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Changing Trends in the Occurrence and Management of Delirium for 5 Years in a University Hospital (일 대학병원에서 5개년간 섬망의 발생 및 치료 경향의 변화)

  • Bae, Jae Ho;Kang, Won Sub;Paik, Jong Woo;Kim, Jong Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.112-119
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    • 2012
  • Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

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A Study on the Relationships between the Oral Health Activities and Oral Health Conditions of the Elderly (노인의 구강보건행위와 구강건강상태와의 관련성 조사 연구)

  • Gwon, Mi-Young;Young, Jin-Young
    • Journal of dental hygiene science
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    • v.6 no.4
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    • pp.271-276
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    • 2006
  • This study set out to analyze the relationships between the senior citizens' dental health activities and dental health conditions, to provide basic data to develop a program for their better dental health, and finally to search for the ways to improve their life quality through dental health care. The subjects were 142 senior citizens(58 were male and 84 were female) who were 65 years old or older and visited a dental hospital or clinic in the Seoul metropolitan area from April 17 to April 28, 2006. With the cooperation from the dentists, the investigators examined their dental conditions and conducted one-on-one interviews to collect the information about their demographic characteristics, dental health activities, and subjective dental health conditions. The collected data were analyzed with T-test, ANOVA and Pearson's correlation coefficient using the SPSS WIN 11.5 program. The analysis results were summarized as follows: First, 58 men(40.8%) and 84 women(59.2%) consisted of the subject group, where percentage of the female participants was bigger Those who were aged from 65 to 69 made the biggest age group in the subjects, accounting for 58.5% with 83. Second, those who had three dental caries or less and then didn't treat them or treated them(F) accounted for the biggest percentage with 117(82.4%) and 72(50.7%) respectively. As for the remaining teeth, the biggest number of them(40 subjects, 28.2%) had three or less remaining. Third, it turned out the female subjects had a higher level of dental health activities than their male counterparts(P = 0.00). As for living expenses, those who were paid salary or earned income themselves carried out their dental health activities in a higher level than those who lived on the benefit from the government(p = 0.02). Fourth, the subjects' subjective dental health conditions had negative correlations with their dental caries not treated. And there were positive correlations between their dental caries not treated and dental caries lost and between their dental caries treated and remaining teeth. Fifth, those subjects who earned their living expenses themselves had the most dental caries treated at 5.4(p = 0.02), and there was statistically significant difference with the numbers. Sixth, those subjects who brushed their teeth in their own manner had 11.8 teeth lost(p = 0.05), which was more than the number of those who brushed their teeth in other methods. And there was statistically significant difference among them. The remaining teeth were found most at 17.3(p = 0.00) among those who brushed their upper and lower teeth separately. In addition, those who visited the public health center often had significantly more teeth treated(4.3) than others(p = 0.00).

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가정 폭력 경험이 남자 범죄 청소년의 남성성에 미치는 영향에 관한 연구

  • Kim, Kyung-Ho
    • 한국사회복지학회:학술대회논문집
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    • 2003.05a
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    • pp.282-309
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    • 2003
  • This exploratory qualitative study investigates the effects of experiencing domestic violence on male adolescent offenders' masculinities. Empirical and theoretical literature suggests that negative male role models in violent families result in male adolescents' experiencing conflict in constructing gender identities, especially masculinities. Moreover. criminologists argue that masculinities are often connected with crimes as a way to prove masculine competence. This study compares male adolescent offenders who have experienced domestic violence with those who have not experienced domestic violence and explores how domestic violence experiences influence the construction of gender identities among male adolescent offenders. The study used a secondary qualitative data analysis method. The data consisted of ethnographic in-depth interview transcripts, observational field notes, and formal facility records collected at a juvenile correctional facility in Minnesota. The process of data analysis was a "constant comparative method" that sought to understand differences and similarities in the expressed gender narratives and identity patterns between the two groups of offenders. This process also examined differences within each group. The qualitative data analysis revealed that domestic violence experiences in childhood may be related to the construction of gender identities during adolescence. The findings of this study showed that male adolescent offenders who had experienced domestic violence tended to attach themselves to oppressed mothers more readily than those who had not experienced domestic violence. Next, their attachment to mothers related to the construction of more relational gender identities although most participants, regardless of domestic violence experiences, had much in common regarding gender expression. Finally, despite these relational gender identities, male adolescent offenders who had experienced domestic violence tended to depend upon violence and crimes to show masculine competence, as did male adolescent offenders who had not experienced domestic violence. The study findings suggest a need for research to understand the construction of gender identities in the context of particular experiences and the importance of building theories that advance a comprehensive understanding of the construction of masculinities and youth crime. This study also discusses the development of social work programs that protect young men from adherence to exaggerated masculinity, which is often associated with crimes.

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Health-Related Behaviors and Nutrient Intake of Police Officers Based on the Level of Job Stress (일부 지역 경찰공무원의 직무스트레스 정도에 따른 건강관련 형태 및 영양소 섭취량에 관한 연구)

  • Joo, Hye-Eun;Sohn, Cheong-Min
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.39 no.4
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    • pp.518-525
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    • 2010
  • The purpose of the study was to examine health-related behaviors and nutrient intake in relation to job stress level of police officers. Total of 166 police officers working in Jeonbuk area participated in the study. The study was conducted from February to March, 2009. Subjects were given self-administered questionnaire on their general health status, dietary and health-related habits. Nutrient intake was assessed by semi-quantitative food frequency questionnaire. Subjects were divided into four groups (very low, low, high, very high) by their job stress level scores. Main concerns of job stress were from 'job demand', 'organizational system' and 'lack of reward'. More than 95% of the subjects were confident of their health status. Health habits, such as drinking, smoking and exercising, were better than that of average Korean men. There were significant differences in dietary habits in relation to job stress level. Lower job stress group showed lower rate of skipping breakfast (p<0.01), more affordable meal time (p<0.05) and better snacking habits (p<0.001). Sweet food preference was higher in lower job stress group (p<0.05). The average calorie intake was $2063\pm532.7$ (88.5% of EER) and there was no significant difference in nutrient intake among job stress levels. However, mean intake of calcium and vitamin $B_2$ was less than 75% of %DRI in higher job stress group. Therefore, further support in nutritional counseling programs to improve dietary behaviors and health habits and to reduce job concerned stress of the police officers will be necessary.

Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V (우리나라 성인남녀의 골밀도 관련요인: 국민건강영양조사 제 5기 1, 2차 년도(2010년, 2011년))

  • Kim, Kyung Sook
    • Journal of agricultural medicine and community health
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    • v.39 no.4
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    • pp.240-255
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    • 2014
  • Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

Effects of Minor Stressful Events on Sleep in College Students (대학생에서 스트레스가 수면에 미치는 영향)

  • Kang, Seung-Gul;Yoon, Ho-Kyoung;Ham, Byung-Joo;Choi, Yun-Kyeung;Kim, Seung-Hyun;Joe, Sook-Haeng;Suh, Kwang-Yoon;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.48-55
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    • 2002
  • Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

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An Analysis of the National Suicide Rate in Korea during 2005 (2005년 전국 자살실태 분석)

  • Kim, Gi-Jeong;Kwak, Jyung-Sik
    • Journal of forensic and investigative science
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    • v.2 no.1
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    • pp.5-22
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    • 2007
  • From the numerous social problems generated by the unbalanced social development and the social trend of belittling life overall, we found the causes of suicide getting worse in its seriousness day by day. In reality, the problem has been approached in a collateral level in contrast with other social problems. There have been an active involvement in studying the definition, causes and ways of prevention of suicide theoretically until now. However, different from other social problems, it is almost impossible to treat or fix the problem of suicide. Only ways to treat or fix the problem is when the suicide has ended in failure. Thus, this study intends to examine the suicide rate among the total accidents during the year 2005, perform the analyses on the actual causes according to the relations such as the means of suicide, occupation, age group, educational background, etc. In order to present a solution to the issue of suicide becoming serious each day. Among the total accidents in 2005, the suicide rate came out to be approximately 52.4%. Among the result, 52.4%, male with 69% resulted higher than female with 31%, which appears to be related to the social functions. While men tends to take more active(80%) means of suicide like jumping off, poison, hanging, etc., women tends to take more passive(60%) means of suicide like sleeping pills, slitting wrist, etc. In terms of the cause, pessimism, illness, denial, mental disorder, etc resulted more than 75%, and there were many cases of suicide after exhibiting the signs of depression. Also there were higher suicide rate of the unemployed engaged in direct labor with educational background lower than college level related to the pessimism regarding the family living cost. We were able to determine the recent increase in the suicidal tendency of the educated people higher than the college level and the retired people with depression caused by the sudden change in social status. Overall there are several reasons for suicide, however, in most cases the signs of depression were exhibited until the final suicide, which tells us the serious psychological problem of suicide. Assuming that the current development of suicide will continue in future, the result of this study will guide the corresponding social policies, be utilized in preparing the insurance or management at the national level dealing with the real social problems that are not just a conflict of an individual, but could spread like a fad and become much bigger than the present by the continuous support at the environmental, social and political levels, and be utilized as the basic data to establish the research plan.

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한국농촌의 식품금기에 관한 연구

  • 모수미
    • Journal of the Korean Home Economics Association
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    • v.5 no.1
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    • pp.733-739
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    • 1966
  • A 371 agricultural households from 26 different communities in South Korea was subjected on a study of food taboos in January of 1966. To the pregnant women, those to whom a high protein diet is particurally important, as many as 14 different kinds of foods, mostly portein rich foods, were avoided to eat. It is believed that if duck is eaten while pregnant her baby may walk like a duck in later life. Some mother have a strong aversion to the rabbit meat that her unborn baby must be a harelip. It is feared to eat chicken, shark or carp by the pregnant mother for her baby may get a gooseflesh appearance, or fish scale-like skin in later life. It is thought that if mother eats soup made of meat borns, especially chicken bones, a disfigured baby may be born. Some area informed that if mother eats crab meat her future baby will always bubble. To the child-bearing mothers 13 different kinds of foods were avoided to eat. Some believe that if raddish kimchi, soybean curd, squash are eaten while dilivery that mother may get dental decay or to lose all her teeth. Other think that highly spiced raddish kimchi cause delivery difficult. To the lactating mothers 7 different items of foods were not recommended to eat. It is a common belief that eating green vegetables, especially fresh lettuce, are restricted that her baby may stool greenish. It is said that eating ginsen-chicken soup, or ginsen tea during lactating reduces breast milk secretion. To the weaning babies 7 different kinds of foods were prohibited to fee. Eggs are not eaten because mothers think her babies will start to talk very late. Eight different items of foods in cases of gastro-intestinal diseases, 5 items for liver disease, 7 items for high blood pressure as well as for paralysis were respectively restricted. It is said that meats including pork, beef, and chicken are neither desirable for the patients of high blood pressure nor those of paralysis. To the measles children 10 varieties of foods were restricted. Especially soybean products and meats were not encouraged to use for avoiding asecond attack of measles. For the common cold 8 different kinds of foods were aversed and men think that eating of soup of undria delays a recovery. For the tuberculosis 4 kinds of foods were prohibited to eat. It is said that wine, red pepper and ginsen will stimulate lung bleeding. Many mothers had a strong aversion to fermented shrimp and fish in case of style. and 5 different items of foods were restricted. In case of menstration not so many foods were restricted as other cases, but meat soup is not eaten in this condition in some areas. Majority of food taboos in Korean villages are neither based on tribal nor religious factors. But no one knows how, since what ages, from where, these food taboos have been transmitted and spread over the country. This survey found a great variety of food taboos, aversions, traditional beliefs and prohibitions latent unknown reseasons, or non-scientific conceptions, or completely different ideas from the modern medical aspect, or somewhat fallacious and superstitious beliefs. For the vascular disease contrasting approach were found between modern the oritical therapy and popular remedy among the rural populations who largely depend on the eastern medication. Further scientific study on either side should be done to lead the patient proper way. Many restricted foods such as rabbit, duck, chicken and fish are best resources of protein rich foods which are available in the village. Emphasis should be laid upon breaking down fallacious and supersititious food taboos through the extended nutrition education activities in order to improve food habit and good eating pattern for healthier and stronger generations of Korea.

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Quantitative Evaluation of Regional Cerebral Blood Flow by Visual Stimulation in $^{99m}Tc-HMPAO$ Brain SPECT ($^{99m}Tc-HMPAO$ 뇌 SPECT에서 시각자극에 의한 국소 뇌 혈류변화의 정량적 검증)

  • Juh, Ra-Hyeong;Suh, Tae-Suk;Kwark, Chul-Eun;Choe, Bo-Young;Lee, Hyoung-Koo;Chung, Yong-An;Kim, Sung-Hoon;Chung, Soo-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.3
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    • pp.166-176
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    • 2002
  • Purpose: The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of $^{99m}Tc-HMPAO$ (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. Materials and Methods: The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and $^{99m}Tc-HMPAO$ SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the legion of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). Results: The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was $32.50{\pm}5.67%$. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Conclusion: Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

Estimated dietary intake of vitamin A in Korean adults: Based on the Korea National Health and Nutrition Examination Survey 2007~2012 (우리나라 성인의 비타민 A 섭취현황 : 2007~2012년 국민건강영양조사 자료를 이용하여)

  • Kim, Seong-Ah;Jun, Shinyoung;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.49 no.4
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    • pp.258-268
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    • 2016
  • Purpose: The purpose of this study was to estimate dietary vitamin A intake and examine major food sources of vitamin A in Korean adults. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 33,069 subjects over 19-years-old were included in this study. We estimated individual daily intakes of retinol, carotenoids such as ${\alpha}$-carotene, ${\beta}$-carotene, ${\beta}$-cryptoxanthin, lutein/zeaxanthin, and lycopene, and vitamin A by linking food consumption data with the vitamin A database of commonly consumed foods. We compared individual vitamin A intakes with the reference value of Dietary Reference Intakes for Koreans. Results: Average dietary vitamin A intakes of study subjects were $864.3{\mu}g$ retinol equivalent/day ($495.7{\mu}g$ retinol activity equivalent/day) in men and $715.0{\mu}g$ retinol equivalent/day ($403.6{\mu}g$ retinol activity equivalent/day) in women. Exactly 42.9% and 70.6% of total subjects consumed less vitamin A than the Estimated Average Requirement (EAR) based on retinol equivalent and retinol activity equivalent, respectively. The major food sources of vitamin A were Korean radish leaves, carrot, red pepper, and laver, and the top 20 foods provided about 80% of total vitamin A intake. Conclusion: This study provides basic data for estimation of vitamin A intake in Korean adults. Further research will be needed to analyze the association of insufficient or excess intakes of vitamin A and health problems in the Korean population.