• 제목/요약/키워드: central depression

검색결과 188건 처리시간 0.028초

사회부과적 완벽주의 성향의 내담자 단일사례연구: Fairbairn의 심리구조를 중심으로 (A Case Study on the Socially-Prescribed Perfectionistic Client: Focused on Fairbairn's Psychological Structure)

  • 고준식;안인숙
    • 산업진흥연구
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    • 제8권2호
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    • pp.109-117
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    • 2023
  • 현대산업사회는 직장인에게 사회부과적 완벽주의 성향을 요구하며, 자기불일치를 야기한다. 이에 본 연구의 목적은 Fairbairn의 심리구조를 중심으로 분열된 자아를 통합하고 대인관계 패턴을 변화시켜 자기불일치를 감소시키는 상담전략을 제안하는 것이었다. 상담은 2022년 3월부터 7월까지 주 1회, 총 14회기를 진행하였다. 연구방법으로 t-검증을 사용하였고, 자기질문지를 사전, 사후 실시하여 내담자의 자기불일치 수준을 비교하였다. 내담자는 상담 초기에 직장상사와 갈등하면서 분노, 우울, 위장장애 등의 신체화 증상과 엄격한 자기 및 타인 평가들을 나타냈으며, 자기불일치 수준이 높았다. 상담을 통해 내담자의 리비도적 자아와 반비리도적 자아가 탈억압되어 중심자아로 기능하는 것을 확인할 수 있었고, 자기불일치가 감소하는 모습이 나타났으며, 자기불일치 사전-사후검사 결과에서 유의미한 상담성과를 보였다. 본 연구는 Fairbairn의 심리구조를 적용한 사례연구로서 사회부과적 완벽주의 성향의 내담자가 대인관계 패턴의 변화를 확인한 연구라는 점에서 의의가 있다.

반추수(反芻獸)의 살서제중독(殺鼠劑中毒)에 관한 병리학적(病理學的) 연구(硏究) (Pathological Studies on the Experimentally Induced Rodenticide Poisoning in Ruminant)

  • 이차수;박청규;조용준;곽수동
    • 대한수의학회지
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    • 제22권2호
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    • pp.221-232
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    • 1982
  • This paper dealt with the pathological and clinical findings on the experimentally induced rodenticide (fluoroacetate, zinc phosphide, thallium sulfate, coumarin) and NaCN poisoning of ruminants (Holstein cattle and/or Korean native goat) for the purpose of the diagnosis in the accidental rodenticide poisoning of cattle. The results observed are summarized as follows: Fluoroacetate poisoning (cattle and goat): in the clinical signs, there were depression, convulsion, dyspnea, groan, grinding of the teeth, vomiting, opisthotonus and post-mortem tympany. In the macroscopical findings, the blood was more or less poor coagulative and dark red, bloody fluid with foam in the trachea, hyperemia and hemorrhage of tracheal mucosa and lung, cloudy swelling and hyperemia of kidney, epicardial hemorrhage(cattle), and hyperemia of abomasum, intestine and brain were observed. In the microscopical findings, there were pulmonary edema and hemorrhage, necrosis of convoluted tubular epithelium and interstitial hemorrhage of kidney, focal coagulative necrosis of myocardium, hemorrhage of pancreas and spleen, dilatation of Virchow-Robin space and hyperemia of brain, and necrosis with desquamation of mucosal epithelia of abomasum and upper small intestine. In the histological lesions of the liver, lobular peripheral hyperemia, centrilobular necrosis and cytoplasmic inclusion bodies of the hetatic cells were observed. The cytoplasmic inclusion body of the hepatic cells was not seen in the affected goat, but hydropic degeneration of the hepatic cells was marked. Zinc phosphide poisoning (cattle and goat): clinically, the affected animals died in recumbent position after ataxia, dyspnea and convulsion. In the macroscopical findings, hyperemia and hemorrhage of lung, cloudy swelling and hyperemia of liver and kidney, hemorrhage of spleen (cattle), and catarrh of abomasum and small intestine were observed. In the microscopical findings, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hemorrhage of spleen, hyperemia of lung, hyperemia or hemorrhage of heart, cloudy. swelling and fatty changes of hepatic cells, dilatation of hepatic central vein, hyperemia of brain, and catarrh of abomasal and small intestinal mucosae were observed. Thallium sulfate poisoning (cattle): in the macroscopical findings dark red color of blood, hyperemia and hemorrhage of lung, bloody fluid with foam in the tracheal mucosa, petechiae of tracheal mucosa, cloudy swelling and hemorrhage of liver, necrotic lesions and hemorrhage of renal cortex and epicardial hemorrhage were observed. In the microscopical findings, severe hemorrhages of the lung, cloudy swelling and necrosis of hepatic cells, hyperemia and hemorrhage of liver, focal coagulative necrosis of mycordium, necrosis of the convoluted tubular epithelium and hyperemia of kidney, hyperemia and hemorrhage of spleen and dilatation of Virchow-Robin apace in brain were observed. Coumarin poisoning (goat): the poisoned animals died in the state of groan and depression. In the macroscopical findings, poor coagulation of blood, hemorrhage of lung, cloudy swelling and severe hemorrhages of liver, cloudy swelling and hemorrhage of kidney, abomasal hemorrhage, catarrh of small intestine, and hyperemia and hemorrhage of the other organs were observed, In the microscopical findings, hyperemia and hemorrhage of lung and kidney, cloudy swelling of the convoluted tubular epithelium of kidney, severe hepatic hyperemia, cloudy swelling and hydropic degeneration of heptatic cell, and hyperemia and hemorrhage of brain and spleen were observed. NaCN poisoning (cattle and goat): clinically, there were convulsion, severe dyspnea, paresis of hind limb, depression and then rigor of four limbs. In the macroscopical findings, bright red color of blood, hyperemia and bright and red tinge of lung cloudy swelling of kidney and liver, and hyperemia of abomasum were observed. In the microscopical findings, cloudy swelling and hydropic degeneration of hepatic cell, hyperemia and edema of lung, necrosis and degeneration of the convoluted tubular epithelium and hemorrhage in kidney, dilatation of Virchow-Robin space of brain and hemorrhage of spleen were observed.

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말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로 (Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines)

  • 이혜란
    • Journal of Hospice and Palliative Care
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    • 제16권4호
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    • pp.205-215
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    • 2013
  • 말기암환자들은 암의 진행으로 인한 여러 가지 육체적, 정신적 증상들로 고통 받고 있으며, 통증뿐만 아니라 피로감, 쇠약감, 식욕부진, 오심 구토, 호흡곤란 등은 말기암환자의 삶의 질 감소에 큰 영향을 미친다. 피로감은 여러 기전 및 원인에 의하여 발생하는데, 치료 가능한 원인으로는 약물부작용, 빈혈, 심한 통증, 수면장애, 우울증 또는 불안감, 영양부족, 내과적 동반질환 등이다. 피로감의 주 기전으로는 사이토카인의 조절이상 및 시상하부-뇌하수체-부신축의 기능부전, serotonin의 조절이상 생체리듬의 파괴, ATP에서의 변화 등이다. 치료는 치료 가능한 원인을 제거하고 환자의 에너지를 보존할 수 있게 하는 방향으로 활동을 계획하고, 교육해야 하며, 약물 치료로는 corticosteroid와 psychostimulants를 사용할 수 있다. 식욕부진과 악액질도 여러 가지 치료 가능한 원인이 있을 수 있는데, 구내염, 구강 캔디다증, 구강 herpes, 구강건조, 변비, 통증과 호흡곤란같이 조절이 안 되는 증상, 섬망, 오심 구토, 우울증, 위장관 운동기능 장애, 역류성 식도염, 내분비 장애가 포함 된다. 식욕부전의 기전은 음식섭취를 조절하는 뇌의 생리적 기전의 이상과 관련, serotonin 분비 증가, IL-$1{\alpha}$, IL-1, IL-6, IL-8 TNF-${\alpha}$와 관련이 있다. 악액질의 기전은 에너지와 기질(substrate metabolism)에서의 변화, 종양에서 생산된 지질분해요소와 단백질 분해요소, 호르몬 이상, 암세포로부터 세포성장에 필요한 영양분을 빼앗기는 것, 에너지 섭취의 감소 등이다. 치료는 정신과 상담 및 환자와 가족의 교육인데, 교육할 때는 환자와 그 가족에게 식욕부진과 악액질이 암으로 인한 임종과정 중 일어나는 자연적인 현상이라는 것을 알리며, 다른 행동으로 환자를 돌보는 방법 등을 교육한다. 약물치료로는 megestrol acetate와 dronabinol, steroid를 사용할 수 있다. 오심 구토의 원인 중 치료가 가능할 수도 있는 것으로는 약물, 요독증, 감염, 불안증, 변비, 상부위장관 폐쇄, 고칼슘혈증, 저나트륨증이 있고, 치료는 metoclopramide, haloperidol, olanzapine 또는 ondansetron 등을 사용해 볼 수 있다. 말기 암에서 호흡곤란의 증상은 폐의 특별한 병변이 없이도 환자가 호소할 수 있는데, 이 경우 opioids가 효과적이다. 말기 암환자에서 환자의 증상을 경감시켜주기 위한 완화치료는 매우 중요하며, 환자의 증상을 잘 평가하고 적절한 치료 및 관리를 해 줌으로써 환자의 삶의 질을 향상시킬 수 있다. 따라서 이들 환자의 증상 호소에 더욱 관심을 갖고 적극적으로 치료하고 관리하여야 할 것이다.

안와부 자가지방이식술 후 시력 저하에 대한 증례보고 (Visual Disturbance following Autologous Fat Injection into Periorbital Area)

  • 전영우;김성수;하상욱;이영대;설철환;탁관철;조을제;유원민
    • Archives of Plastic Surgery
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    • 제34권5호
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    • pp.663-666
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    • 2007
  • Purpose: Autologous fat injection into the facial area is a frequently used technique in aesthetic plastic surgery for augmentation of the soft tissue. Fat injection is a very safe procedure because of the advantage of being autologous tissue. Minimal foreign body reaction or infections are noted after fat injection. However, there may be some complications including those as severe as blindness. There have been some case reports on visual disturbances after autologous fat injection reported in the literature. Methods: A 21-year-old female patient underwent autologous fat injection into left eyebrow area to correct depression of soft tissue. Immediately after injection of autologous fat, she complained sudden visual loss on the left eye. She had come to our emergency room and ophthalmologic evaluation showed that the patient could only recognize hand motion. There was no abnormality of the optic nerve on magnetic resonance imaging. Suspecting an ischemic optic neuritis from fat embolism of the central retinal artery, the patient was treated conservatively with occular massage, antiglaucomatic agent, anti-inflammatory drugs and antibiotics. Visual field examination showed visual defect of half the lower hemisphere. Results: While maintaining antiglaucomatic agents and non steroidal anti inflammatory drugs, fundoscopic examination showed no abnormalities on the second day of admission. Visual field examination showed an improvement on the fourth day along with decreased eyeball pain. Significant improvement of vision was noted and the patient was discharged on the fifth day of admission. The patient was followed-up 2 days afterwards with improved vision and visual field defect. Conclusion: We describe an unusual case of sudden unilateral visual disturbance following autologous fat injection into periorbital area.

미국이민 한국인의 스트레스 반응 양상과 생활사건과의 상관 연구 (Correlation Study between Stress Responses and Life Events as a Stressor)

  • 이소우
    • 대한간호학회지
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    • 제23권2호
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    • pp.299-315
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    • 1993
  • Koreans are one of the fastest growing immigrant groups in America. Stress responses and stressors among this large cultural minority has been rarely been studied by nursing researchers. Adjusting to life in foreign country produces a great deal of stress. Differences in culture, language, expectations and social behavior can lead to misunderstandings between health care providers and clients. These misunderstandings are not well accounted for in health assessment. This study investigated the relationship between life events or / and daily activities as a stressor and the symptoms of stress among a sample of Korean immigrants in America. The symptoms of stress scale (SOS) was used to identify stress responses and open-ended questions were used to identify life events and daily activities considered by the respondents to be stressful. A simple random sample of 283 subjects was selected from the Directory of the Korean Society of Chicago, New York, Los Angeles, Philadelphia and Seattle. Demographically, the subjects ranged in age from 20 to 69 years, and the percentage of women and men was approximately 50% each. Almost ninety percent of the subjects were highly educated, 17% owners of business, 19% white collar professionals, 14% employed in sales or as skilled /unskilled labor, 27% as housewives and students and 3% had no occupation. The total group SOS mean was 0.8042 ; the SOS men for man was 0.7371, and for women was 0.8713. The stress response of this subject group was high, -the stress response of women higher than that for men. In an earlier study(June, 1992) with another sample, the total mean SOS score was similar to this one. The main stressful life events or / and daily activities were, in order, economic problems (N=97), interpersonal problems (N=68), children care problems (N=258), health problems (N=49), communication problems (N=42), family problems (N=38), worry about future career (N=36), and religious problems (N=25). There was a significant difference in the SOS means between the group that expressed life events or / and daily activities to be stressful and the group that did not. Interpersonal relationships and economic and family problems were stressors for those who complained about peripheral manifestations. cardiopulmonary symptoms, central-neurological symptoms, gastrointestinal symptoms, muscle ten-sion, habitual patterns, depression, anxiety, emotional irritability and cognitive disorganization. In summary, interpersonal relationships and economic and family problems influenced stress response manifestations. Income, the number of people in the family, the year of immigration. the level of education, and marital status were related to physiological and psychosocial stress responses.

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통증 개념을 다룬 국내 간호 연구 분석 (An Analysis of Nursing Research on Pain Reported in Korea from 1970 to 1994)

  • 박정숙;박청자
    • 대한간호학회지
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    • 제25권1호
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    • pp.30-44
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    • 1995
  • This study aimed at analyzing the trend of re-search on pain in Korea, suggesting direction future pain research, and contributing to the use of pain interventions in nursing practice. Research studies on pain were selected from journals of medical and nursing schools, the Korean Nurse, the Korean Nurses' Academic Society Journal, the Central Journal of Medicine, the New Medical Journal, and from theses and dissertations, which were conducted between 1970 and 1994. The total number of the studies was 93. These studies were analyzed for 1) time of publication or presentation, 2) thesis for a degree or nondegree, 3) research design, 4) characteristics of subjects used in each study, 5) measurement tool, 6) types of correlated variables, 7) Korean terms for pain 8) types of nursing interventions, and 9) results of studies. The findings of the analysis can be summerized as follows : 1) The number of studies related to pain has increased rapidly since the early 1980's. The number of experimental research studies related to pain has increased chronologically, but the number of survey research studies related to pain was highest from 1981 to 1985, after that it decreased slowly. 2) The subjects in 19 studies were healthy people and, in 73 studies, patients with various illnesses. Thirty two studies were conducted with surgical patients. 3) Sixty one pain research studies were done for a thesis for a degree and 32 were nondegree research studies. 4) As measurement tools for pain, self- report pain scales were used in 54 studies and more than two tools were used in 28 studies. In the experimental studies, the trend was to use more than two tools. And in the nonexperirnental studies, the trend was to use self-report pain scales only. 5) There were 11 correlational studies. In these studies, the trend was to study anxiety, depression and variables such as intravenous infusion as related to pain.6) In the thirty six experimental studies, the effects of 16 types of nursing interventions weretested. Teaching and information, and relaxation technique were the most popular interventions for pain. 7) In eighteen methodological studies, the majority were studies testing the validity and re-liability of Dr. Lee's Korean Pain Rating Questionnaire. The following suggestions are made based on the above findings : 1) The patterns of these studies related to pain in Korea need to be compared with trends in other countries. 2) Meta - analysis should be done to analyze and integrate the results of various studies. 3) This analysis of pain research is needed to identify the present trend of pain research and to suggest the direction of future pain research, so these patterns of studies should be done in 5 to 10 year intervals. 4) More replicated pain research is needed to prove the effect of nursing interventions and more qualitative research on pain is needed to identify indepth the meaning of pain. 5) Pain researchers should make an effort to apply research result in various clinical settings and try to carry out team research with clinical nurses or with other multidiscipinary researchers.

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모노아민 산화효소에 대한 식용버섯류의 저해활성 검색 (Screening of Inhibitory Activity of Edible Mushrooms on the Monoamine Oxidase)

  • 황금희;김현구;한용남
    • 한국식품과학회지
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    • 제29권1호
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    • pp.156-160
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    • 1997
  • 식용버섯류들의 MAO 저해활성을 검색할 목적으로 몇가지 유기용매를 이용하여 추출분획을 조제하고 이들의 MAO에 대한 저해활성을 검색하였다. 검색된 3종 버섯류의 유기용매 추출물들은 영지버섯 bud의 $CHCl_3$ 층을 제외하고는 모두 MAO-A에 대한 저해활성이 나타나지 않았으나 영지 bud의 경우 $CHCl_3$ 층에서 비교적 강력한 MAO-A 저해활성을 나타내어 영지 bud의 항암활성이 영지의 항암활성과 비교하여 더욱 강력하다는 기존의 보고와 관련하여 아주 흥미로운 결과로 영지의 성분연구에 아주 중요한 단서를 제공해 줄 것으로 생각된다. 또한 검색된 3종 버섯류의 유기용매 추출물들은 영지 bud, 표고버섯의 EtOAc 층에서 각각 51.3, 55.9%로 역한 정도의 저해활성이 관찰되었으며 그 외의 다른 버섯류들에서는 전혀 MAO-B에 대한 저해활성이 확인되지 않았다. 또한 영지버섯의 경우, $CHCl_3$ 층, EtOAc 층, $H_2O$ 층 모두에서 아주 미약하나마 MAO-B에 대한 저해활성을 나타냈으나 영지 bud의 경우 $CHCl_3$ 층에서 전혀 MAO-B에 대한 저해활성을 나타내지 않고 EtOAc 층에서 약한 MAO-B에 대한 저해활성이 확인되어 MAO-A와 MAO-B에 대한 영지버섯의 작용성분이 다른 성분일 것으로 추측된다.

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1978년 진해만 적조와 양식굴의 대량폐사 (MASS MORTALITYS OF OYSTER DUE TO RED TIDE IN JINHAE BAY IN 1978)

  • 조창환
    • 한국수산과학회지
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    • 제12권1호
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    • pp.27-33
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    • 1979
  • 1978년 진해만에서 있었던 적조현상과 양식 굴의 대량폐사에 관한 조사결과를 요약하면 아래와 같다. 1. 진해만에서 1978넌 9월중 양식 굴의 대량폐사가 있었다. 폐사량은 $96\%$인 5,687M/T으로 피해액은 22억 7천 5백만원이었다. 2. 상기의 대량폐사는 지속된 고온, 대규모의 적조와 그로 인한 저층수의 빈산소 내지 무산소화로 인한 질식이 주 원인의 일보였다고 추측된다. 3. 적조의 원인종은 와편모조의 일종인 Ceratium fusus로서 각장 $340{\mu}m$, 각폭 $20{\mu}m$ 정도의 대형 식물플랑크톤이었다. 클로로필-a량은 최고 $50mg/m^3$ 이었다.4. 춘기의 가뭄과 6월의 다우로 성층이 형성된데다 지속된 고온과 장일조 그리고 해상의 평온함이 대규모의 적조를 유발시킨 원인의 일부라 생각된다.

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Lidocaine이 아미노산 신경전도물질의 유리, 수용체 결합, 및 섭취에 미치는 효과에 관한 시험관내 실험에 관한 연구 (Effect of Lidocaine on the Release, Receptor Binding and Uptake of Amino Acid Neurotransmitters In vitro)

  • 오안민;정동균;모리 마사까즈
    • 대한약리학회지
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    • 제24권1호
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    • pp.17-29
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    • 1988
  • Lidocaine 투여에 의한 전신경련의 작용기전을 추구하고자 흰쥐의 전체뇌를 또는 선조체, 해마, 및 중뇌를 부위별로 적출하여 synaptosomes를 마련하고 $20{\mu}M$ veratrine또는 $5{\mu}M\;K^+$ 첨가에 의한 신경 전달물질 (Aspartic acid, Glutamic acid, GABA, Norepinephrine)의 유리촉진작용에 미치는 lidocaine, propranolol, norepinephrine 또는 serotonin의 억제효과를 관찰하였고 $[^3H]M$$[^3H]-glutamic$ acid의 synaptosomes로의 섭취에 미치는 lidocaine의 영향도 관찰하였다. 아울러 crude synaptic membrane을 이용하여 $[^3H]-GABA$$[^3H]-glutamic$ acid의 수용체 결합에 미치는 lidocaine의 작용도 실험하여 다음과 같은 결과를 얻었다. 1. Lidocaine과 propranolol은 veratrine에 의한 aspartate, glutamate, GABA 및 norepinephrine의 유리를 억제하였고, 그중 GABA 유리에 대한 억제작용이 가장 현저하였다. 2. Norepinephrine과 serotonin은 $100{\mu}M$의 농도에서 veratrine에 의한 aspartate, glutamate 및 GABA의 유리촉진 작용을 억제하였다. 3. Lidocaine은 veratrine에 의한 아미노산 유리촉진 효과에 대해서 보다 과 $K^+$ 에 의한 유리촉진 효과를 더욱 약하게 억제하였고 특히 GABA 유리에 대한 억제작용이 가장 약했다. 4. GABA와 glutamic acid의 수용체 결합과 synaptosomes로의 섭취는 1 mM 이하의 lidocaine농도에서 크게 면화가 없었다. 이상의 결과로 보아 신경전도물질의 veratrine에 의한 유리가 과 $K^+$에 의한 유리보다 더욱 생리적이라는 점을 고려한다면, lidocaine 경련은 lidocaine이 흥분성 전도물질인 aspartate나glutamate보다 억제성 전도물질인 GABA의 유리를 더욱 현저하게 억제함으로서 나타남을 시사한다.

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다학제 팀의료에 의한 노인의료센터 입원환자의 항콜린약물부담 감소효과 분석 (Impacts of Pharmacist-involved Multidisciplinary Geriatric Team Services on Reducing Anticholinergic Burden)

  • 이주혜;박가영;서예원;이정화;이은숙;김은경;최정연;김광일;이주연
    • 한국임상약학회지
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    • 제30권2호
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    • pp.113-119
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    • 2020
  • Background: Reducing the total anticholinergic burden (AB) in older adults is recommended owing to the several peripheral and central adverse effects. This study aimed to identify the AB status of patients admitted to geriatric centers for assessing the influence of the pharmacist-involved multidisciplinary geriatric team care on reducing the AB. Methods: We retrospectively reviewed the medical records of 328 older patients hospitalized in geriatric centers from July 1, 2018 to June 30, 2019, who received comprehensive geriatric assessment and pharmaceutical interventions from a multidisciplinary geriatric team. We measured the total AB scores for the medications at the time of admission and upon hospital discharge using the Korean Anticholinergic Burden Scale (KABS). The pre-admission factors associated with high AB (KABS score ≥3) at the time of admission were identified. Results: The proportion of patients with high AB significantly decreased from 41.8% (136/328) at the time of admission to 25.0% (82/328) on discharge (p<0.001). The pre-admission AB of patients transferred from skilled nursing facilities (odds ratio[OR]: 2.85, 95% CI: 1.26-3.75), taking more than 10 medications (OR: 3.70, 95% CI: 1.55-8.82), suffering from delirium (OR: 2.80, 95% CI: 1.04-7.50), or depression (OR: 2.78, 95% CI: 1.04-7.41) were significantly high. Antipsychotics were the most frequent classes of drugs that contributed to the total KABS score at the time of admission, followed by antihistamines. Conclusions: This study demonstrated that the multidisciplinary teams for geriatric care are effective at reducing AB in older adults. The factors associated with high AB should be considered when targeting pharmaceutical care in geriatric individuals.