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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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Pericentric Inversion of the X Chromosome in a Male with Azoospermia and in the Family of a Pregnant Female Carrier (무정자증을 보이는 남성과 정상 생식력을 가진 여성의 가계에서 관찰된 X 염색체의 Pericentric Inversion)

  • Lee, Bom-Yi;Ryu, Hyun-Mee;Lee, Moon-Hee;Park, Ju-Yeon;Kim, Jin-Woo;Lee, Joong-Shik;Kim, Hye-Ok;Kim, Min-Hyung;Park, So-Yeon
    • Journal of Genetic Medicine
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    • v.5 no.2
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    • pp.139-144
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    • 2008
  • We report on two cases of pericentric inversion of X chromosome. The cases were found in a 40-year-old man with azoospermia and in a family of a 38-year-old pregnant woman. The first case with 46,Y,inv(X)(p22.1q27) had concentrations of LH, prolactin, estradiol, and testosterone that were within normal ranges; however, FSH levels were elevated. Testis biopsy revealed maturation arrest at the primary and secondary spermatocytes without spermatozoa. There were no microdeletions in the 6 loci of chromosome Y. For the second case, the cytogenetic study of thepregnant woman referring for advanced maternal age and a family history of inversion X chromosome was 46,X,inv(X)(p22.11q27.2). The karyotype of her fetus was 46,X,inv(X)(p22.1q27). Among other family members, the karyotypes of an older sister in pregnancy and her fetus were 46,X,inv(X)(p22.11q27.2), and 46,Y,?inv(X), respectively. The proband's father was 46,Y,inv(X)(p22.11q27.2). All carriers in the family discussed above were fertile and phenotypically normal. In addition, the ratio of inactivation of inv(X) by RBG-banding was discordant between the two sisters, with the older sister having only 4.1% of cells carrying inactivated inv(X) while the proband had a 69.5% incidence of late replicating inv(X). Therefore, we suggest that the cause of azoospermia in the first case might be related to inversion X chromosome with positional effect. Also, the family of the second case showing normal phenotype of the balanced inv(X) might be not affected any positional effect of genes.

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Influence of Motivational, Social, and Environmental Factors on the Learning of Hackers (동기적, 사회적, 그리고 환경적 요인이 해커의 기술 습득에 미치는 영향)

  • Jang, Jaeyoung;Kim, Beomsoo
    • Information Systems Review
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    • v.18 no.1
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    • pp.57-78
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    • 2016
  • Hacking has raised many critical issues in the modern world, particularly because the size and cost of the damages caused by this disruptive activity have steadily increased. Accordingly, many significant studies have been conducted by behavioral scientists to understand hackers and their practices. Nonetheless, only qualitative methods, such as interviews, meta-studies, and media studies, have been employed in such studies because of hacker sampling limitations. Existing studies have determined that intrinsic motivation was the dominant factor influencing hackers, and that their techniques were mainly acquired from online hacking communities. However, such results have yet to be causally proven. This study attempted to identify the causal factors influencing the motivational and environmental factors encouraging hackers to learn hacking skills. To this end, hacker community members using the theory of planned behavior were observed to identify the causal factors of their learning of hacking skills. We selected a group of students who were developing their hacking skills. The survey was conducted over a two-week period in May 2015 with a total of 227 students as respondents. After list-wise deletion, 215 of the responses were deemed usable (94.7 percent). In summary, the hackers were aware that hacking skills are considered socially unethical, and their attitudes toward the learning of hacking skills were affected by both intrinsic and extrinsic motivations. In addition, the characteristics of the online hacking community affected their perceived behavioral control. This study introduced new concepts in the process of conducting a causal relationship analysis on a hacker sample. Moreover, this research expanded the discussion on the causal direction of subjective norms in unethical research, and empirically confirmed that both intrinsic and extrinsic motivations affect the learning of hacking skills. This study also made a practical contribution by raising the educational and policy response issues for ethical hackers and demonstrating the necessity to intensify the punishment for hacking.

Analysis to Determine the Employment Status of Married Women's on the Social Factors Associated (기혼여성의 고용지위 결정요인에 관련한 사회변인 분석)

  • Hwang, Hee-Sook;Kim, Youn-Jae;Park, Jung-Woo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.3
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    • pp.181-190
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    • 2012
  • After industrialization, the labor force participation rates of women, especially married women is drastically increasing. So, this study was designed to analyze the determinants of married women's employment status considered. For this, the determinants of married women's employment status were divided into individual-related, children-related, household-related and job-related variables to establish the research models. Based on this, the following results were drawn from a multinominal logistic regression analysis of the determinants of married women's employment status. First, an analysis of individual-related variable showed that married women had the employment status of labor wages with residence in the center of the city and high academic background. Second, an analysis of children-related variable showed that they had the employment status of labor wages with many their children and no their children under the age of six. Third, an analysis of household-related variable showed that they had the self-employment status of labor wages with nuclear family and few income earners of family members. Finally, an analysis of job-related variable showed that they had the employment status of labor wages when they got a job before they got married, their husband didn't get a job, and their husband worked in a professional field. As for findings stated above, as there was a difference in the determinants of married women's employment status, the ways for improvement in the married women's employment status would be suggested as follows. First, married women with young children have the low employment status, basically, requiring problem-solving ways for this because the housekeeping and child-rearing burden caused by marriage and childbirth are factors that continue to obstruct a job. For this, the flexible working hours system, which housekeeping and child-rearing can harmonize with economic activities like developed countries, needs to be activated. But the activation of such flexible working system will produce actual results under institutional protection, such as a related-protection law. Second, the Leave of Child Care System is debated as one of the most representatively systems that housekeeping can harmonize with economic activities. Now, although the System is legislated, the use is very poor.

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Prenatal Diagnosis of the 22q11.2 Duplication Syndrome

  • Lee, Moon-Hee;Park, So-Yeon;Lee, Bom-Yi;Choi, Eun-Young;Kim, Jin-Woo;Park, Ju-Yeon;Lee, Yeon-Woo;Oh, Ah-Rum;Lee, Shin-Young;Yang, Jae-Hyug;Ryu, Hyun-Mee
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.175-178
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    • 2009
  • The 22q11.2 duplication syndrome is an extremely variable disorder with a phenotype ranging from normal to congenital defects and learning disabilities. Recently, the detection rate of 22q11.2 duplication has been increased by molecular techniques, such as array CGH. In this study, we report a familial case of 22q11.2 duplication detected prenatally. Her first pregnancy was terminated because of 22q11.2 duplication detected incidentally by BAC array CGH. The case was referred due to second pregnancy with same 22q11.2 duplication. We perfomed repeat amniocentesis for karyotype and FISH analysis. Karyotype analysis from amniocytes and parental lymphocytes were normal, while FISH analysis of interphase cells presented a duplication of 22q11.2 in the fetus and phenotypically normal mother. The fetal ultrasound showed grossly normal finding. After genetic counseling about variable phenotype with intrafamilial variability with 50% recurrence rate, the couple decided to continue the pregnancy. The newborn had no apparent congenital abnormalities until 2 weeks after birth. We recommend that family members of patients with a 22q11.2 duplication be tested by the interphase FISH analysis. Also, we point out the importance of genetic counseling and an evaluation of the clinical relevance of diagnostic test results.

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Occurrence and Molecular Phylogenetic Characteristics of Benthic Sand-dwelling Dinoflagellates in the Intertidal Flat of Dongho, West Coast of Korea (서해안 동호 사질 조간대에 서식하는 저서성 와편모류의 출현양상 및 분자계통학적 특성)

  • KIM, SUNJU;YOON, JIHAE;PARK, MYUNG GIL
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.20 no.3
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    • pp.141-150
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    • 2015
  • Dinoflagellates are ubiquitous and important primary producers in the oceans. They have diverse trophic modes, i.e., phototrophic, heterotrophic, and mixotrophic modes and thereby, play important ecological role in marine microbial food-web. While many studies have been focused on planktonic dinoflagellates in pelagic ecosystems, benthic, sand-dwelling dinoflagellates that inhabit in intertidal zone have been very poorly documented worldwide. We investigated biodiversity, occurrence, and molecular phylogeny of benthic, sand-dwelling dinoflagellates from the intertidal flat of Dongho, west coast of Korea during low-tide, monthly from November 2012 to February 2014. About 27 species of 13 genera in orders Gonyaulacales, Gymnodiniales, Peridiniales, Prorocentrales have been identified, of which members in the genus Amphidinium constituted a major part of the sand-dwelling dinoflagellates in this area. A total of 34 isolates from 16 species of the sand-dwelling dinoflagellates were isolated from Dongho, Mohang, Gamami, and Songho in the west coast and Hyupjae in Jeju of Korea, their 28S rDNA sequences were successfully amplified, and applied for molecular phylogenetic analyses. In the 28S rDNA phylogeny, Amphidinium species diverged across three major clusters within the order Gymnodiniales and formed polyphyletic group. Based on the unambiguously aligned partial 28S rDNA sequences including variable D2 region, the genotypes of Amphidinium mootonorum Korean strains greatly differed from that of Canadian strain with 19.2% of pairwise nucleotide difference, suggesting that further ultrastructural studies may provide additional characters to clearly separate these genotypes. Two potential toxic species, Amphidinium carterae and A. operculatum appeared occasionally during this study. Quantitative assessment and toxicity of those species should be addressed in the future.

Improved Acroparesthesia During Enzyme Replacement Therapy in a Patient Lately Diagnosed with Fabry Disease (진단이 지연된 Fabry 병 환자에서 효소대체요법을 통한 사지 말단 동통의 호전을 보인 1례)

  • Yang, Aram;Kim, Jinsup;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.17 no.3
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    • pp.92-95
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    • 2017
  • Fabry disease (FD) is an X-linked lysosomal storage disorder caused by an ${\alpha}$-galactosidase A (GLA, MIM 300644) enzyme deficiency due to pathogenic variants in the ${\alpha}$-galactosidase A gene (GLA). The disease leads to accumulation of globotriaosylceramide (Gb3) and related glycophospholipids affecting nearly all major organ systems, with the primary sites damaged by Gb3 including renal glomeruli, myocardium, neurons of the dorsal ganglion and autonomic nervous system, and vascular endothelial and smooth muscle. Progressive deposition in these organ systems present with various clinical manifestations including acroparesthesia, renal failure and heart failure. Here, we report a Chinese male diagnosed with Fabry disease in his late $4^{th}$ decades showing improvement of acroparesthesia during enzyme replacement therapy (ERT). A 48-year-old Chinese man who presented with chronic recurrent severe burning pain in his fingers and toes since the age of 10, with worse involvement of the former visited to our clinic for further evaluation. His medical history included a transient ischemic attack aged 40 and diagnosed with stage 4-5 chronic kidney disease aged 47. In the family history, the patient's brother was found to be have Fabry disease 1 month before his visit. Except for his brother, all other members of the family are healthy. Based on his medical history and family history, he was strongly suspicious for Fabry disease. He was found to have a galactose-alpha-1,3-galactose level 4.96 (Reference range, 42.5-67.9) suggestive of Fabry disease. The followed sequencing of GLA coding region in our patient revealed hemizyosity for the mutation c.988C>T (Q330X) in Exon 7. Since ERT start, he showed significant improvement in his symptoms of burning sensation of fingers and toes. On the contrary, due to deteriorating kidney function even with ERT, he is considered for kidney transplantation. Despite of diagnostic delay until late 4th decades, ERT showed a potential improvement of acroparesthesia in our patient. However, late start of ERT can lead to poor outcome in multiorgan function. Therefore, early diagnosis with high index of suspicion followed by continuous ERT with regular monitoring have an impact on quality of life in Fabry disease.

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Comparison of Hyang-Sa and Bulchunwee Rituals and Food in Kyungbuk - Focused on Daegu and Andong Areas - (경북 지역의 향사와 불천위제례의 진설과 제수 비교 - 대구와 안동지역 중심으로 -)

  • Choi, Jeong-Hee;Park, Geum-Soon
    • Korean journal of food and cookery science
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    • v.24 no.6
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    • pp.801-810
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    • 2008
  • The principal objective of this study was to assess Korea's traditional ritual food culture, and to compare two types of ancestral rites the Hyang-Sa and Bool-cheon-wi rites which were held in the Daegu and Andong regions of Korea. In this study, we describe the performance of the Bool-cheon-wi rites held by two head families located near the Andong area namely, the head family of Seoae Ryu Seong-Ryong(1542-1607)(Seoae) who was well-respected for his writings and personality, and the head family of Dangye Ha Wee-Ji(1412-1456)(Dangye) who was well-known and famous as one of the members of the Sa-ryuk-sin. This research was conducted via diredt engagement in these memorial services and several interviews with the families. The results were summarized as follows; Foods used in the Hyang-sa rites including Mae(bap), Kook, Jaban(Jogee), Po(dried fish), Juck, boiled and seasoned vegetables, fruits, confections, and liquor. Jobap and Ssalbap were used as Mae at SD(Seo Dalsung), and PMPH(Pahoi Myogul Habin Park) used Jo, Hyunmy, Pi and Susu in the raw. The dishes on the table were arranged as follows. A wine cup was placed in the first row, Po(a dried pollack), and jujube and nuts in the second row, Ryukpo(slices of dried beef), Sangeogogi were set at the third row, and Soegogi, pork, Mu, and Minary were placed in the fourth row, and the head of the pig was placed in the center of the table at SD. A wine cup, Soegogi, and pork were positioned in the first row, Mu, Minary, Pi and Susu were placed in the second row, and Jogee, Jo, and Hyunmy were placed in the third row at PMPH. The sacrificial foods offered for Bool-cheon-wi rites were as follows; Mae(bap) Kook noodle Jogee Tang(stew) Po Juck Tucks boiled, seasoned and salted vegetables Jeon fruit confectioneries liquor(chungju). The head family of Seoae Yu Seong-Ryong utilized 5 types of Tang(meat stew, fish stew, chicken stew, vegetable stew, seafood stew), whereas the head family of Dangye Ha Wee-Ji utilized 3 kinds of Tang(meat stew, fish stew, vegetable stew). As a basic Tuck, Shi-roo-tuck(a steamed rice cake), piled up to 25 layers, was primarily utilized. In particular, Jung-Gae(Seoae's favorite food) was placed on the table. For grilled-meat food(Juck), Yu's family used raw meat and Ha's family the half-cooked meat. The main types of Jucks used were meat-Juck, fish-Juck, chicken-Juck, and these were not served one by one. Hyang-sa and Bool-cheon-wi rites have an the educational function, in that they allow for the carrying out of filial duties by a heartfelt performance of performing the ceremony, by taking great care from the pre-rite preparations to the post-rite period. In addition, these rites have various meanings, as events that strengthen the ties of blood relations of ancestors and themselves, and to promote and harmonize family friendships, they may also have religious meaning in the culture, as prayers are offered that all the family's descendants may be blessed, live long and enjoy abundance whlie respecting their ancestors. As for the role of Hyang-sa and Bool-cheon-wi rites in today's nuclear family society, it can be said that these rites remain especially important as a method to strengthen community consciousness by fostering an understanding of the meaning of existence itself, and thus inspiring the roots of consciousness.

Staged Improvement in Awareness of Disease for Elderly Cancer Patients in Southern China

  • Li, Xing;Dong, Min;Wen, Jing-Yun;Wei, Li;Ma, Xiao-Kun;Xing, Yan-Fang;Deng, Yun;Chen, Zhan-Hong;Chen, Jie;Ruan, Dan-Yun;Lin, Ze-Xiao;Wang, Tian-Tian;Wu, Dong-Hao;Liu, Xu;Hu, Hai-Tao;Lin, Jia-Yu;Li, Zhuang-Hua;Liu, Yuan-Chao;Xia, Qing;Jia, Chang-Chang;Wu, Xiang-Yuan;Lin, Qu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6311-6316
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    • 2015
  • Background: In mainland China, awareness of disease of elderly cancer patients largely relies on the patients' families. We developed a staged procedure to improve their awareness of disease. Materials and Methods: Participants were 224 elderly cancer patients from 9 leading hospitals across Southern China. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between family and patients, patient awareness of their disease and participation in medical decision-making. After first cycles of treatment, increased information of disease was given to patients with cooperation of the family. Then patient awareness of their disease and participation in medical decision-making was documented. Results: Among the 224 cancer elderly patients, 26 (11.6%) made decisions by themselves and 125 (55.8%) delegated their rights of decision-making to their family. Subordinate family members tended to play a passive role in decision-making significantly. Patients participating more in medical decision-making tended to know more about their disease. However, in contrast to the awareness of disease, patient awareness of violation of medical recommendations was reversely associated with their participation in medical decision-making. Improvement in awareness of diagnosis, stages and prognosis was achieved in about 20% elderly cancer patients. About 5% participated more actively in medical decision-making. Conclusions: Chinese elderly cancer patient awareness of disease and participation in medical decision-making is limited and relies on their family status. The staged procedure we developed to improve patient awareness of disease proved effective.

KOREAN CHILD AND ADOLESCENT PSYCHIATRY - A REVIEW OF THE PAST, THE PRESENT AND THE FUTURE - (한국 소아 ${\cdot}$ 청소년정신의학 - 과거 ${\cdot}$ 현재 ${\cdot}$ 미래 -)

  • Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.139-149
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    • 2003
  • Objectives:To review the history of the development and current status of Korean Child and Adolescent Psychiatry and to propose the future tasks at this 20th anniversary of Korean Academy of Child and Adolescent Psychiatry. Methods:Records and publications of Korean Academy, personal communications with senior members of the Academy, the author's recollections and memoirs. Results:Korean Child Psychiatry started with opening Child Psychiatry Clinic at Seoul National University Hospital in 1979 and establishing Division of Child and Adolescent Psychiatry at the same hospital in 1980. A Child Psychiatry Study Group was formed in 1983 and it transformed into Korean Academy of Child and Adolescent Psychiatry in 1986. In the past 20 years, Korean child and adolescent psychiatry made an impressive progress and contributed significantly to the development of Korean medicine as well as to the establishment of child mental health service. There are 77 board-certified and 48 board-eligible child psychiatrists, and 18 child psychiatry fellows are in training as of 2003. Main forces of this successful introduction of child psychiatry are 1) 7 child psychiatry training centers at major university hospitals, 2) publication of Korean Journal of Child and Adolescent Psychiatry in 1990, 3) the establishment child psychiatry board certification system in 1996. Korean child psychiatry has extended its role in the international child psychiatry and took leadership in establishing Asian Society of Child and Adolescent Psychiatry and Allied Professions(ASCAPAP). Conclusion:Korean child psychiatry has achieved a remarkable progress for the past 20 years and is currently producing 15 or more child psychiatry each year. However, there are needs of more active involvements in adolescent problems, more active consultation-liaison services at general hospitals as well as community mental health institutions. More school consultation and preventive educational services are desired. There is a urgent need of carrying out more empirical studies with strong scientific rigor. Korean Academy should pay attention and provide assistance to the development of child psychiatry service in other countries in Asia.

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