The Journal of Korean Academic Society of Nursing Education
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v.9
no.1
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pp.51-63
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2003
The purpose of this study was to identify the prevalence of urinary incontinence of community residing climacteric women, and to identify the relationship between urinary incontinence and quality of life. The subjects of this study were 156 women(45 to 59 years old). Data was collected from Sep. 1 to Dec. 1 2002 by an interview or self-reporting by a structured questionnaire. The questionnaire was composed of items of general characteristics, urinary characteristics, and conditions of urinary incontinence, using the modified Henderickson's stress incontinence scale(1981), and the quality of life scale developed by RO, You Ja(1988). The data was analyzed by the SPSS/WIN program using descriptive statistics, Pearson correlation coefficients, t-test and AVOVA. The results of the study were as follows : 1. The prevalence of urinary incontinence was 76.3%. Of the incontinent women, 42.0% had experienced urinary incontinence for a period of one to three years. Frequency of urinary incontinence was once or twice per day for 42.9% of the urinary incontinent women. Most of the participation with urinary incontinence(91.6%) had mild leakage of urine. In the whole urinary incontinent women, 70.6% had never treated or managed their urinary incontinence. Most of the subjects(79.8%) were mildly incontinent, and the prevalence of moderate and severe urinary incontinence was 20.2%. The mean scores among the items of urinary incontinence, in descending order, were increase of abdominal pressure($1.45{\pm}1.05$), coughing($1.16{\pm}0.93$), and sneezing($1.03{\pm}0.92$). 2. The average score in the level in the quality of life variables was 3.12. The urinary incontinence and quality of life were correlated negatively(r=-0.103, p<0.001). 3. There were statistically significant differences in the score of climacteric woman's self reported quality of life according to : amount of urinary incontinence(F=12.68, P=0.001), duration of urinary incontinence(F=6.97, P=0.009), number of urinary incontinence(F=4.77, P=0.03), existence of urinary incontinence(t=148, P=0.05). In conclusion, this study was a preliminary study to provide nursing practice guidelines for climacteric woman with urinary incontinence. Nurses working with climacteric woman should develop and provide adequate care for the incontinent climacteric subjects. In future research, it is recommended to identify comprehensive factors related to urinary incontinence, including the effective management of urinary incontinence.
Thyroid hormones are essential for cellular energy homeostasis and regulation by interacting with the sympathetic nervous system. This study was conducted to investigate the relationship between thyroid hormone and risk factors of metabolic syndrome for medical checkups of male patients. The study subjects were 12,250 males between 20~80 years old who visited the hospital for a health check-up at one General Hospital in Gyeonggi-do during the period of January 2011 to December 2013. According to the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), the metabolic syndrome criteria is defined as the presence of 3 or more risk factors. FT4 was lower in the metabolic syndrome group than in the normal group (p<0.001). The level of FT4 decreased as the levels of abdominal obesity (p=0.001), hypertriglyceridemia (p<0.001), blood pressure (p=0.005) and blood glucose (p=0.005) increased. The TSH level increased hypertriglyceridemia (p=0.047). FT4 had an influence on the waist circumference and triglyceride (p<0.001). HbA1c, insulin, HOMA-IR, hs-CRP were higher in the lowest quartile than in the highest quartile (p<0.001). FT4 had effects on the waist circumference and triglyceride, but TSH had no effect on metabolic syndrome risk factors. The metabolic syndrome was lower in the highest quartile of FT4 than in its lowest quartile.
Objectives : The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). Methods : We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings : elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. Results : The MS was more common in those persons , with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. Conclusions : Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.
Kim, Soo-Yeon;Sun, Seung-Ho;Yoo, Jun-Sang;Koh, Sang-Baek;Park, Jong-Ku
The Journal of Internal Korean Medicine
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v.30
no.3
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pp.510-524
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2009
Objective : This study was designed to find the correlation between Sasang Constitution and heart rate variability(HRV). Method : There were 665 subjects (280 men and 385 women), between 39 and 72 years old. in a rural community. Sasang Constitution was diagnosed by a Sasang constitutional specialist using PSSC (Phonetic System for Sasang Constitution), face and tongue photo and checkup-list. A structured-questionnaire was used to assess the general characteristics. HRV was recorded using SA-2000 (medi-core). HRV was assessed by time domain and by frequency domain analysis. Metabolic syndrome was defined on the basis of clustering of risk factors, when three or more of the following cardiovascular risk factors were included : blood pressure, fasting blood sugar, triglyceride HDL-cholesterol, and abdominal obesity (waist). Because of the skewness of the data, logarithmic transformation was performed on the absolute units of the spectral components of HRV, and the resulting logarithmic values and normalized units were compared between the groups by a logistic regression. The 95% confidence interval (CI) of the odds ratio was used and calculated from the data laid out for a cross sectional study. Results : 1. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly lower than that of Soyangin in LF norm and LF/HF ratio. Odds ratios of Taeeumin and Soeumin in female adults below 60 years old were significantly higher than that of Soyangin in HF norm. 2. There was no significant correlation between HRV and Sasang Constitution in female adults from 60 years old and over. 3. There was no significant correlation between HRV and Sasang Constitution in male adults. Conclusion : There is a statistically significant correlation between the HRV and Sasang Constitution. There is a tendency of increase in the sympathetic activity in Soyangin. There is a tendency of decrease in the parasympathetic activity in Taeeumin and Soeumin.
Journal of Physiology & Pathology in Korean Medicine
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v.27
no.5
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pp.509-519
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2013
Through the study on judgment of Body form and settle Energy flow(立形定氣) before diagnose the patients, the results are as follows. The observation of the body form is to determine prosperity and deficiency of each internal organ. It is necessary to distinguish Body form loss(形脫) and Body form fullness(形充). Fat man(肥人), Thin man(瘦人), Creamy man(膏人), Muscular man(肉人), Small Fat man(脂人) are discriminated by fat distribution, fat content, and muscle mass. The observation of the body form means the observation of structure disorder, color change, develop part at body, head and face. The observation of the body form that is to determine prosperity and deficiency of each internal organ is from the limited knowledge of the anatomy. The observation of face color is considered by blood perfusion, blood oxygenation and accumulation of carotinoid, bilirubin and change of melanin in the facial skin. The prosperity and the deficiency of energy flow is considered by symptom combined with growth (<40 years) and aging (>40 years). The prosperity of energy flow includes the anger, anxious emotion and the deficiency of energy flow includes the fear, depressive emotion. The breathing type is expiratory exhalation like asthma patients in the prosperity of energy flow. The deficiency of energy flow is weakness to overcome the disease. The prosperity and the deficiency of energy flow are considered by body metabolic ratios (Basal metabolic Rate: BMR, Resting metabolic rate: RMR, Physical activity ratios: PASs). Development of subcutaneous fat is good in the person of prosperous energy flow. The person of prosperous energy flow is hard to overcome to heat weather than cold weather. The person of deficiency of energy flow has tendencies of low blood pressure, insufficiency of blood flow in the peripheral and being shocked. The person of deficiency of energy flow has tendencies of chronic fatigue syndrome or automatic nerve disorder. If the patient who has deficiency of energy flow has severe weight loss should be checked for the presence of disease. The observation of small and large of bone is to check the development and disorder of bone growth and aging. The observation of thickness and weakness of muscle is to check the development of muscle, particularly biceps, gastrocnemius, and rectus abdominal muscle. The observation of thickness and weakness of skin is to check the ability of regulating body temperature by sweating.
Park, Jun-Han;Chun, Jin-Ho;Kang, Jang-Mi;Son, Byung-Chul;Kim, Dae-Hwan;Lee, Chang-Hee;Jeong, Kui-Won;Urm, Sang-Hwa
Journal of Preventive Medicine and Public Health
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v.31
no.4
s.63
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pp.728-739
/
1998
To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.
Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.
Yang, Geun Jin;Kim, Mun Chul;Chung, Hoon;Lee, Sang Pyung;Choi, Gi Whan;Yeo, Hyung Tae
Journal of Korean Neurosurgical Society
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v.29
no.5
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pp.644-649
/
2000
Objective : Acute hydrocephalus can be caused by many pathologic conditions such as sub- arachnoid hemorrhage, intraventricular hemorrhage, inflammatory diseases. External ventricular drainage(EVD) through trephination of the skull is essential procedure for progressing or persistent symptomatic acute hydrocephalus. If the EVD can not be removed in short period, the chance of ventriculitis increases and periodic transposition of the draining catheter should be considered. Shunt procedure can not be performed in acute hemorrhage or infectious condition because of the risk of shunt malfunction or intra-abdominal spreading of the infection, respectively. The authors replaced EVD with continuous lumbar drainage(CLD) for the purpose of controlling acute hydrocephalus and preventing ventriculitis simultaneously, or treating ventriculitis more effectively in case of infection which had already broken out. CLD has many advantages over EVD, although, it can complicate disastrous downward brain herniation in patients with elevated intracranial pressure. The authors performed CLD with EVD maintained and then tested the possibility of the brain herniation with quite simple method. If the CLD was proven as safe through the test, EVD could be replaced with it without terrible herniation. Material and Method : Between September 1998 and April 1999, 10 patients underwent CLD in replacement of EVD. Among them, 5 were patients with aneurysmal subarachnoid hemorrhage, 2 were patients with thalamic hematoma and intraventricular hemorhage and 3 were patients with traumatic intracranial hemorrhage. Results : In eight of them the replacements were successfully done and one of them died on account of medical illness. In two of them the replacement could not be performed because of the risk of herniation and all expired owing to ventriculitis. Two patients required permanent shunt operation. Conclusion : This article provides a valuable alternative method of treatment for persistent symptomatic hydrocephalus which can not be managed with shunt operation immediately.
Objectives : To satisfy the demand of good treatment of constipation Methods : we investigated the literatures of Oriental Medicine about Constipation. Results: 1. There are three categories of etimological factors of constipation, that is, endogenous, exogenous and non-exo-endogenous factor. The endogenous factor is caused by seven emotions, called depression of Ki and stagnation of Ki. The exogenous factor is six excessive atmospheric influences, for example, wind, cold, dampness, heat and dryness. And the non-exo-endogenous factors are overfatigue, improper diet, stagnated blood and deficiency of Ki and blood that comes from old age, long disease and after delivery. 2. Classification: According to cause of disease it is classified by constipation due to cold, heat, wind, dryness, retention of undigested and phlegm. According to Internal Organs there are constipation due to deficiency syndrome of the stomach, excess syndrome of the stomach, deficiency syndrome of kidney and splenic constipation. And Differentiation of syndromes according to Ki and blood, there are constipation of deficiency type and excess type. There are constipation due to stagnation and deficiency of Ki, deficiency of blood and stagnated blood. 3. Principles and Methods of treatment 1) Herbal Medicine (1) Excess type [1] Constipation due to heat : Seunggitang(承氣湯) and Majainwhan(麻子仁丸) [2] Constipation due to stagnation of Ki : Samatang(四磨湯) and Yukmatang(六磨湯) (2) Deficiency type [1] Constipation due to deficiency of Ki : Whanggitang(黃?湯) [2] Constipation due to deficiency of blood: Yunjangwhan(潤腸丸) [3] Constipation due to cold : Jechunjun(濟川煎) and Banyuwhan(半硫丸) 2) Enema therapy: It is a method to induce defecation by honey or pig's bile juice for weak people. 3) Acupuncture and Moxibustion: Acupoints used to treat constipation are BL25, ST25 and TE6. Moxibustion at CV8, CV6 is good for constipation due to cold. (4) Diet therapy: It is very important that we eat meals regularly and defecate on the same time even if you don't. And we have to eat food like fruits, vegetables and beans. (5) finger pressure: Finger pressing around these points like ST25, SP25, BL25, BL31, BL32, BL33 and BL34 is good for it. (6) Kigong therapy: Abdominal breathing (7) Old man' s constipation: Hip bath or diet therapy is commended. Laxation with lubricant like Supungyunjangwhan(搜風潤腸丸) is used. (8) Women' s constipation: After delivery, we have to administer tonifying prescription Sipjundaebotang(十全大補湯) and enema can be used. Conclusion : We have to examine the cause of disease and bowl movement carefully. After comprehensive analysis of the data gained by the four methods of diagnosis, we diagnose and treat patients on the base of overall of symptoms and signs.
Purpose: The management of hemorrhagic shock is critical for trauma patients. To assess hemorrhagic shock, the clinician commonly uses a change in positional blood pressure, the shock index, an estimate of the diameter of inferior vena cava based on sonography, and an evaluation of hypoperfusion complex shown on a CT scan. To add the finding for the hypoperfusion complex, the 'halo sign' was introduced recently. To our knowledge, this 'halo sign' has not been evaluated for its clinical usefulness, so we designed this study to evaluate its usefulness and to find the useful CT signs for hypoperfusion complex. Methods: The study was done from January 2007 to May 2007. All medical records and CT images of 124 patients with trauma were reviewed, of which 103 patients were included. Exclusion criteria was as follows: 1) age < 15 year old and 2) head trauma score of AIS ${\geq}$ 5. Results: The value of kappa, to assess the inter-observer agreement, was 0.51 (p < 0.001). The variables of the halo-sign-positive group were statistically different from those of the halo-sign-negative group. The rate of transfusion for the halo-sign-positive group was about 10 times higher than that of the halo-sign-negative group and the rate of mortality was about 6 times higher. Conclusion: In the setting of trauma, early abdominal CT can show diffuse abnormalities due to hypoperfusion complex. Recognition of these signs is important in order to prevent an unwanted outcome in hemorrhagic shock. We conclude that the halo sign is a useful one for hypoperfusion complex and that it is useful for assessing the degree of hemorrhagic shock.
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