• 수면정신생리
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• 제2권2호
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• pp.146-155
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• 1995

Jet lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zone. The consequences of jet lag include fatigue, general malaise, sleep disturbances, and reductions of cognitive and psychomotor performance, all of which have been documented in experimental biological and air crew personnel studies. Thus authors tried to study the jet lag of natural travellers by modified self reporting sleep log. Total 61 healthy travellers was studied for 3 days before and 7 days after jet-flights across seven to ten time zone. The eastbound travelling group was 38 persons, aged 19 -70 and westbound travelling group was 23 persons, aged 13 - 69. Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggested that the 7 to 10 time zone shift gave significant influence to traveller's sleep-wake cycles. The date which subjective physical condition was recovered on was $5.16{\pm}1.50$ day after arrivals for eastbound, while for westbound, $4.91{\pm}1.62$ day. In eastbound travelling, sleep onset time became later than baselines and could not recover until 7th day. But in westbound, it became earlier than baseline and could recover until 6th day. The mean score of 24-hour sleepiness was greater in eastboumd than westbound. Therefore the eastbound travelling caused more sleep-wake cycle disturbance and daytime dysfunction than westbound travelling. In other parameters, there was no definite difference between east and westbound. From our results, it was suggested that the symptom severity of jet lag was dependent on the travelling direction. To demonstrate more definite evidence, large sized data collections and comparision by age difference were needed.

• Journal of Acupuncture Research
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• 제31권1호
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• pp.149-158
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• 2014

Objectives : The aim of this study is to investigate the influence of anxiety and depression on motor recovery of acute Bell's palsy to estimate how much psychological factors affect the clinical prognosis. Methods : A total of 20 inpatients with acute unilateral Bell's palsy within 1 week of onset participated in this study. The severity of participants' facial palsy was measured by Yanagihara(Y-system) score, FDI and House-Brackmann scale at the time of 1 week and 3 weeks from the onset. The motor recovery of acute Bell's palsy is defined as ${\Delta}Y$-system during 2 weeks. Beck anxiety scale(BAI) and the center for epidermiologic studies depression scale(CES-D) were adopted to assess anxiety and depression, respectively. Correlation analysis and linear regression analysis were conducted between ${\Delta}Y$-system and prognostic factors including anxiety and depression. Results : Significant associations were found between ${\Delta}Y$-system and depression(CES-D) but no significant associations were found between ${\Delta}Y$-system and other prognostic factors, hypertension, diabetes, postauricular pain, disgeusia, age, degree of initial palsy and anxiety(BAI). And a regression equation with 0.295 for coefficient of determination was obtained. Through this analysis, the ${\Delta}Y$-system can be predicted using regression equation which cover 29.5 % of depression index(CES-D). Conclusion : Depression is a significant clinical prognostic factor on motor recovery of acute Bell's palsy. So, Bell's palsy treatment should be combined with psychological care and support.

• 한국보건간호학회지
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• 제26권3호
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• pp.453-464
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• 2012

Purpose: The purpose of this study was to provide the basic data for university students to develop program for achieving successful developmental task. Method: The subjects involved this study were 462 1-4th grade university students located at Kangwon-Do & Chungchung-Do. Data were measured using Global assessment of recent stress scale, CES-D and Self-esteem scale. Data were analyzed using SPSS WIN 17.0 program that included mean, standard deviation, ANOVA, Sheffe test and Pearson correlation coefficients. Results: 1) The mean score of the degree of perceived stress was 4.17(${\pm}1.43$), depression was .92(${\pm}.47$), and self esteem was 2.89(${\pm}.48$). 2) There were significant differences in the degree of stress according to gender(t=2.03, p=.043), level of living(F=3.55, p=.029). Likewise, there were significant differences in the degree of depression according to gender(t=3.35, p=.001), age(t=2.15, p=.032), level of living(F=3.38, p=.035) and in the degree of self-esteem there were significant difference according to gender(t=3.64, p<.001), age(t=2.81, p=.005), participation of regular meeting or not(t=3.14, p=.002), frequency of alcohol drinking(F=5.59, p=.004), onset age of alcohol drinking(t=2.43, p=.016). 4) There was a significant relationship between stress and depression(r=.556, p<.001), self-esteem (r=-.423, p<.001). Also, there was a significant relationship between depression and self esteem(r=-.667, p<.001). Conclusions: Nursing interventions and educational programs which can help the students to accomplish the developmental tasks required.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.299-305
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• 2009

Purpose: Recently, the incidence of malignant melanoma has been steadily increasing. Malignant melanoma is already known to have poorer prognosis than other primary skin cancers. Despite the poor prognosis, it is relatively less known to the public so that a number of patients visit hospital carrying advanced stage tumor. Yet, extensive study about malignant melanoma is currently insufficient, and specific guidelines and statistical figures in Korea are almost inexistent. Therefore, authors reviewed patients with malignant melanoma who have visited our hospital for last 14 years. Methods: Between January 1994 and January 2008, 62 patients were diagnosed with malignant melanoma at our hospital. A retrospective study was performed with data from patients' charts and biopsy results. Annual incidence, mean age of onset, gender, tumor location, tumor thickness, pathologic ulceration, clinicopathologic subtype, and clinical AJCC stage were evaluated. Analysis of factors associated with survival were performed using the Cox proportional hazard model. Kaplan - Meier method was used to generate survival curves. Results: Clinicopathologic features of 62 patients (32 male, 30 female) with average age of 57 years were evaluated. Most lesions were found in lower limb, and the most common subtype was acral lentiginous melanoma. We could also find that age, tumor thickness, and clinical stage were the only significant prognostic factors. Conclusion: Clinicopathologic features of malignant melanoma were analyzed in this study, but the result is not ready to be generalized because the number of cases is too small. Further study must be performed to report clinical guidelines for prognosis and treatment for malignant melanoma patients in Korea.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.75-80
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• 2017

Purpose: To investigate the frequency, presentation, management, and outcome of cytomegalovirus (CMV) infection in pediatric patients who underwent renal transplantation. Methods: We performed a retrospective chart review of 70 patients under the age of 18, who underwent renal transplantation between January 1990 and November 2014. A diagnosis of CMV infection was based on serology, molecular assays, antigenemia assays, and culture. CMV infection was defined as detection of virus and CMV disease was diagnosed when clinical signs and symptoms were present. Results: The number of patients with CMV infection was 18 (25.7% of renal transplant recipients). Twelve were male (66.7%), and the $mean{\pm}standard$ deviation (SD) age at infection was $13.3{\pm}3.9$ years. Median time of infection after renal transplantation was 4 months (range 1.0-31.0 months). Pretransplantation CMV status in the infected group was as follows: donor (D)+/recipient (R)+, 11 (61.1%); D+/R-, 7 (38.9%); D-/R+, 0; and D-/R- 0. Nine patients had CMV disease with fever, leukopenia, thrombocytopenia, or organ involvement such as enteritis, hepatitis, and pneumonitis. The age of disease occurrence was $13.1{\pm}3.9$ years and the median time to disease onset after renal transplantation was 8 months (range 1.0-31.0). Immunosuppressive agents were reduced or discontinued in 14 patients (77.8%), antiviral agents were used in 11 patients (61.1%), and all patients with CMV infection were controlled. Conclusions: A quarter of the patients had CMV infection about 4 months after renal transplantation. CMV infection was successfully treated with reduction of immunosuppressants or with antiviral agents.

• 한국수정란이식학회지
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• 제28권2호
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• pp.149-155
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• 2013

Mullerian inhibiting substance (MIS) is a member of the TGF-${\beta}$ (transforming growth factor-${\beta}$) family whose members play key roles in development, suppression of tumour growth, and feedback control of the pituitary-gonadal hormone axis. MIS is expressed in a highly tissue-specific manner in which it is restricted to male Sertoli cells and female granulose cells. The serum levels of MIS in prenatal and postnatal ICR mice were measured using the enzyme-linked immuno-solvent assay (ELISA) using the MIS/AMH antibody. Mice were grouped by age: the significant periods were at the onset of development. During sex organ differentiation, no remarkable difference between female and male foetus MIS serum levels (both<0.1 ng/ml) was observed. However, MIS serum levels in pregnant mice markedly changed (4.5~12.2 ng/ml). After birth, postnatal female and male mice serum MIS levels changed considerably (male: <0.1~138.5 ng/ml, female: 5.3~103.4 ng/ml), and the changing phase were diametrically opposed (male: decreasing, female: fluctuating). These findings suggest that MIS may have strong associations with not only develop-ment but also puberty. For further studies, establishing the standard MIS serum levels is of importance. Our study provides the basic information for the study of MIS interactions with reproductive organ disability, cancer, and the effect of other hormone or menopause. We hypothesise that if MIS is regularly injected into middle-age women, meno-pause will be delayed. We detected that serum MIS concentration curves change with age. The changing phase is different between males and females, and this difference is significant after birth. Moreover, MIS mRNA is expressed during the developmental period (prenatal) and also in the postnatal period. This finding indicates that MIS may play a significant role in the developmental stage and in growth after birth.

• Journal of Korean Neurosurgical Society
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• 제49권2호
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• pp.92-96
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• 2011

Objective : We retrospectively evaluated the prognostic factors that can influence long-term survival in patients who suffered acute large cerebral infarction. Methods : Between June 2003 and October 2008, a total of 178 patients were diagnosed with a large cerebral infarction, and, among them, 122 patients were alive one month after the onset of stroke. We investigated the multiple factors that might have influenced the life expectancies of these 122 patients. Results : The mean age of the patients was $70{\pm}13.4$ years and the mean survival was $41.7{\pm}2.8$ months. The mean survival of the poor functional outcome group ($mRS{\geq}4$) was $33.9{\pm}3.3$ months, whereas that of the good functional outcome group ($mRS{\leq}3$) was $58.6{\pm}2.6$ months (p value=0.000). The mean survival of the older patients (270 years) was $29.7{\pm}3.4$ months, whereas that of the younger patients (<70 years) was much better as $58.9{\pm}3.2$ months (p value=0.000). Involvement of ACA or PCA territory in MCA infarction is also a poor prognostic factor (p value=0.021). But, other factors that are also known as significant predictors of poor survival (male gender, hypertension, heart failure, atrial fibrillation, diabetes mellitus, a previous history of stroke, smoking, and dyslipidemia) did not significantly influence the mean survival time in the current study. Conclusion : Age (older versus younger than 70 years old) and functional outcome at one month could be critical prognostic factors for survival after acute large cerebral infarction. Involvement of ACA or PCA territory is also an important poor prognostic factor in patients with MCA territorial infarction.

• 중환자간호학회지
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• 제3권2호
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• pp.37-48
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• 2010

Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.

• 한방안이비인후피부과학회지
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• 제27권4호
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• pp.101-109
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• 2014

Objective : The purpose of this study is to summarize the differential diagnosis between allergic and nonallergic rhinitis and suggest management. Methods : We reviewed the current update of medical history and physical examination for allergic and nonallergic rhinitis. Then we analyzed clinical characteristics according to onset age, gender incidence and state of nasal symptoms, etc. Results : 1. Patients with nonallergic rhinitis tend to develop symptoms at a later age(>35 years of age), and there is a female-to-male incidence ratio for nonallergic rhinitis of 2:1 to 3:1. 2. Patients with nonallergic rhinitis report nasal congestion, nasal rhinorrhea and more often report postnasal drip rather than sneezing and itching, which are predominant symptoms of allergic rhinitis. And the nasal mucosa in nonallergic rhinitis usually looks normal. 3. Patients with nonallergic rhinitis have few complaints of concomitant symptoms of allergic symptoms and the absence of other atopic diseases in the patient or in the family supports the diagnosis of nonallergic rhinitis. 4. Common triggers of nonallergic rhinitis are nonspecific irritant exposures and many patients with nonallergic rhinitis find that antihistamines have no benefit. Conclusions : The differential diagnosis between allergic and nonallergic rhinitis is clinical and relies on a detailed medical history and physical examination.

• 중환자간호학회지
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• 제14권1호
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• pp.28-39
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• 2021

Purpose : This study investigated the occurrence of postoperative ileus and its related factors in patients after spinal surgery. Methods : After a retrospective review of data from patients who underwent spinal surgery at a single hospital located in Busan from 2012 through 2016, a total of 253 patients were included. The subjects were divided into non-ileus and ileus groups. We compared patient-, surgery-, and postoperative hematological-related factors. Results : A total of 41 (16.2%) out of 253 patients experienced postoperative ileus. Data analysis revealed significant differences between the two groups in mean age (68.44 vs 60.50 years), occupation (9.8 vs 28.8%), cardiovascular comorbidity (63.4 vs 37.7%), approach of surgery (supine/prone: 29.3/70.7 vs 12.7/87.3%), duration of anesthesia (5.86 vs 4.43 hours), narcotic use (75.6 vs 56.6%), postoperative serum hemoglobin level (3 days: 10.81 vs 11.41 g/dL), postoperative serum protein (immediately/3 days: 5.30/5.43 vs 5.62/5.68 g/dL), postoperative albumin level (3 days: 3.17 vs 3.40 g/dL), postoperative C-reactive protein level (3 days: 11.44 vs 8.36 mg/dL), postoperative bed stabilization period (3.32 vs 2.50 days), and onset of bowel movement (2.59 vs 1.94 days). In multivariate logistic regression, age and time of anesthesia were independent risk factors of postoperative ileus. Conclusion : To detect ileus after spinal surgery early, nurse education is needed with intensive screening on advanced age, surgery-related factors, and postoperative hematological indices.