• 보건의료산업학회지
• /
• 제9권3호
• /
• pp.201-210
• /
• 2015

Objectives : The purpose of this study was to identify the effect on cognitive function in elderly people above 65 years of age. Methods : The data were collected from June 1 to August 30 2014. Data were collected by questionnaire from 994 elderly people. The instruments for this study were ADL, IADL, depression, MMSE-DS. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, multiple linear regression with the SPSS/WIN 18.0 program. Results : The significant factors influencing MMSE-DS were education(${\beta}=-0.314$, p<.001), IADL(${\beta}=0.196$, p<.001), age(${\beta}=-0.168$, p<.001), exercise time(${\beta}=0.089$, p=.004), economic conditions(${\beta}=0.086$, p=.007), depression(${\beta}=-0.084$, p=.001), income(${\beta}=-0.083$, p=.003), sleep time(${\beta}=-0.079$, p=.001), medical insurance(${\beta}=0.059$, p=.024) and leisure(${\beta}=0.057$, p=.039). Conclusions : Based on the study, subjects with cognitive impairment detected at an early stage it is necessary to intervene in consideration of the individual characteristics and to develop and apply the program that improve the living habits such as exercise and sleep, and decreasing depression.

• 성인간호학회지
• /
• 제23권4호
• /
• pp.363-373
• /
• 2011

Purpose: Fatigue is a common problem in Parkinson's disease (PD), affecting 30~65% of patients with that diagnosis. Only recently has fatigue been recognized as an important clinical feature of PD. The aim of this study was to investigate the level of fatigue and related factors in patients with PD. Methods: Between March 1, and September, 30, 2010, a sample of 181 PD patients agreed to be interviewed. Results: The female patients' PFS (Parkinson Fatigue Scale) score was higher than those of the male patients. Household income and having a Job were significantly correlated with the PFS scores. Among the disease characteristics, motor fluctuations, dyskinesia and modified Hoehn and Yahr stage were significantly correlated with the PFS scores. On stepwise regression analysis, the most important factors related to the PFS scores were depression and sleep disturbance. Conclusion: Fatigue in patients with PD was associated with many factors and strongly associated with depression and sleep disturbance. Fatigue is a multidimensional construct; therefore, multidimensional strategies for relieving specific aspects of fatigue are needed.

• 수면정신생리
• /
• 제10권2호
• /
• pp.100-107
• /
• 2003

배 경：뇌파 미세각성은 수면 회복감을 저하시키고 주간 피로감을 초래하는 것으로 알려져 있다. 수면중 주기성 사지운동증은 뇌파기록의 육안판독 소견에 나타나는 미세각성 유무에 따라 두 종류로 나뉘어진다. 미국 수면장애협회에서 제시한 기준은 수면중 주기성 사지운동 이후에 뇌파의 변화가 3초 이상 지속되는 경우를 미세각성으로 판정하고 있다. 그러나 육안판독 만으로는 뇌파 활동의 일부 미세한 변화를 찾아내기 어렵다는 주장도 제기되고 있다. 그러므로 본 연구의 목적은 미세각성이 없는 수면중 주기성 사지 운동의 뇌파변화를 스펙트럼 분석방법을 이용하여 세밀하게 측정하여 수면중 주기성 사지운동증에서 나타나는 각성 반응을 보다 자세히 이해하는데 있다. 방 법：야간 수면다원검사로 수면중 주기성 사지운동증 진단을 받은 환자 10명을 대상으로 하였다. 각각의 피험자에서 2단계 비렘수면에서 발생한 주기성 사지운동 중에서 뇌파의 미세각성이 없는 삽화 30개를 무작위로 선택하여 스펙트럼 분석을 실시하였다. 본 연구에서는 알파파나 세타파로 뇌파변화가 최소 1초 이상 나타날 경우라도 미세각성으로 간주하여 대상군에서 제외함으로써 때문에 최소 3초 이상을 미세각성으로 삼는 미국수면장애학회의 기준보다 엄격한 기준을 적용하였다. 사지운동이 시작된 시각을 기준으로 시작 전 4초 구간과 시작 후 4초 구간의 두 군으로 나누고 해당 뇌파를 각각 스펙트럼 분석하였고 독립 스튜던트 t 검증을 사용하여 두 군을 비교하였다. 결 과：수면중 주기성 사지운동증 지수의 평균은 $16.7{\pm}10.0$회였고 수면중 주기성 사지운동증 지속시간의 평균은 $1.3{\pm}0.7$초였다. 독립 스튜던트 t 검증의 결과 델타파(p=0.000) 영역의 비교활동도가 사지운동후에 유의하게 증가하였고, 알파파(p=0.01) 영역과 시그마파(p=0.000) 영역은 유의하게 감소하였다. 세타파(p=0.05), 베타파(p=0.129), 그리고 감마파(p=0.062) 영역이 감소하였으나 유의할 만한 수준은 아니었다. 결 론：델타파 영역이 증가를 보인 결과는 각성반응이 단계적인 순서로 일어난다는 이론과 합치되는 소견이다. 본 연구의 대상환자가 이전의 유사한 연구의 대상환자에 비하여 평균 지속시간이 더 짧다는 점과 평균 지수가 낮다는 점을 고려한다면, 경한 형태의 수면중 주기성 사지운동증에서도 신경생리학적인 변화가 유발된다고 결론을 내릴 수 있다.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.27-35
• /
• 1999

Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of "psychogenic rheumatism". Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls ($mean{\pm}SD$: $178.3{\pm}75.5$ ng/ml versus $166.3{\pm}76.6$ ng/ml; p=0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.

• 동의신경정신과학회지
• /
• 제19권3호
• /
• pp.309-317
• /
• 2008

For this study, the Chuna Manual Relaxation Therapy, a therapeutic procedure in Oriental Medicine was carried out on patients suffering from insomnia following hospitalization. If a patient with no prior medical history in insomnia should suffer from insomniac symptoms, the following procedure was carried out on thos patients showing 15 points on the Insomnia Severity Index starting on the day when the patient first complains of symptoms associated with insomnia, stages 1, 2 & 3 of the 'JS Cervical Shinyoun Therapy' in accordance with the Korea Chuna medical Index standard was carried out on the patient's bed from 8pm to 9pm everyday for 1 week. After the 1 week procedure, a medical examination by interview was carried out the following day, and the Insomnia Severity Index measured again. (1 being when the patient's state of sleep is at its worst, and 10 being when it is the most satisfactory. In case of 5 patients, Insomnia is disappeared, and the quality of sleep improved. In regards to insomnia suffered after hospitalization, Stage 1,2 and 3 of "JS Cervical Shinyoun Therapy" for relaxing tension showed effective results to the patient.

• 보건교육건강증진학회지
• /
• 제27권1호
• /
• pp.21-34
• /
• 2010

Objectives: The objective of this study was to investigate risk factors for falls in the elderly by life-cycle. Methods: This study used the data on 435 male and female elderly generated from a survey taken at 21 Welfare Centers for the Elderly in Seoul. The incidence of demographic characteristics, physical changes brought about with ageing, health-related behavior, chronic diseases, and environmental characteristics on falls in the elderly was analyzed. Hierarchical Logistic Regression analysis was also conducted to investigate the incidence by life-cycle (early-mid-late stage) and the results were used for predicting falls. Results: The incidence of risk factors on falls varied across life-cycle. Among the elderly in the early (ages from 65 through 74), marital status, the existence of a companion, the quality of sleep, the chronic diseases, and the condition of the bathroom floor were found to be related to falls. Among those in the mid-stage (ages from 75 through 84), sex, marital status, the existence of a companion, hearing capacity, sense of balancing, chronic diseases, the exclusive use of rooms, and the side bar with bath tub were found to affect falls. Finally, for the elderly in their late stage (85 years of age and older), drinking and vision were found to be related to falls. Conclusion: The incidence of risk factors on falls was found to vary according the stage in the elderly. A key implication of this finding is that falls prevention programs and interventions must be catered to specific age sub-groups.

• Clinics in Shoulder and Elbow
• /
• 제3권2호
• /
• pp.102-108
• /
• 2000

The aim of this study is to determine if intra-bursal morphine and Bupivacaine mixed infusion provided useful analgesia after subacromial arthroscopic operation. At the end of the subacromial arthroscopy, continuous intra-bursal infusion catheter was inserted. In a double-blind randomized trial, Sixty patients were allocated to one of two groups: placebo group(n=30) received continuous saline infusion. Study group received mixed 5㎖ of 0.5% Bupivacaine, 2㎎ of morphine and 0.05㎖ of 1/1000 epinephrine as bolus and mixed solution of 40㎖ of 0.5% Bupivacaine and 8㎎ of morphine as maintenance dose with continuous infusion pump(0.5㎖ hourly). In the placebo group, two patients were discontinued due to leakage and catheter coming out each. Intensity of pain was evaluated preoperatively and postoperatively for 3 days by 10 graded visual analogue scale. Night pain, pain on motion, sleep disturbance, lying on painful shoulder and amounts of intramuscular pain killer were recorded. Analgesic effect for pain was cleared at 1st and 2nd postoperative day and there was less sleep disturbance for 3 days postoperatively in study group. There was no difference in pain on motion postoperatively. In study group, less pain killers were used in the first 48 hours postoperatively. The continuous intra-bursal infusion decreased perception of pain at resting stage and reduced supplemental analgesic requirement for 2 days postoperatively.

• 수면정신생리
• /
• 제9권1호
• /
• pp.24-33
• /
• 2002

목 적 : 폐쇄성 수면무호흡증(이하 수면무호흡증) 환자에서 고혈압이 흔히 병발되나 지속적 상기도 양압술(이하 양압술)에 따른 고혈압 해소 정도는 연구방법에 따라 상이한 결과를 보이고 있다. 이에 저자들은 지속적-비관혈적 혈압 측정법을 이용하여 기초 혈압치가 다양한 수면무호흡증 환자군에서 양압술을 적용하면서 야간 수면중 혈압 및 심박 동수 반응에 양압술이 미치는 영향을 연구하고자 하였다. 또한 양압술에 의한 혈역학적 변화에 영향을 줄 수 있는 요인들을 찾고자 하였다. 방 법 : 연구대상으로는 수면무호흡증의 임상 증상을 지니고 있으며 기초 측정일의 야간 수면다원검사 결과 호흡장애지수가 5이상인 환자 10명(평균연령 52.2$\pm$12.4세, 남자 9명, 여자 1명)을 선택하였다. 양압술을 시행하지 않은 상태인 기초 측정일과 양압술을 시행한 양압술 시행일 모두에서 야간 수면다원기록과 동시에 지속적-비관혈적 혈압측정기($Finapres^{(R)}$)를 사용하여 매 박동(beat-to-beat)시의 수축기 혈압, 이완기 혈압, 그리고 심박동수를 측정하였다. 또한 매 2초마다 혈중산소포화도($SaO_2$)를 측정하였다. 기초 측정일과 양압술 시행일 두 군간에 혈역학적 및 호흡기적 변인들의 평균치를 비교하였다. 기초 측정일 값에서 양압술 시행일 값을 뺀 수축기 혈압 델타값 및 이완기 혈압 델타값 각각과 기초 측정일의 측정치들(수축기 혈압, 이완기 혈압, 그 각각의 혈압 변이도, 심박동수 및 심박동수 변이도, 혈중산소포화도 평균치, 그리고 호흡장애지수), 양압술 시행일의 측정치들(양압술 처방압력 및 총 각성시간 분율), 연령, 그리고 비만도 간의 상관관계를 분석하였다. 결 과 : 1) 혈중 산소포화도의 평균치와 호흡장애지수가 기초 측정일에 비해 양압술 시행일에서 각각 증가(p<.01) 및 감소(p<.01)하였으나, 혈역학적 변인을 포함한 다른 비교 변인들에서는 차이가 없었다. 2) 기초 측정일의 혈압에서 양압술 시행일의 혈압을 뺀 델타값들을 분석한 결과 기초 측정일의 혈압치와 대상군의 연령에 따라 혈압 반응이 차별적으로 나타났다. 수축기 혈압 델타값과 기초 측정일의 수축기 혈압간에 유의한 정적 상관관계를 보였으나(p<.01), 이완기 혈압 델타값과 기초 측정일의 이완기 혈압간에는 각성기(p<.01)를 제외한 다른 수면단계에서 유의한 상관관계가 없었다. 렘수면단계를 제외한 모든 수면단계에서 이완기 혈압의 델타값과 연령 사이에 유의한 역 상관관계가 있었지만(p<.05), 수축기 혈압의 델타값과 연령 간에는 유의한 상관관계가 없었다. 3) 수축기 혈압 델타값 및 이완기 혈압델타값 각각과 기초 측정일의 측정치들, 양압술 시행일의 측정치들, 그리고 비만도 간의 상관관계를 분석한 결과, 이완기 혈압 델타값과 양압술 시행일의 각성시간 분율간의 유의한 정적 상관관계(p<.01) 외에는 유의한 상관관계가 없었다. 결 론 : 양압술 적용에 따라 수축기 혈압 델타값과 이완기 혈압 델타값이 기초 측정일의 수축기 혈압치와 대상군의 연령에 따라 각각 증가 또는 감소하였다. 따라서, 본 연구는 양압술에 따른 혈압 반응은 단순 감소로 나타나는 것이 아니라 여러 변인의 조건에 따라 차별적 혈압 반응 양상으로 나타나는 복합적인 현상이며 앞으로 좀더 세밀하게 연구되어야 할 대상임을 시사한다.

• Journal of Communications and Networks
• /
• 제14권1호
• /
• pp.40-50
• /
• 2012

The Berkeley-medium access control (B-MAC) is a lightweight, configurable and asynchronous duty cycle medium access control (MAC) protocol in wireless sensor networks. This article presents an analytic modelling of single-hop B-MAC protocol under a Poisson traffic assumption.Our model considers important B-MAC parameters such as the sleep cycle, the two stage backoff mechanism, and the extended preamble. The service delay of an arriving packet and the energy consumption are calculated by an iterative method. The simulation results verify that the proposed analytic model can accurately estimate the performance of single-hop B-MAC with different operating environments.

• 보건교육건강증진학회지
• /
• 제25권3호
• /
• pp.59-75
• /
• 2008

Objectives: The purpose of this study was to identify the stages of change distributions for nine major health behaviors among poor children in underserved area, and to provide basic information for developing specific objectives and strategies for health education program. Methods: The health behavior data were obtained with a self-administered questionnaire and analysed for 3,081 poor children in 106 local children's centers nationwide. Stages of change classification were based on self-reported responses to five statements. The health behaviors included were balanced diet, safety behavior (helmet and protective device use while riding), regular exercise, smoking, alcohol use, drug use, sleep pattern, weight management and stress management. Results: Poor children were more likely in precontemplation and less frequently in action and maintenance stages for a safety behavior. 33.1% of respondents were precontemplators, 29.9% contemplators, and 6.5% in preparation stage. Only 4.3% and 9.6% were in action and maintenance stages, respectively. Gender differences were apparent. Boys were more likely to be precontemplators for nine health behaviors. Children from the lowest socioeconomic status and disrupted family were more likely to be in precontemplation for weight management and exercise behaviors. Children living with both parents were more likely to be in the action and maintenance stages for nine health behaviors. Stages of change for balanced diet and smoking were significantly related with those for other eight health behaviors. And the stage of exercise adoption was found to be significantly related with those for other seven health behaviors. Conclusion: Safety education must receive high priority in health education program for low income children. Balanced diet smoking cessation and regular exercise could be a possible gateway behavior toward healthier lifestyle practices.