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Changes in Water and Electrolyte Distribution and Blood Glucose Concentration following Irreversible Hemorrhagic Shock (비가역성 실혈성 쇽에서 본 가토심근, 혈장의 전해질 및 혈당량 변화)

  • Kim, Ki-Whan;Nam, Kee-Yong
    • The Korean Journal of Physiology
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    • v.2 no.1
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    • pp.47-52
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    • 1968
  • Twenty white rabbits anesthetized with nembutal (30 mg/kg) were employed in this experiment. Five of them served as controls; the remaining rabbits as experimental group were subjected to irreversible hemorrhagic shock. Shock was induced by bleeding the animals until mean blood pressure decreased to a level of 50-40 mmHg. This level of pressure was maintained for 3-4 hours, after which the drawn blood was reinfused. The reinfusion of blood caused the elevation of arterial pressure almost the control level for some minutes, after which a gradual and progressive decline of blood pressure became evident. This decline was thought to be the result from irreversible hemorrhagic shock. When mean blood pressure declined to less than 50 mmHg, chest was opened and samples of arterial blood and left ventricular muscle were taken. Left ventricular muscle and blood plasma were analyzed for potassium, sodium, chloride and water content. Blood glucose concentration was determined by Somogyi-Nelson's method. Extracellular and intracellular myocardial water and electrolyte content were calculated on the basis that electrolytes are distributed between plasma water and interstitial water according to Gibbs-Donnan equilibrium. In this calculation extracellular water was substituted for Na space. The findings obtained were as follows: 1. The concentration of blood glucose was 87mg% in the controls and it rose to 222 mg% in shock (P<0.01). 2. Plasma potassium elevated significantly from 3.3 mEq/l in controls to 8.0 mEq/l in shock (P<0.01), while small decreases in sodium (151-146 mEq/l) and chloride (102-96 mEq/l) were observed (P<0.3, P<0.1), 3. The changes of blood water content (83.1-84.3%) and cardiac water content (77.5-78.3 gm/100gm WT) were observed. 4. In control animals myocardial potassium levels which averaged 30.2 mEq/100 gmDT rose significantly to 40.3 mEq/100 gmDT in shock (P<0.01), while moderate decreases in sodium(16.3-14.3 mEq/100 gmDT) were observed in shock. 5. The calculated transmembrane resting potential of left ventricular muscle of control animals averaged 95 mV, while rabbits in shock averaged 77 mV. (P <0.01). The findings of this experiment do not correspond with the conclusions that myocardial depression seems to be the cause of irreversible hemorrhagic shock, because the excitability of heart muscle is elevated. From the point of view that the lowered transmembrane resting potential, the cause of death in terminal stage of irreversible hemorrhagic shock may be ventricular fibrillation. It can't be said, however, that the lowered transmembrane resting potential is responsible for the transition from reversible to irreversible hemorrhagic shock. The marked increase in blood glucose suggested that glycogenolysis in the liver is favorably active in shock.

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A Study on Risk Factors of Metabolic Syndrome and Health Behaviors in a Region - 2014 community health survey - (일 지역 대사증후군 위험인자와 건강행태에 관한 연구 -2014 지역사회건강조사-)

  • Ahn, Ok-hee;Choi, Seong-hui;Kim, Seo-Hyeon;Ryu, Si-Ok;Choi, Young-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.218-225
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    • 2016
  • Recently, Korea has undergone rapid social and economic development, and with that came various changes in living habits and disease patterns; the nation, accordingly, has been alerted to the associated risks of chronic ailments. As risk factors of metabolic syndrome commonly include causal factors of chronic diseases, prevention is important. The prevalence of metabolic syndrome in Korean adults is 22.4%, which comprises a large portion of the whole disease (Korean National Health and Nutrition Examination Survey, 2013). This study aims to examine the elements of healthy living practices by analyzing the risk factors of metabolic syndrome and health behaviors, and provide basic materials to contribute to the activation of health promotion. Among 12,481 subjects of the source data from the 2014 community health survey, which was performed on adults aged 19 and over in Jeonlabuk-do, 12,185 people were analyzed in this study using SPSS 23.0. There were significant differences with respect to sex, smoking status, age, education level, and number of days of physical activity among the results of the difference of the risk factors of the metabolic syndrome according to the characteristics of the health behavior of the subjects. Of the risk factors for metabolic syndrome, this study emphasized the necessity of strategies to promote health programs regarding the management of drinking, smoking, physical activities, depression, subjective health condition and quality of life to the group of those with dyslipidemia, hypertension, and diabetes.

Association with Self-Perception for Obesity and Mental Health among Korean Adolescent (한국청소년에서 자가비만인식도와 정신건강과의 관련성)

  • Hwang, In-Cheol;Lee, Kyoung-Shik;Park, Dong-Kyun;Jung, Eun-Young;Choi, Chung-Hyun;Cho, Seong-Jin;Bae, Seung-Min
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.2
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    • pp.112-119
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    • 2011
  • Objectives : Obesity has been linked to various psychological problems as well as medical complications, especially among adolescents. Previous studies have suggested an association between body weight and depression or self-esteem ; however, there has been little evidence on self-perception of weight and mental health. The aim of this study was to examine the association of perceptional weight status with mental health in Korean adolescents. Methods : This study was based on data obtained from the third Korean National Health and Nutritional Examination Survey (2005). The study sample consisted of 583 adolescents (268 boys, 315 girls) aged 12-18 years, who had completed the health survey, the health examination, and the nutritional survey. Participants were divided into two groups based on the actual or perceptional weight status: non-obese and obese. Questionnaires for stress, depressive mood, and suicidal thoughts were utilized as mental health indicators. Results : The agreement between actual and perceptional weight status was moderate (k value, 0.585 ; p<0.01). The influencing factors for the discrepancy between actual and perceptional weight status were body mass index of subjects and their parents' education. The obese group was likely to have higher stress levels and more experience of depressive mood or suicidal ideation in regard to both actual and perceptional weight status. A multiple logistic regression analysis revealed that girls who had perceived themselves as obese were more likely to have an experience of depressive mood than other girls (unadjusted OR, 4.98 ; adjusted OR, 5.15). Conclusion : An experience of depressive mood was significantly associated with the perception of weight status and not actual weight status in Korean female adolescents.

Study on Case-Mix in Long-Term Care Facilities for Elderly (장기요양시설 노인의 환자구성에 관한 연구)

  • Jeon, Yi-Jee;Kim, Suck-Il;Hum, Yu-Seung;Yi, Sang-Wook
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.130-147
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    • 2001
  • This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

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Health Complaints of Elderly Persons Using a Modified C.M.I. (C.M.I.간이법에 의한 노인들의 건강수소율)

  • 박오장
    • Journal of Korean Academy of Nursing
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    • v.13 no.2
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    • pp.44-57
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    • 1983
  • The explosion of the aging population is changing the social environment of today's older people. Traditionally in Korea, a large percentage(over 90%) of elderly parents have lived with their married first son. But today, the number of elderly who live with their married sons has decreased(65.6%) The number of those who live in a different situation such as with their married daughter, unmarried offspring, with a spouse or alone has increased (34.4%) We can expect that the number of the elderly who have to live in institution will increase. The objective of this investigation was to determine differences in the number of health Complaints of older people according to their living situation with a view to planning more effective health care. The sample consisted of 231 persons over 65 years of age, 60 living in an Old Age Home ana 171 living in their own home in Kwangju. Data were gathered from July 9 to 26, 1983 by nursing students using a Questionnaire which was a modified form of the Cornell Medical Index. The data were categorized according to the subjects, living, sex, educational level, previous occupation, hobbies and sexual activity. The date were analyzed for statistical significant differences using F and X²tests. findings included the following: 1. There was a higher number of health complaints from persons who live in the institution than those living at home, but the difference was not significant. 2. The highest number of health Complaints were from persons who live alone, followed by those living with their daughters, and then by those living in the institution. Persons who live with their sons had the least Complaints. The difference in the number of Complaints accord-ing to with whom they were living was significant. 3. Women had signincantly more Complaints than men. Persons who were not living with their spouses had significantly more complaints than those living with their spouses.4. The higher eductional level the persons had, the less health Complaints they had. The number of Complaints accoraing to educational level was significantly different. 5. The highest number of health complaints were from persons who had involved in Commerce and industry, followed by those in Agriculture. Persons who were civil servant had the least 6. There were more complains from persons who had no hobby than those with hobbies. The complaints. The difference was significant. difference was significant. 7. Persons who said they were sexually inactive had significantly more complaints than those who said they were sexually active. As age increased, sexual activity significantly decreased. Those who lived with their spouse were significantly more sexually active. 8. The highest number of Somatic Complaints were eye fatigue, followed by nocturnal frequency, lumbago, cramps in extremities, vertigo, stiffness in Shoulder, tinnitus, common cold and constipation. The order of Psychic Complaints from higher to lower were anger. sensitivity, anxiety, depression and loneliness. 9. This group of Elderly persons said they valued Health the most, followed by Harmony, Religion, Money and Honor.

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Related Factors with Medication Task Ability in Rural Elderly (일부 농촌 노인에서의 약물복용 수행능력과 관련된 요인)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.35-47
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    • 1999
  • Medication non-compliance among the elderly results in medical problems and substantial cost to the health care system. This study investigate predicted variable related to the medication task ability among elderly. This study was done in the selected 4 villages in Kimchun County of Kyungbuk Province from July to August, 1996. The subject was the resident that 202 adults above 60 years of age. The questionnaire of interview included medication task ability, socio-demographic data, COOP/WONCA chart, family ABGAR score. BDI(Beck depression inventory), ADL(activities of daily living), IADL(instrumental activities of daily living), and MMSE-K(minimental state examination-Korean version). The results were as followed : 1. Approximately 49% of study population was taking drug medication currently. We found that 93% of study population was successful at the medication task all alone, 6% was failure at the medication task all alone, so need help partly or completely. 2. Significant variables between group of medication task ability were age, educational attainment, IADL, and MMSE-K in univariate analysis. And significant correlated variables with medication task ability were ADL, IADL, MMSE-K, and BDI in correlation analysis. 3. Major predictors to medication task ability on multiple logistic regression were IADL and sex finally. Findings suggest that IADL is related to medication task ability than other test battery of health status, so IADL could be used to necessary for medication management and add information to conventional methods of assessing mental status.

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DEVELOPMENT OF KOREAN ADOLESCENT FORM OF SUICIDAL IDEATION QUESTIONNAIRE (한국형 청소년 자살사고 설문 개발)

  • Suh, Dong-Soo;Yang, Suk-Hoon;Lee, Kil-Hong;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.168-177
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    • 2004
  • Objectives : This study was done to develop Korean form of Reynolds' SIQ-JR(Suicidal Ideational Questionnaire-Junior). Through this study we evaluated reliability and validity of Korean form SIQ-JR. Methods : Subjects were 1,160 middle and high school students and 114 adolescent psychiatric patients. SIQ-JR and 8 self-reporting scales highly related with suicidal ideation and suicide behaviors were applied to them. Results : In reliability aspect of Korean form of SIQ-JR, internal consistency, test-retest reliability and item-total correlation were statistically significant results. In factor analysis, concerning about other person was extracted as a indepenedent factor. This results reflect our cultural characteristics. There were statistical differences of SIQ-JR scores in groups by sex and age. Clinical group showed significantly(P<0.01) higher scores than general population. Among the 8 suicidal relating scales, depression(r=0.42), aggression(r=0.36), trait anxiety(r=0.35), and anger-in(r=0.31) were highly related with suicidal ideation but impulsivity and hopelessness were not significantly related with suicidal ideation. Conclusion : Korean form of SIQ-JR was useful instrument in reliability and validity. We hope that this instrument widely used in school mental health, community psychiatry and clinical setting for screening tool.

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Topiramate for the Treatment of Binge Eating Disorder or Bulimia Nervosa : A Systemic Review of Human Clinical Studies and Case Reports (Topiramate의 신경성 폭식증 치료효과: 국내외 보고된 임상연구결과 및 치험사례 중심으로)

  • Lee, Yu-Jeung;Bang, Joon-Seok
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.6-12
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    • 2007
  • The clinical investigations above suggest that topiramate may be an effective agent in the treatment of BED or BN by reducing binging/purging episodes, improving the HRQOL, and decreasing weight. The case report and case series also support these findings. However, there are several limitations in the above studies and cases. All these had relatively small sample size, and two of them were only 10-week-period studies. Optimal duration of treatment with topiramate in patients with BED or BN is unknown. As most clinicians treat the patient with BED or BN for 6 to 12 months and then reassess, at least 6 months period is needed to show its efficacy. One of studies included only women in the patient group. In the case series, all patients had severe comorbid mood disorders such as major depression and bipolar disorder besides BN. Therefore, notwithstanding its clinical usefulness, additional researches are needed to define the role and the benefits of topiramate in the treatment of BED or BN more thoroughly.

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Right Amygdalar Laterobasal Subregional Differences in Healthy Adults with Different Novelty Seeking Tendencies (정상 성인에서 자극추구 기질에 따른 우측 편도체의 측기저 세부구조의 차이)

  • Cho, Han-Byul;Kim, Bin-Na;Choi, Ji-Hye;Jeon, Yu-Jin;Kim, Ji-Hyun H.;Jung, Ji-Young J.;Im, Joo-Yeon Jamie;Lee, Sun-Hea
    • Korean Journal of Biological Psychiatry
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    • v.19 no.2
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    • pp.71-76
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    • 2012
  • Objectives : Novelty seeking (NS) represents a dopaminergically modulated tendency toward frequent exploratory activity. Considering the reports showing the relationship between exploratory activity and amygdalar function and structure, and the fact that amygdala is one of the key structures that constitute the dopaminergic pathway in the brain, amygdala might be closely related to NS tendencies. Amygdalar subregional analysis method, which has the enhanced sensitivity compared to the volumteric approach would be appropriate in investigating the subtle differences of amygdalar structures among healthy individuals. The aim of the current study was to examine whether amygdalar subregional morphometric characteristics are associated with the NS tendencies in healthy adults using the amygdalar subregional analysis method. Methods : Twenty-six healthy adults (12 males, 14 females ; mean age $29.8{\pm}6.2$ years) were screened for eligibility. All subjects completed the Korean version of the Temperament and Character Inventory (TCI) and underwent high-resolution brain magnetic resonance imaging. Individuals were divided into 2 groups according to NS scores of the TCI. Results : Individuals of the high NS group had significantly larger laterobasal subregions in right amygdala, after adjustment with the brain parenchymal volumes. Sensitivity analyses for each potential confounding factor such as age, education years and Hamilton Depression Rating Scale (HDRS) scores demonstrated consistent results. Conclusions : This study suggests that NS differences are associated with the laterobasal subregion of the amygdala.

A Study on the Possibility of Homegrown Terrorism in Korea Depending on Internalization and Strategy to Cope with the Terrorism (국제화에 따른 한국내 자생테러 발생 가능성과 대응전략)

  • Yu, Hyung-Chang
    • Korean Security Journal
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    • no.31
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    • pp.125-155
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    • 2012
  • Terrorist organization has shown the trend of secret organization and it is harder to cope with terrorism because of uncertainty of terrorism. Homegrown terrorism is the one, whose preparation, execution and effect are restricted to domestic area. By the way, in the worldwide economic depression, violence and radical demonstration have shown the expansion trends as in Middle East, political revolution of Africa, anti-social resistance of Europe and Wall Street Occupation of USA. Homegrown terrorism is occurring in various countries such as UK and Spain as well as USA. Specialists warn homegrown terrorism in Korea. The purpose of this study was to prospect the possibility of homegrown terrorism that can be generated in the transfer to multi-culture society as various foreigners come to Korea rapidly and suggest the method to cope with the trend. The study analyzed environment and analysis of homegrown terrorism that Korea faces now. The methods to cope with homegrown terrorism are as follows. First, distribution of radical homegrown terrorism via internet should be prevented. Second, the connection between terrorist organization and homegrown terrorist should be prevented. Third, there should be a cooperation among government, residents and religious group. Fourth, there should be an open approach against multi-culture society. Fifth, there should be a systematic control for cause of new conflict. Finally, there should be a long-term approach to cause of new conflict. If we do not make an effort to prevent homegrown terrorism, terrorism environment may face new aspect and national and social cost for it will increase.

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