Lee, Chang Woo;Jeon, Sehyun;Cho, Seong-Jin;Kim, Seog Ju
Sleep Medicine and Psychophysiology
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v.26
no.1
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pp.16-22
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2019
Objectives: The objective of this study was to investigate the correlation between insufficient sleep and visuospatial memory in adolescents using a computerized neurocognitive function test. Methods: A total of 103 high school students (26 males and 77 females; mean age $17.11{\pm}8.50years$) without a serious psychiatric problem was recruited. All subjects were requested to complete a self-report questionnaire about weekday total sleep time and weekend total sleep time. The epworth sleepiness scale (ESS) and the beck depression inventory (BDI) were administered to measure daytime sleepiness and symptoms of depression. Seven subsets of the Cambridge Neuropsychological test automated battery were examined to assess visuospatial memory. Results: After controlling for age, sex, ESS, and BDI, longer weekend total sleep time was correlated with poor performance on delayed matching to sample (r = -0.312, p = 0.002) and immediate recall on pattern recognition memory (r = -0.225, p = 0.025). Increased weekend catch-up sleep time was correlated with poor performance of delayed matching to sample (r = -0.236, p = 0.018), immediate recall on pattern recognition memory (r = -0.220, p = 0.029), and delayed recall on pattern recognition memory (r = -0.211, p = 0.036) after controlling for age, sex, ESS, and BDI. Conclusion: This study showed that increased weekend catch-up sleep time reflecting insufficient weekday sleep were associated with poor performance in delayed recall tasks of visual memory. This finding suggests that insufficient sleep during adolescence might produce a decline of visuospatial memory.
This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.
Kang, Hyo Shin;Yun, Ji Hae;Ahn, Inn Sook;Moon, Yu Jin;Hwang, Tae Young;Lee, Young Min;Kim, Hyeran;Kim, Doh Kwan
Journal of Korean geriatric psychiatry
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v.16
no.1
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pp.24-30
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2012
Objectives : The purpose of this study was to compare the efficacy of galantamine treatment, especially attention ability between patients with pure Alzheimer's disease (AD) and Mixed dementia (MD) during a 24-week trial. Methods : A total of 40 patients were recruited for this 24-week study. The effect of galantamine on attention was measured using Seoul Computerized NeuroCognitive Function Test (SCNT) and frontal functions test of Seoul Neuropsychological Screening Battery (SNSB). Patients'activities of daily living using the Seoul-Activities of Daily Living (S-ADL) and the Seoul-Instrumental Activities of Daily Living (S-IADL) ; behavioral symptoms using the Korean version Neuropsychiatric Inventory (K-NPI) were measured at baseline and 24-week. Results : 17 pure AD patients and 23 MD patients were analyzed in this study. Attention as measured by SCNT was not significantly different from baseline after 24 weeks of treatment in both groups. There was no significant difference between two groups in mean change from baseline in the SCNT, S-ADL, S-IADL and K-NPI scores at 24-week. Conclusion : Galantamine showed a therapeutic effect on cognition, activities of daily living, neuropsychiatric symptoms in pure AD and MD. Furthermore, Galantamine may specifically help to maintain attention and it may have positive effects on other cognitive and functional abilities.
Lee, Heon-Jeong;Song, Hyung-Seok;Ham, Byung-Joo;Suh, Kwang-Yoon;Kim, Leen
Sleep Medicine and Psychophysiology
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v.8
no.2
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pp.129-137
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2001
Objectives: The purpose of this study is to investigate the effects of 38-hour sleep deprivation on fine motor performance. The Motor Performance Series (MPS) in the Vienna Test System (computerized neurocognitive function tests) was used in this study. Methods: Twenty four subjects participated in this study. Subjects had no past history of psychiatric disorders and physical illness. Subjects had normal sleep-waking cycle without current sleep disturbances and were all right-handed (Annett's Hand Preference Questionnaire: above +9 points). To minimize the learning effects, familiarization with the Vienna Test System was performed one day before the study. Subjects were to get up at 6:00 in the morning after getting enough sleep according to his or her usual sleep-wake cycle. After awakening, subjects remained awake for 38 hours under continuous surveillance. During two consecutive study days, the subjects tested MPS at 7 AM and 7 PM each day, which means the MPS was done four times in total. During the experiment, anything that could affect the subjects' sleep such as coffee, tea, alcohol, a nap, tiring sports, and all medications were prohibited. Results: In MPS, the fine motor functions of both hands decreased after 38 hours of sleep deprivation. The decrement in motor performance was prominent in the dominant right hand. In the right hand, the total number of tapping was reduced (p<.005), and the number of misses (p<.05) and the length of misses (p<.05) of line tracking, the total length of inserting a short pin (p<.01), the total length of inserting a long pin (p<.05), and the number of misses in aiming (p<.05) increased. Such performance decrement was distinct in the morning sessions. Conclusions: These results suggest that fine motor performance decrement during sleep deprivation is predominant in the right hand, which exerts maximal motor function. The finding of decrement in motor function in tapping during sleep deprivation also suggested that the time required for exhaustion of muscles is shortened during sleep deprivation. More deterioration of motor performance was shown in the morning, which could be explained as circadian rhythm effects.
Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.
Objectives: In narcoleptic patients diagnosed with ICSD (international classification of sleep disorders, 1990) criteria, nocturnal polysomnography, and MSLT (multiple sleep latency test), we tried to find characteristic features of quantitative electroencephalography (QEEG) in a wakeful state. Methods: We compared eight drug-free narcoleptic patients with sex- and age-matched normal controls, using computerized electroencephalographic mapping technique and spectral analysis. Absolute power, relative power, interhemispheric asymmetry, interhemispheric and intrahemispheric coherence, and mean frequency in each frequency band (delta, theta, alpha and beta) were measured and analyzed. Results: Compared with normal controls, narcoleptic patients showed decrease in monopolar interhemispheric coherence of alpha frequency bands in occipital ($O_1/O_2$), parietal ($P_3/P_4$), and temporal ($T_5/T_6$) areas and beta frequency band in the occipital ($O_1/O_2$) area. Monopolar intrahemispheric coherences of alpha frequency bands in left hemispheric areas ($T_3/T_5$, $C_3/P_3$ & $F_3/O_1$) decreased. Decrease of monopolar interhemispheric asymmetry of delta frequency band in the occipital ($O_1/O_2$) area was also noted. The monopolar absolute powers of beta frequency bands decreased in occipital ($O_2,\;O_z$) areas. Conclusion: Decreases in coherences of narcoleptic patients compared with normal controls may indicate fewer posterior neocortical interhemispheric neuronal connections, and fewer left intrahemispheric neuronal connections than normal controls in a wakeful state. Therefore, we suggest that abnormal neurophysiological sites of narcolepsy may involve complex areas such as neocortex and subcortex as well as the brainstem.
Objective: The purpose of this study was to evaluate the validity of midsagittal reference (MSR) planes constructed in maxillofacial 3D images. Methods: Maxillofacial computed tomography (CT) images were obtained in 36 normal occlusion individuals who did not have apparent facial asymmetry, and 3D images were reconstructed using a computer software. Six MSR planes (Cg-ANS-Ba, Cg-ANS-Op, Cg-PNS-Ba, Cg-PNS-OP, FH${\perp}$(Cg, Ba), FH${\perp}$(Cg, Op)) were constructed using the landmarks located in the midsagittal area of the maxillofacial structure, such as Cg, ANS, PNS, Ba and Op, and FH plane constructed with Po and Or. The six pairs of landmarks (Z, Fr, Fs, Zy, Mx, Ms), which represent right and left symmetry in the maxillofacial structure, were selected. Statistically significant differences of the right and the left measurements were examined through t-test, and the difference of the right and the left measurement was compared among the six MSR planes. Results: The distances from the right and the left landmarks in each pair to each MSR plane did not show a statistically significant difference. The reproducibility of the landmark identification was excellent. Conclusion: All the six planes constructed in this study can be used as a MSR plane in maxillofacial 3D analysis, particularly, the planes including Cg and ANS.
The Purpose of this study was to estimate relative importance among the causative factors o( arch length discrepancy(ALD) and Possibility of prediction of the ALD in the mixed dentition. The sample consisted of the casts of the 142 young adults who had no abnormal muscle function, no skeletal abnormalities and Class I molar relationship. We classified the sample by gender and the extent of ALD, and measured mesiodistal diameters of each tooth and the dimensions of the dental arch. The computerized statistical analyses was carried out with SPSS win program. The results were as follows ; 1. Most of the variables of spacing group and some variables of dental arch dimension of crowding group were significantly different between genders. But in normal group, there were few differences. 2. In male crowding and female spacing group, mainly measurements of tooth dimension were significantly different from those of normal group. 3. In male spacing and female crowding group, measurements of dental arch dimension were significantly different from those of normal group. 4. The measurements of dimension of dental arch were highly correlated with ALD in correlation analysis and factor analysis. 5. Prediction equations for adult's ALDs by means of what can be measured in the mixed dentition(mesiodistal dimensions of incisors and first molar, intermolar width and arch length) showed R square from $63\%$ to $80\%$.
The purpose of this study was to compare the asymmetric degree between maxillofacial hard and soft tissues in individuals with facial asymmetry. Computerized tomographies (CT) of 34 adults (17 male, 17 female) who had facial asymmetry were taken. The CT images were transmitted to personal computers and then reconstructed into three-dimensional (3D) images through the use of computer software. In order to evaluate the degree of facial asymmetry, 6 measurements were constructed as the hard tissue measurements while 6 counterpart measurements were taken as the soft tissue measurements. The means and standard deviations were obtained for each measurement using 3D measure, then t-test was used to investigate the differences between each hard tissue measurement and the corresponding soft tissue measurement All measurements used in the present study showed statistically significant differences between the hard and soft tissues. The degree of soft tissue asymmetry was smaller than that of corresponding hard tissue asymmetry in case of chin deviation, frontal ramal inclination difference, and frontal corpus inclination difference. On the other hand, the degree of soft tissue asymmetry was greater than that of underlying hard tissue asymmetry in the measurement of lip canting and lip cheilion height difference The present study suggests that asymmetric differences of hard and soft tissue is observed nu facial asymmetric subjects and thus soft tissue analysis is needed in addition to hard tissue analysis when making an evaluation of facial asymmetry.
In order to take cue of the dying persons and their survivors in a more positive and affirmative atti-tube. and to understand the valuable meaning of and dying. a survey was performed to 550 cases of health care personnels including 116 nursing students. 238 medical students. 137 nurses. and 59 doctors. Samplings were made through census Procedure from the entire group of medical and nursing students in College of Medicine. Chung-Ang University. and of licenced nurses and doctors in Chung-Ang University Hospital. and in Han-Gang Sacred Heart Hospital from the first to the end of march. 1980. These collected data were computerized at KIST by SPSS programming and were statistically analyzed by chi-square test. Through content analysis of the word associated with death and descriptive analysis of the death-re-lated variables. the following conclusion in is reached. First. Total numbers of death-word percieved by health care personnels were 198 kinds. Among them, 40 kinds of words associated with death were responded from than 1% of the total. As to the 10 death related word responded by free word association method. it was revealed that individual average number of death related word was 7.70 word. which came from higher number of words in the senior students (8.96 word) or the graduates (8.10 word) compared with the freshman (6.84 word). Second. In Content specific analysis of the death related word. more frequently perceived types summarized as the following order; the affective context of death. the diseases. the disasters. the religion, the funeral ceremonies. the separation, the drakness. and the life. Third. The most prevalent 10 words associated with death which the the respondents gave response to the the first recalling word. were as following o order; the dieases. the sadness, the vanity. the darkness, the frustration. the suicide. the incurable dieases, the graves. the dead. and the catastrophes. By sex, the diease is outstanding in females, but the vanity is in males. By occupation. the vanity and the dead was frequently observed in student group including senior students. while the incurable dieases presented by doctors. Fourth. In health care personnels. the first perceived ages of death were 11.47 $\pm$3.33 years (8.14- 15.80 years). Among them. senior students were inclined to percept death at the earliest age of life (11.28years). while doctors and nurses perceived death later in their life (12.98 years). Fifth, It is revealed in this survey that the most frequently responded death perceiving motives by health care personnels ar“psychological conflict”and“death of those around them”. Death perceiving motives can be classified in two factors; personality and life circumstances. Sixth It is of interest that only 11.3% health care personnels was found to feel death as inevitable or acceptable event. whereas 58.3% deny or reject it.
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