 성격과 문제를 가지고 있다. " 앞으로 보다 효과적인 학생들의 소아과 간호학 실습을 위한 연구를 위해 다음의 몇 가지를 본 연구의 결과를 가지고 제언한다. 1. 보다 여러 지역에서 다양한 교육 방법을 가진 학교의 학생을 대상으로 한 연구의 필요성. 2. 학생들이 실습 전 선입견이나 이미 들어서 생긴 긴장감의 개입 여부를 밝힐 수 있는 연구. 3. 학생 개인의 과거 경침이 긴장감 유발에 미치는 영향을 위한 연구 4. 이 연구의 결과를 입증할 수 있는 종단적 연구. 5. 이 연구에서 나타난 긴장감이 학습 행위에 미치는 영향을 알기 위한 관찰적 연구. 이 연구를 위해 많은 도움을 주셨던 보스턴대학의 Dr. Kennedy와 연세대학의 여러 선생님께 심심한 감사를 드립니다.

• Clinical and Experimental Pediatrics
• /
• v.46 no.3
• /
• pp.217-223
• /
• 2003

Purpose : Every year, there is a remarkable increase in the prevalence of children with excess body fat. The aim of this study is to find a useful screening method in assessing adolescent, obesity and to specify the predictable risk factors that are related to adult cardiovascular disease according to BMI and obesity index. Methods : From July to November in 2001, a total of 2,814(male : female=2,011 : 803) mid to high school students who were in the obesity range according to obesity index(>20%) were evaluated according to height, weight, body mass index(BMI), obesity index, and serum lipid levels. Results : Among the obese students over 20% by obesity index, 86.6% were over the range of 95 percentile by BMI. Among students defined as obese by BMI, 21.0% of males and 21.4% of females students had hypercholesterolemia; by obesity index, the ratio was 20.7% male and 19.0% female. The frequency of hypertriglyceremia in male students was 15.0% in group I(overweight group, 85P97p); in female students 11.8%, 20.7% and 28.2% respectively. Conclusion : In this study, using BMI alone to test the serum lipid level in adolescent obesity had a limit of 10.0-17.0% omission. Therefore using obesity index as a screening method to find the adult cardiovascular disease would rather reduce the omission rate. The risk factor of cardiovascular disease according to BMI was the increasing level of triglyceride in both male and female students. We think that using the obesity index has more rationale rather than BMI in assessing lipid profiles.

• Korean Journal of Applied Biomechanics
• /
• v.12 no.2
• /
• pp.345-359
• /
• 2002

The purpose of the study was to provide the fundamental data to instruct athletes through the analysis athletes' movement in javelin. Three athletes in the level of national representative were participated in this study. The study analyzed kinematic variables(lead foot and releasing javelin) through 3-D analysis and obtained the following results. 1. During withdrawal, it is important to maintain of running horizontal velocity. 2. It was showed that throng average height was $84{\pm}3.3%$ and javelin adequative degree, Among the athletes, $S_2$ who had the best record was released the javelin with the fast velocity, but throw the javelin with the less releasing velocity. 3. $S_2$ released after lead foot were completely landed and therefore it is no problem in a kinematic aspect. However, $S_1$ angle was too small. it caused increase of release velocity to be prevented. 4. $S_2$ showing the best result indicated shorter in duration time. Generally, the shorter duration time in release phase showed the longer release distance. Especially $S_1$ and $S_3$ showing the worse result indicated the longer duration time in preparatory phase, causing the breakup of force. Therefore to improve the record, it should be decreased the duration time in preparatory phase. 5. Compared with $S_1$ and $S_3$, $S_2$ showing the best record indicated the higher velocity in center of mass, trunk, upper arm, lower arm and hand That is the higher velocity of upper arm at release leaded the better velocity transfer from upper arm to following lower arm and hand, these action should be considered to be helpful of better record. According to the above conclusion, when the athletic leaders cauch athletes, they should focus on maintaining knee angle, upper body and hip angle in a previous stage of release and throwing angle, throwing height, throwing velocity in a release stage.

• Journal of Hospice and Palliative Care
• /
• v.7 no.2
• /
• pp.189-199
• /
• 2004

Purpose: Despite the small incidence, head and neck cancer may cause a wide range of physical transformation by surgical operation, damage to active functions such as eating and speaking. It may provoke hopelessness, change self-esteem and self-concept after its operation, influencing the quality life of head and neck cancer patients. Thus nursing intervention should be developed to provide supportive nursing for head and neck cancer patients and play roles as competent supporters. Methods: This study was a nonequivalent, control group, pretest-posttest, non-synchronized quasi-experimental research designed to determine how supportive nursing intervention effects on hopelessness, self-esteem and self-concept of head and neck cancer patients. Subjects of the study included 40 adult inpatients of K University hospital in Pusan who were diagnosed as having head and neck cancer and operated. They were divided into experimental and comparison groups, each consisting of 20 members. The data were collected during the period from December 1, 1999 to April 11, 2000. Tools of the study included the protocol of supportive nursing intervention which was developed by researcher by means of reference, literal review and expert's advice. The measurement tool of hopelessness was translated by Won was the device of hopelessness self-evaluation from Beck, the tool for self-esteem measurement was developed by Rosenberg and translated by Kim, and the device of self-concept used by Lee et al, modified by Lee were used respectively. Data were analyzed using the SPSS/PC 9.0 program. The homogeneity of the subjects were tested using $x^2-test$ and t-test. 3 hypotheses were tested using t-test. Results: The results of the study can be summarized as follows. 1. The third hypothesis that the experimental group receiving supportive nursing intervention showed a little hopelessness than the control group not receiving supportive nursing intervention was supported (t=4.550, P=.000). 2. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-esteem than the control group not receiving supportive nursing intervention was supported (t=-6.40, p=.000). 3. The third hypothesis that the experimental group receiving supportive nursing intervention showed more self-concept than the control group not receiving supportive nursing intervention was supported (t=-6.065, P=.000). Conclusion: Supportive nursing intervention was effective nursing intervention strategy for reducing hopelessness and increasing self-esteem and self-concept of head and neck cancer patients. Then the quality of life of head and neck cancer patients can be enhanced by providing supportive nursing intervention in nursing practice.

• The Korean Journal of Food And Nutrition
• /
• v.11 no.2
• /
• pp.192-199
• /
• 1998

1. 조사 대상자들의 평균 키와 체중은 각각 161.00$\pm$4.15cm, 50.45$\pm$8.15kg이었으며 BMI는 19.81$\pm$3.98, 체지방율은 26.12$\pm$4.12, skinfold thickness는 40.40$\pm$12.56mm로 나타났다. 2. 조사 대상자들의 혈액성상은 적혈구 수, 헤모글로빈, 헤마토크리트치, albumin, globulin, 총 콜레스테롤, LDL-콜레스테롤, HDL-콜레스테롤, 총 중성지방을 측정하였으며 헤마토크리트치를 제외한 나머지 성상들은 모두 정상 범위에 속하였다. 헤마토크리트치는 정상범주에 미달되는 것으로 나타나 이로 말미암아 철분 결핍성 빈형에 노출될 확률이 아주 많음을 보였다. 3. 용돈별로 체지방율을 분류하여 분석한 결과 한달 용돈이 평균 20~30만원을 쓰는 group의 체지방율이 22.00%로서 정상 수준 이었으며, 30만원 이상 사용하는 group은 비만으로 나타났다.(p<0.05) 한편, 그 외의 group들은 체내 체지방율 수준도 정상 수준인 20~25%를 넘어 체중으로 나타났다. 또한 30만원 이상 사용하는 group은 다른 group보다 RBC(million/㎣), Hb(g/이), Hct(%) 모두가 낮게 나타났으며, 빈혈로 판정될 수 있는 수준이었다. 4. 다이어트 빈도별 각 요인들간의 상관관계를 살펴보면 다이어트 시도를 자주 한다고 답변한 group이 거의 실시하지 않는다., 실시해 본 적이 없다라고 대답한 group보다 체중과 BMI가 유의적으로 낮았다.(p<0.05) 그러나 skinfold thickness(mm)와 체지방율은 유의차가 나타나지 않았다. 따라서 비록 다이어트 실시를 자주할 경우 절대적인 체중감량은 감소되지만 체내 지방량이 감소되는 것은 아니라고 판단된다. 5. 다이어트 실시기간에 따라 혈액 성상을 분석한 결과, 4개월 미만 다이어트를 실시하였으나, 1개월 전부터 현재(설문지에 응답한 시점)까지 기간 중에는 다이어트를 실시한 적이 없다고 대답한 group의 Alb(g/dl)과 Glo(g/dl)의 수치가 다이어트를 실시한 적이 없다고 대답한 group에 비해 유의적으로 높게 나타났다.(p<0.05) 6. 체중은 BMI와 양의 상관관계를 나타내었으며, BMI는 견갑골과도 높은 양의 상관관계를 가졌다. 상완부는 견갑골, skinfold thickness(mm), 체지방율과 높은 양의 상관관계를 보였으며, 반면 Hb(g/dl), Hct(%)와는 음의 상관관계를 나타내었다. 견갑골은 BMI 뿐 아니라 skinfold thickness(mm), 체지방율과 양의 상관관계를 나타내었으며, skinfold thickness(mm)는 체지방율과 유의적인 양의 상관관계가 있음이 나타났다. 7. RBC(million/㎣)는 Hb(g/dl) 및 Hct(%)와 유의적인 양의 상관관계를 나타내었으며, Hb(g/dl)도 Hct(%)와 유의적인 양의 상관관계를 나타내었다. Alb(g/dl)은 Glo(g/dl) 및 TCH(mg/dl), HDL(mg/dl)과도 양의 상관관계를 가졌다. Glo(g/dl)은 TCH(mg/dl)과 양의 상관관계를 보였으며, TCH(mg/dl)은 Alb(g/dl), Glo(g/dl)이에도 TTG(mg/dl), LDL-cho(mg/dl) HDL-cho과도 양의 상관관계를 나타내었다. TTG(mg/dl)은 LDL-cho(mg/dl)과는 양의 상관관계를 HDL-cho(mg/dl)과는 음의 상관관계를 나타내었다.

• Journal of Hospice and Palliative Care
• /
• v.1 no.1
• /
• pp.47-55
• /
• 1998

Background : It is almost important therapy modality to control pain for the terminal cancer patients for the last 24 hours because those terminally illed patient deserved to have pain free and peaceful time before death. Physician who is deal with terminal cancer patients for their last 24 hours does not need to worry about drug addiction or other untoward side reactions of pain medications. The purpose of this study was to evaluate if terminally illed cancer patient was given pain medication properly and sufficiently and if there was any different behavior to control pain of terminal cancer patients between medical physicians and surgeons in terms of type, amount and administration route and frequency. Methods : A retrospective chart audit of analgesic type, amount and administration route was performed on the medical recorders of 160 hospitalized terminal cancer patients who had died in the Korea University Medical Center Anam Hospital during the period of July 1, 1994 to June 30, 1995. Patients were classified into 103 patients were cared for by medical physicians and 57 patients were cared for by surgeons. After then, we analysed the difference of pain control pattern between them. Different types and amount of analgesics were converted to a common standard, an oral morphine equivalents(OME) relative to 1mg of oral morphine. Results : 1) The total number of patients was 160, male 102 cases(63.8%), and the female was 58 cases(36.2%) respectively. 2) The mean age was 56.4(${\pm}14.62$) years old and mean admission period was 27.8 days(${\pm}34.85$). 3) The frequent cancer site was stomach 42 cases(26.315), lung and liver 29 cases(18.1%) each, pancreas 10 cases(6.2%) in order 4) 125 out of 160 subjects (78.13%) complained pain, and 66 out of 103(64.08%) and 31 out of 57(54.39%) were treated with analgesics to relieve pain. 50 out of 97(51.55%) were able to continue on oral medication. 5) 86 cases(53.75%) were well oriented 24 hours prior to death. 6) The frequent analgesics for regular basis were long acting form of oral morphine 34 cases(Medical phsicians 24, Surgeons 10), intravenous morphine 26 cases(Medical physicians 20, Surgeons 6) in order, and the most common p.r.n.(pro re nata) analgesics used was intravenous morphine. 7) The mean amount of analgesics on regular basis was 115.41 OME by medical physicians and 52.7 OME by surseons(P<0.05). The mean amount of p.r.n. analgesics was significantly larger in patients are for by surgeons(66.64 OME) than medical physicians 23.49 OME(P<0.01). 8) The mean frequency of administrated number of p.r.n. analgesics was 0.62 times/day on medical part and 1.88 times/day on surgical part (P<0.001). Conclusion : Of the 97 patients with advanced cancer, 51.55% were able to take oral medications in the last day of life. The parenteral analgesics were more frequently used in the patients cared for by surgeons than medical physicians. Over the half of terminal cancer patients were well oriented in the last day of life. Doctor's knowledge and attitude towards pain is very important to mange the pain, effectively.

• Sleep Medicine and Psychophysiology
• /
• v.25 no.2
• /
• pp.51-57
• /
• 2018

Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.