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Characteristics of Patients Who Need Hypnotics on the Night before Elective Surgery (수면전일 수면제를 필요로 하는 환자들의 특성)

  • Lee, Soo-In;Yoon, Jin-Sang;Lee, Hyung-Young
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.172-180
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    • 1997
  • Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

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Analysis of Most Recent Dream Content Korean Early Adolescents by Hall/Van de Castle System (Hall/Van de Castle System에 의한 한국 초기 청소년의 최근 꿈 분석)

  • Song, Hyoung-Seok;Chang, Sok-Ha;Kang, Seung-Gul;Park, Young-Min;Lee, Heon-Jeong;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.14 no.1
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    • pp.33-41
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    • 2007
  • Objectives: It has been known that the contents of dreams change according to neuro-developmental differences in sex, progression of age and various environments, unlike the established psychoanalytic theory. To investigate the changes, we collected "most recent dream report" and analyzed the contents of dreams by using Hall/Van de Castle System. Method: Most recent dream reports were gathered from age 12-14 years old, 2,673 middle school students (1,544 male 1,129 female) and analyzed those reports using Hall/Van de Castle System. The data were sorted in SAS and dream SAT. Result: There were prominent differences between male and female middle school students in Male/Female Percentage (male/ female;56%/35%), Familiarity Percentage (57%/69%), Aggression/Friendliness Percentage (79%/65%), Befriender Percentage (50%/33%), Physical Aggression Percentage (90%/70%), Indoor Setting Percentage (40%/55%), Negative Emotion Percentage (56%/68%) and Torso/Anatomy Percentage (51%/36%). There were significant differences in Male/Female Percentage (65%/44%), Friendliness, Physical Aggression and Self Negativity Percentage in male and there were significant differences in Friendliness, Familiarity and Friends Percent in female between 1st and 2nd grade. But, it showed much similar dream patterns between 2nd and 3rd grade in both gender. In male, Aggression/Character Index with male character is significantly increased by 2nd grade (1st/ 2nd/ 3rd;0.48/ 1.04/0.98), In female, Friendliness/Character Index with male character had significantly decreased by 2nd grade (0.38/ 0.19/0.20). Conclusion: There were apparent differences between age 12-14 years old male and female. Male adolescents have differences mostly in categories related with aggression, but female adolescents have differences in categories related with environment or character. It shows that developmental level of male are slower than female as of yet and male needs more active interpersonal relationship to find identity. Otherwise, the influences of passive attitude and actual circumferential environment are reflected in female's dream. There are no prominent differences among ages, but age 12-13 years old adolescents shows significant differences in interacting with the other gender. It means that circumferential environment and interpersonal relationship affect the contents of dreams and also the cognitive development related to age and sex. Afterwards, the development of dreams could be better understood through the neurocognitive study and dream analysis between other ages and nations.

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Clinical Implication of Serum TNF-$\alpha$ and IL-1$\beta$ Measurement in Patients with Sepsis (패혈증환자에서 혈청 TNF-$\alpha$ 및 IL-1$\beta$)

  • Kim, Jae-Yeol;Choi, Hyung-Seok;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Min, Kyung-Up;Kim, Yoo-Young;Shim, Young-Soo;Yoo, Chul-Gyu
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.217-224
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    • 2000
  • Background : It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-$\alpha$ and IL-1$\beta$. However, there is an alteration in the macrophages' responsiveness when they are challenged with repeated bouts of endotoxin, termed "endotoxin tolerance" which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. Methods : Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE II score. Peripheral blood monocytes were isolated from the patients and diluted to $1{\times}10^5$ well. After stimulation with endotoxin (LPS of E. coli O114 : B4, 100 ng/ml), they were incubated at $37^{\circ}C$ in 5% $CO_2$ incubator for 24 hours. Supernatant was collected for the measurement of TNF-$\alpha$ and IL-1$\beta$ with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. Results : The APACHE II score (mean$\pm$SD) of the patients at the time of blood sampling was 12.2$\pm$5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods (10 cases), gram positive cocci (6 cases) with two cases of mixed infection. Serum TNF-$\alpha$ could be measured in 4 cases with 29.9$\pm$27.7 pg/ml. Serum IL-1$\beta$was measurable in only one patient. The TNF-$\alpha$ level of supernatant of cultured peripheral blood monocytes was 2,703$\pm$2,066 pg/ml in patients and 2,102$\pm$1914 pg/ml in controls. The IL-1$\beta$level of supernatant was 884$\pm$1,050 pg/ml in patients and 575$\pm$558 pg/ml in controls. There was no difference of TNF-$\alpha$ and IL-1$\beta$ level between patients and controls. Conclusion : We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.

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Clinical Characteristics of Asthmatic Patients Who Visited Emergency Room (응급실로 내원한 천식환자들의 임상적 특성)

  • Suh, Jung-Kyung;Lee, So-Ra;Lee, Sang-Youb;Lee, Sang-Hwa;Cho, Jae-Youn;Shim, Jae-Jeong;In, Kwang-Ho;Kang, Kyung-Ho;Yoo, Se-Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.290-297
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    • 1997
  • Background : Despite remarkable progress of understanding the pathophysiology and therapy of bronchial asthma, asthma morbidity and mortality are on the rise. Also hospitalization and attending rates of emergency department for asthma have been increasing gradually. We analyzed clinical characteristics and prognosis of patients who visited emergency room due to asthma attack in order to define clinical characteristics of these group of patients. Method : We reviewed 105 adult asthmatic patients who attended emergency department of Korea University Hospital between August 1995 and July 1996, retrospectively. Results : 103 patients(56 female, 47 males, mean age : 48.6 years) attended-68 self referral, 18 practitioner referral and 17 OPD transfer- and 86 patients(83.5%) were admitted. Attending emergncy department was clearly more frequent in December(13.6%) and May(12.6%). Time lag between onset of asthmatic attack and arrival at the hospital was $14.2{\pm}15.5$ hour and initial peak expiratory flow rate was $166.7{\pm}68.3L/min$.(43.3% predicted) The commonest cause for visiting emergency room was aggravation of asthma due to upper respiratory tract infection in mild asthmatics. About half of them had history of previous ER visits. Their prognosis was not bad, but after discharge, about half of patients escaped from OPD follow-up. Conclusion : As a group they merit detailed attention and follow up arrangement. Clinician need to monitor and review the treatment plans, the medications, the patient's management technique, and the level of asthma control. For this group, plans for longer term treatment, including asthma education program and adjustment of overall treatment plan should be made.

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Clinical Course of Untreated Sarcoidosis (스테로이드 치료를 받지 않은 유육종증 환자의 임상경과)

  • Koh, Young-Min;Chung, Kyeong-Jae;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.807-816
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    • 1999
  • Background: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this study is to observe the clinical course of untreated sarcoidosis. Methods: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, $FEV_1$, DLco) were evaluated every 3mooths compared between corticosteroid treated(n=5) and non-treated(n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test(2) worsening in the degree of dyspnea(3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. Results: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved(13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. Conclusion : These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.

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A Study on Infant Weaning Practices Based on Maternal Education and Income Levels (양육인의 교육 및 수입정도에 따른 이유기 식생활관리에 대한 실태조사)

  • Kim, Song-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.7
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    • pp.1000-1007
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    • 2005
  • The aim of the present study was to examine the relationship of maternal factors such as knowledge, attitude and practice of weaning with infant feeding. The subjects were 103 mothers visiting a public health center in Gumi, Kyungbook who filled out self-administered Questionnaires. First of all, about $90\%$ of the participants recognized the importance of complementary foods and proper weaning practices. The response for the recognition of the importance of infant weaning process showed a significant difference by education levels. Concerning an appropriate time for the introduction of weaning foods, $53\%$ of mothers had commenced weaning at age $4\~6$ months, while $38\%$ had done so at age $6\~8$ months. Approximately $76\%$ of mothers fed their babies without the knowledge of age-related weaning method and type of weaning foods. There were no statistical differences in maternal weaning knowledges between levels of education and house income. Mothers with higher levels of education and family income tended to show high perception scores regarding possibility of food allergies caused by baby foods. A demand for reliable sources and education related to nutritious weaning foods and weaning practices were strong in the group with higher education. Knowledge of weaning method and baby foods were obtained by 59 of the 103 mothers from mass media, 35 from friends caring babies, and 9 obtained advice from health professionals or family. Advice from the heath professionals was not the main influence on their decision to introduce weaning foods. Although commercial baby foods are the most commonly used as first weaning foods, those with higher education groups considered commercial baby food are not nutritionally better than home-maid foods. The current findings suggest to us that to improve weaning process, mothers should be educated on the selection and preparation of nutritious, balanced weaning foods and on good weaning practices. It is advised that supportive health professionals from community public health centers should lead the education of infant feeding practices based on maternal characteristics and on basic food and nutritional knowledge.

Psychological Make-up of Korean Green Consumerism: A Path Model Analysis (한국록색소비심리구성(韩国绿色消费心理构成):일개로경분석모형(一个路径分析模型))

  • Kim, Joo-Ho;Kim, Yeon-Shin
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.249-261
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    • 2010
  • As consumers' concern for the environment has continued to increase, many firms have actively engaged in environmental marketing to achieve their objectives. However, consumers' high concerns about the environment are not always reflected in their purchasing behavior. This indicates the need for an in-depth understanding of the development of green consumption within the individual's belief system. In consideration of psychological approaches, a large body of research has examined the factors underlying ecologically conscious "green" consumer behavior and the interrelationships of these factors. However, most previous studies have concentrated on Western countries. Using a sample of Korean consumers, this study attempts to understand the basis of Korean green consumerism and find universal values that are cross-culturally important in guiding consumers' environmental attitudes and behaviors. To this end, this study relates Schwartz's 10 universal values (Schwartz 1992) to environmental behaviors in a hierarchical model of value-attitude-behavior. With reference to the value-attitude-behavior framework, the conceptual model developed for the study explains what motivations can be manifested in Korean consumers' environmental attitudes, and subsequently how the attitudes affect their green choices. Using the pattern of relationships among values that can be related to environmentalism, the first hypothesis holds that there would be particular relationships between motivational value types and environmental attitudes. Hypothesis 2 assumes that environmental attitudes predict environmental behaviors. On the basis of the claim that favorable attitudes toward the environment may be expressed in many different behaviors, the assumption is that consumers' favorable attitudes toward the environment would be linked to a variety of environmental behaviors because people with high environmental attitudes can be more interested in and knowledgeable about environmental actions. Consistent with H2, H3 hypothesizes that there would be a positive relationship between different types of environmental behavior. A total of 564 university students participated in the study. The sample included 308 men, 254 women, and two participants who did not indicate their gender. The average age of the participants was 22.5 years, with a range of 19 to 39. Regarding majors, special efforts were made to draw the participants from different departments of the university. Data were collected by a survey administered via self-completion questionnaires., which assessed the participants' value priorities, environmental attitudes, and behaviors. Path analysis conducted to test the proposed model found the overall fit to be ${\chi}^2$=72.01 (p=0.00), GFI=0.983, CFI=0.982, NFI=0.970, RMR=0.070, and REMSEA=0.050. Thus, most of the fit measures indicated a good fit of the model with the data, and a hierarchical relationship from values to environmental attitudes to environmental non-purchasing behavior to environmental purchasing behavior was confirmed. An assessment of all the predicted paths by path coefficients led to several major hypothesized effects being confirmed. Out of the ten value types, universalism and power were significantly but conversely related to environmental attitudes. In line with the other studies, these findings confirm that environmental attitudes are an important factor in leading to a variety of green behaviors. Finally, significant relationships were found between environmental purchasing and non-purchasing behaviors. The path analysis supported the idea that universalism values provide a motivation for Korean consumers' greenness and indirectly promote environmental acts through favorable attitudes toward the environment. Participants with high environmental attitudes were found to actively engage in diverse forms of green consumer behavior. This research provides an opportunity to examine cross-cultural differences with respect to values leading to environmentalism, and, further, to verify previous findings. The study also examined the attitude-behavior relationship with respect to three distinct types of environmental behaviors. The different strengths of paths between green attitudes and behaviors suggest that researchers should consider the specificity of behavior explained as an effort to improve the low attitude-behavior correlation. Finally, the findings here illustrate that with increased environmental concerns among people, they come to include more such behaviors in their green portfolios.

Personality Characteristics of Patients with Obstructive Sleep Apnea and Simple Snoring : A Preliminary Study (2014.21.1.21폐쇄성수면무호흡증과 단순코골이 환자의 성격 특성 : 예비연구)

  • Kang, Jae Myeong;Kang, Seung-Gul;Lee, Yu Jin;Jeong, Joo Hyun;Kang, Il Gyu;Hwang, Hee Young;Kim, Ji-Eun;Lee, Heon-Jeong;Shin, Seung-Heon;Park, Kee Hyung;Kim, Seon Tae
    • Sleep Medicine and Psychophysiology
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    • v.21 no.1
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    • pp.21-28
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    • 2014
  • Objective: Few studies have evaluated the personality characteristics of patients with obstructive sleep apnea (OSA) and simple snoring. We investigated the personality characteristics of OSA and simple snoring patients and compared differences in personality between the two groups using the Eysenck Personality Questionnaire (EPQ). Materials and Methods: Two hundred and thirty-seven patients who were suspected to have OSA or simple snoring participated in this study. A self-questionnaire which included the EPQ was administered to all participants. All subjects underwent polysomnography in a sleep laboratory and those with an apnea-hypopnea index (AHI) ${\geq}5$ were included in the OSA group, while those with an AHI <5 were included in the simple snoring group. Results: OSA patients had significantly lower scores for Psychoticism (F=4.563, p=0.034) than simple snorers. There were no significant differences in Extraversion (F=3.029, p=0.083), Lie (F=0.398, p=0.529), or Neuroticism (F=3.367, p=0.068) scores between the two groups. In the correlation analysis of the OSA group, AHI was positively correlated with Extraversion score (r= 0.16, p=0.029) and negatively correlated with Lie score (B=-0.31, p<0.001). Using multiple stepwise linear regression analysis with the four EPQ parameter scores as dependent variables, Lie score was associated with older age (B=0.14, p<0.001) and lower AHI (B=-0.05, p<0.001), Psychoticism score was associated with higher Pittsburgh Sleep Quality Index (PSQI ; B=0.14, p<0.001), Neuroticism score was associated with higher PSQI (B=0.34, p=0.001) and female sex (B=3.15, p=0.003), and Extraversion score was associated with younger age (B=-0.08, p=0.020) and higher body mass index (B=0.26, p=0.023). Conclusion: This study suggests that patients with OSA are significantly less prone to psychotic personality characteristics than those with simple snoring. Among OSA patients, higher AHI was correlated with low falsehood and high extraversion tendencies.

A Comparative Study of Korean Home Economic Curriculum and American Practical Problem Focused Family & Consumer Sciences Curricula (우리나라 가정과 교육과정과 미국의 실천적 문제 중심 교육과정과의 비교고찰)

  • Kim, Hyun-Sook;Yoo, Tae-Myung
    • Journal of Korean Home Economics Education Association
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    • v.19 no.4
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    • pp.91-117
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    • 2007
  • This study was to compare the contents and practical problems addressed, the process of teaching-learning method, and evaluation method of Korean Home Economics curriculum and of the Oregon and Ohio's Practical Problem Focused Family & Consumer Sciences Curricula. The results are as follows. First, contents of Korean curriculum are organized by major sub-concepts of Home Economics academic discipline whereas curricular of both Oregon and Ohio states are organized by practical problems. Oregon uses the practical problems which integrate multi-subjects and Ohio uses ones which are good for the contents of the module by integrating concerns or interests which are lower or detailed level (related interests). Since it differentiates interest and module and used them based on the basic concept of Family and Consumer Science, Ohio's approach could be easier for Korean teachers and students to adopt. Second, the teaching-learning process in Korean home economics classroom is mostly teacher-centered which hinders students to develop higher order thinking skills. It is recommended to use student-centered learning activities. State of Oregon and Ohio's teaching-learning process brings up the ability of problem-solving by letting students clearly analyze practical problems proposed, solve problems by themselves through group discussions and various activities, and apply what they learn to other problems. Third, Korean evaluation system is heavily rely on summative evaluation such as written tests. It is highly recommended to facilitate various performance assessment tools. Since state of Oregon and Ohio both use practical problems, they evaluate students mainly based on their activity rather than written tests. The tools for evaluation include project documents, reports of learning activity, self-evaluation, evaluation of discussion activity, peer evaluation in a group for each students for their performance, assessment about module, and written tests as well.

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Development and Application of Health Belief Model Based Milk Education Program for Elementary, Middle, and High School Students (건강 신념 모델에 근거한 초.중.고등학교 우유 교육 프로그램 개발 및 적용)

  • Yoo, In-Kyung;Jang, Myung-Hee;Kim, Gyu-Tae;Park, Dong-Ho;Seo, Ji-Young;Park, Sun-Young;Kim, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.19 no.4
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    • pp.17-36
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    • 2007
  • The purpose of this study was to develop health belief model based various milk education program as print education media and apply to elementary, middle, and high schools. The subjects were 432 students(124 elementary, 122 middle, 186 high school students). We designed one group pretest-posttest study model. The data were obtained from pre and post-study with self-administered questionnaires. Before applying this education program, we evaluated the degree of awareness on milk. Their awareness on milk was very low, 35.5% lower elementary, 32.7% higher elementary, 52.5% middle, and 54.3% high school students were answered they don't know the milk well. After they had implemented milk education program, their recognition on milk had changed that milk is nutritious as supplementary food. And their reasons for drinking milk were also changed that 'they want to eat it' in elementary school students, 'they want to be healthier' in middle school students, and 'they want to be taller' in high school students. Their nutrition knowledge score showed a significant increase(p<0.05). As a results. milk nutrition education has improved nutrition knowledge and recognition on milk in elementary, middle, and high school students. To improve their milk eating behaviors, nutrition education programs will have to be continued.

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