• 성인간호학회지
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• 제14권1호
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• pp.125-134
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• 2002

Purpose: The objectives for this study were to identify the factors that correlate with appraisal of illness and to explore what variables are predictive of cancer patients primary caregivers' cognitive appraisal for stress. Method: The subjects were selected by convenient sampling and 130 caregivers who completed a questionnaire. Measures used in this study included the Family Inventory of Resources for Management, Social Support Index, Family Crisis Oriented Personal Evaluation Scales and Family Coping Coherence Index. Pearson correlation was used to identify the relationship among factors and multiple regression was used to determine the individual and cumulative effect of potential predictors on the caregivers' appraisal. Results: Patient's level of activity, severity of the disease, quality of relation between patient and caregiver, caregiver's subjective health status, economic status, family resources and coping were significantly correlated. Among the variables, coping, family resources, economic status and quality of relation between caregiver and patient predicted 49.2 percent of the variance in appraisal of caregivers' stress condition. Conclusion: These findings suggest that coping mechanisms and family resources are important for positive appraisal. Nurses should provide adequate nursing care for the primary caregiver about professional care information and supportive counseling.

• 정신신체의학
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• 제6권2호
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• pp.104-119
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• 1998

This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.

• 생물정신의학
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• 제24권4호
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• pp.225-234
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• 2017

Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

• 대한임상검사과학회지
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• 제40권2호
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• pp.129-134
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• 2008

Obstructive sleep apnea syndrome (OSAS) is occurred by apnea by the obstruction of upper trachea while sleeping, followed by repetitive drop on arterial oxygen saturation ($SpO_2$). Therefore, the present study was focused on relation between $SpO_2$ of while having difficulty in breathing and clinical characteristics of OSAS while sleeping. The study took place at Ewha women university Mokdong hospital with 149 subjects (male 121, female 28) who were examined for polysomnography (PSG) from May 2007 to February 2008. All subjects were adhered to electrodes and sensors to measure electroencephalogram (EEG), electrooculogram (EOG), chin & leg electromyogram (EMG), airflow at nasal and oral cavities, breathing movement of chest and abdominal snoring sound and $SpO_2$. Lowest $SpO_2$ in male was meaningfully low with higher body mass index (BMI), louder snoring sound and thick neck circumference (p<0.01). While mean $SpO_2$ based on the degree of AHI did not show significant difference, lowest $SpO_2$ was significantly low with high AHI (p<0.001). Also, lowest $SpO_2$ was closely correlated with BMI (r=-00.343, p<0.001), snoring sound (r=0.177, p<0.05), apnea index (r=-0.589, p<0.001), hypopnea index (r=-0.336, p<0.001) and apnea-hypopnea index (r=-0.664, p<0.001). $SpO_2$ was closely related to clinical characteristics of OSAS, like male, BMI, snoring sound and neck circumference. Also, polysomnography accompanied by recent development of sleep study is considered as critical test to diagnose OSAS, decide the severity of illness, and evaluate the treatment plan.

• 대한응급의학회지
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• 제29권5호
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• pp.509-518
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• 2018

Objective: The evidence that hyperbaric oxygen (HBO) therapy is more effective for improving the acute neuropsychological status (ANS) of carbon monoxide poisoning than normobaric oxygen (NBO) therapy is not convincing. This is because the levels of carboxyhemoglobin (COHb) do not correlate with the clinical severity of carbon monoxide poisoning and there is no universally accepted severity scale of carbon monoxide poisoning. This paper suggests a new scale for the clinical and neurological severity of carbon monoxide poisoning, called the ANS, and assesses the effect of HBO therapy for each level of ANS compared to NBO therapy. Methods: A total of 217 patients who had been hospitalized because of carbon monoxide poisoning from January 2009 to July 2013 were studied. ANS was suggested as a new severity scale of carbon monoxide poisoning considered in the Glasgow Coma Scale, acute neuro-psychologic signs and symptoms, or cardiac ischemia on the initial medical contact. HBO therapy is indicated in those who have a loss of consciousness, seizure, coma, abnormal findings on a neurological examination, pregnancy, persistent cardiac ischemia, level of COHb >25%, or severe metabolic acidosis (pH <7.2). The end point is the day of discharge, and recovery is defined as a normal neuro-psychological status without any sequelae. Results: The levels of troponin T and creatinine increased significantly with increasing ANS score. In the moderate to severe group (ANS 2 and 3), the recovery rate was significantly higher when treated with HBO therapy than with NBO therapy (P=0.030). On the other hand, the development of delayed neuro-psychological sequelae (DNS) did not correlate with any level of ANS, type of oxygen therapy, or recovery on discharge. Conclusion: In the moderate to severe poisoned group, HBO therapy is more effective for improving the ANS from carbon monoxide poisoning than NBO therapy. On the other hand, the development of DNS of HBO therapy is no more preventable than with NBO therapy. Although the level of ANS is low, the patient needs to be provided with sufficient information and a follow-up visit is recommended for any abnormal symptoms because the ANS does not correlate with the development and degree of DNS.

• 대한임상독성학회지
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• 제5권2호
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• pp.99-105
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• 2007

Purpose: Pyrethroid is an insecticide that produces moderate intoxication in mammals, with neither exposure to skin nor inhalation resulting in severe systemic manifestations. In 2005 we made a nationwide survey of agrichemical human intoxication. The object of this study is to analyze pyrethroid intoxications based on the 2005 survey. Methods: We prospectively collected data from 1 August 2005 to 31 July 2006 by a standard investigation protocol. We analyzed demographic data, exposure data (cause, amount, ingredients), clinical features, and courses. Results: A total of 125 cases of pyrethroid intoxication were surveyed. The mean patient age was $56.78{\pm}16.158$ years old, and the mean amount ingested was $121.85{\pm}110.732ml$. Patients were classified into four severity groups according to symptoms and mental status: the asymptomatic group (27 patients, 21.6%), the mild symptom group (48, 38.4%), the moderate symptom group (21, 16.8%), and the severe symptom group (7, 5.6%). There were statistically significant differences in mental status, severity, and mean ICU days between two groups. Admission days by severity grade for the asymptomatic, mild, moderate, and severe symptom groups were $5.49{\pm}16.051,\;3.65{\pm}4.143,\;4.59{\pm}3.335,\;and\;8.14{\pm}7.199days$, respectively (p=0.047). Conclusion: Nationwide surveillance was extremely telling in uncovering a high frequency of agrichemical intoxication in Korea. In pyrethroid intoxication, severity grading can be a useful prognostic tool.

• Pediatric Infection and Vaccine
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• 제25권1호
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• pp.8-16
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• 2018

목적: 본 연구는 바이러스성 크루프로 입원하는 환아의 임상적 및 역학적 특성을 분석하여 원인 바이러스 감염에 따른 중증도를 평가하고자 하였다. 방법: 2013년 5월부터 2016년 12월까지 원주세브란스기독병원 소아청소년과에 바이러스성 크루프로 입원한 10세 이하 환아 중 비강인두도말 검체 채취 및 다중 역전사중합효소연쇄반응 검사를 하여 호흡기 바이러스가 검출된 302명을 대상으로 의무기록을 후향적으로 검토하였다. 바이러스성 크루프의 중 증도를 평가하기 위하여 Westley의 점수제를 사용하였다. 결과: 전체 302명 중 중증 바이러스성 크루프로 입원한 환아는 149명(49.3%)이었으며, 이 중 남아가 88명, 여아가 61명으로 남녀 비는 1.44:1이었다. Parainfluenza virus가 110예(48.7%)로 거의 절반에 가까운 빈도를 보였으며, 이후로 influenza virus (15.5%), human rhinovirus (11.9%), respiratory syncytial virus (10.2%) 순이었다. 중증 바이러스성 크루프와 원인 바이러스와의 연관성에 대한 분석에서는 parainfluenza virus 2형에서만 위험도가 의미 있게 높은 것으로 나타났다. Parainfluenza virus 2형은 연령에 따라서는 발병 빈도에 차이가 없었으나 여름, 가을에 상대적으로 더 높은 감염 빈도를 보였다. 결론: 본 연구에서 중증 바이러스성 크루프와 연관이 있었던 바이러스는 parainfluenza virus 2형이 유일하였다. 추후 전향적, 다기관 연구 및 추가적인 변수들을 복합적으로 고려하여 원인 바이러스 감염에 따른 중증도를 재확인하고, 원인 바이러스에 대한 지역별, 시기별, 연령별 분석이 필요하다.

• 대한불안의학회지
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• 제7권2호
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• pp.92-100
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• 2011

Objectives : The aim of this study was to investigate Post Traumatic Stress Disorder (PTSD)-related symptom severity, level of functional impairment and personality profiles between full-blown PTSD, partial PTSD and non-PTSD groups among 59 adolescent survivals from the Incheon fire disaster. Method : Using Short Screening Scale for DSM-IV PTSD, victims of the disaster were assigned to a full-blown PTSD group (n=18), a partial PTSD (n=22), or a non-PTSD group (n=19). Assessments included the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), the Impact of Event Scales (IES), the McBride's Degree of General Labor Loss, and the Korean Version of Temperament and Character Inventory (K-TCI). Results : Significantly severe PTSD symptoms (F=4.832, df=2, p<.05) and functional impairment (F=12.144, df=2, p<.01) were demonstrated by PTSD groups as compared to the non-PTSD group. Interestingly, full and partial PTSD did not differ in these comparisons. Similarly, the subtypes of PTSD did not differ with respect to personality profiles using the K-TCI ; however, personality profiles were sharply differentiated between the PTSD and non-PTSD group. Conclusion : Although high subject homogeneity and small sample size may limit the results of this study, the present results highlight the possibility of the underestimation as well as the insufficient, treatment and compensation of partial vs full PTSD.

• Clinical and Experimental Pediatrics
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• 제61권3호
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• pp.84-89
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• 2018

Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was $84.0{\pm}54.8months$, and the mean hospital stay was $4.6{\pm}1.7days$. Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at $9.6{\pm}6.1mg/dL$. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ${\geq}103.5months$ (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ${\geq}4.55mg/dL$ (sensitivity, 80%; specificity, 69%). Conclusion: Age (${\geq}103.5months$) and higher CRP level (${\geq}4.55mg/dL$) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.

• 예술인문사회 융합 멀티미디어 논문지
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• 제7권11호
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• pp.525-536
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• 2017

연구목적: 본 연구는 성인 통합 중환자실에 입실 환자를 대상으로 중환자실 체류기간에 영향을 미치는 요인을 인구사회학적, 질병관련 특성을 중심으로 파악하여 효율적인 중환자 간호 중재 개발의 기초적 자료를 제공하기 위하여 실시하였다. 연구방법: 서울특별시에 소재한 일 종합병원의 성인 통합 중환자실에 입실한 환자 최종 270명을 분석한 후향적 조사연구이다. 연구결과: 분석대상 270명 환자 중 중환자실 체류기간이 5일 이상 그룹이 116명(43%)이었으며, 중환자실 체류기간은 FCI score (r=0.33, p<.001), APACHE II(r=0.19, p=.001)와 통계적으로 유의한 상관관계가 있는 것으로 나타났다.로지스틱 회귀분석 결과 중환자실 체류기간의 영향요인은 일반적 특성을 통제한 상태에서 대상자의 중환자실 입실경로(p=0.013), FCI score(p<0.001), APACHE II(p=0.012)로 나타났다. 결론: 중환자실 입실시 응급실 경유나 중증도가 높은 환자의 경우, 입실 초기 보다 집중적인 환자간호를 통해 환자의 체류기간을 줄이도록 하는 다양한 중재개발이 모색되어야 하겠다.