• Title/Summary/Keyword: change pattern

Search Result 3,599, Processing Time 0.032 seconds

A Study of the Insulin and the C-Peptide Responses to Oral Glucose Load in Nondiabetic and Diabetic Subjects (정상인(正常人) 및 당뇨병환자(糖尿病患者)에서의 경구당부하시(經口糖負荷時) 혈중(血中) Insulin과 C-Peptide의 변동(變動))

  • Lee, Myung-Chul;Choi, Sung-Jae;Kim, Eung-Jin;Min, Hun-Ki;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
    • /
    • v.11 no.1
    • /
    • pp.17-32
    • /
    • 1977
  • The present study was undertaken to evaluate the significance of the insulin and the C-peptide rseponse to oral glucose loads in normal and diabetic subjects and to establish the effects of the obesity. In this study, the authors have measured plasma insulin and C-peptide by means of radioimmunoassay in 10 nonobese normal, 5 obese normal, 13 nonobese moderate diabetic patients, 9 obese moderate diabetic patients and 9 severe diabetic patients. The results obtained were as follows; 1. In 10 nonobese normal subjects, the plasma insulin level at fasting state and at 30, 60, 90, and 120 min after oral glucose loads were $15.7{\pm}3.4,\;48.3{\pm}9.8,\;40.4{\pm}6.7,\;37.4{\pm}6.5\;and\;26.0{\pm}4.2uU/ml(Mean{\pm}S.E.)$ and C-peptide were $1.9{\pm}0.3,\;3.9{\pm}0.6,\;6.3{\pm}0.6,\;5.7{\pm}0.5\;and\;4.0{\pm}0.5ng/ml$. The change of C-peptide was found to go almost parallel with that of insulin and the insulin value reaches to the highest level at 30 min whereas C-peptide reaches to its peak at 60min. 2. The plasma insulin level in 5 obese normal subjects were $38.9{\pm}12.3,\;59.5{\pm}12.3,\;59.2{\pm}17.1,\;56.1{\pm}20.0\;and\;48.4{\pm}17.2uU/ml$ and the C-peptide were $5.5{\pm}0.4,\;6.8{\pm}0.5,\;7.9{\pm}0.8,\;7.9{\pm}0.8\;and\;7.8{\pm}2.0ng/ml$. The insulin response appeared to be greater than nonobese normal subjects. 3. In 13 nonobese moderate diabetic patients, the plasma insulin levels were $27.1{\pm}4.9,\;44.1{\pm}6.0,\;37.3{\pm}6.6,\;35.5{\pm}8.1\;and\;34.7{\pm}10.7uU/ml$ and the C-peptide levels were $2.7{\pm}0.4,\;4.9{\pm}0.7,\;6.5{\pm}0.5,\;7.0{\pm}0.3\;and\;6.7{\pm}1.0ng/ml$. There was little significance compared to nonobese normal groups but delayed pattern is noted. 4. In 9 obese moderated diabetic patients, the plasma insulin levels were $22.1{\pm}7.9,\;80.0{\pm}19.3,\;108.0{\pm}27.0,\;62.0{\pm}17.6\;and\;55.5{\pm}10.1uU/ml$ and the C-peptide levels were $5.2{\pm}0.4,\;8.0{\pm}1.0,\;10.4{\pm}1.6,\;10.4{\pm}1.7\;and\;10.1{\pm}1.0ng/ml$ and its response was also greater than that of nonobese moderate diabetic patients. 5. The plasma insulin concentrations in 9 severe diabetic subjects were $8.0{\pm}3.8,\;12.1{\pm}3.5,\;16.8{\pm}4.6,\;19.6{\pm}5.2\;and\;15.0{\pm}5.0uU/ml$ and the C-peptide levels were $1.6{\pm}0.3,\;2.4{\pm}0.4,\;4.1{\pm}0.6,\;4.0{\pm}0.8\;and\;4.5{\pm}0.7ng/ml$ and the insulin and C-peptide responses were markedly reduced in severe diabetic groups. 6. There were-significant differences between each groups of patients on the magnitude of total insulin or C-peptide areas, the insulinogenic index and the C-peptide index.

  • PDF

Characteristics and Formation conditions of the Rhodoliths in Wu Island beach, Jeju-do, Korea: Preliminary Report (제주도 우도의 홍조단괴 해빈 퇴적물의 특징과 형성조건 : 예비연구 결과)

  • 김진경;우경식;강순석
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
    • /
    • v.8 no.4
    • /
    • pp.401-410
    • /
    • 2003
  • Three beaches of the Seogwang-ri coast in the western part of Wu Island, Jeju-do, are solely composed of rhodoliths (red algal nodules). The beach sediments are coarse sand to granule in size and they show the banded distribution according to size. Commonly the larger pebble-sized rhodoliths are concentrated near the rocky coast, resulting from the transportation of the nodules from shallow marine environments by intermittent typhoons. Based on the internal texture of the rhodoliths, it appears that crustose red algae, Lithophyllum sp., is the main contributor for the formation of the rhodolith. The coarse sand to granule-sized grains show that they started to grow from the nucleus as rhodoliths, but the surface was severely eroded by waves. However, the pebble to cobble-sized grains exhibit the complete growth pattern of rhodoliths and sometimes contain other calcareous skeletons. It is common that encrusting red algae are intergrown with encrusting bryozoan. The surface morphology of rhodolith tends to change from the concentric to domal shape towards the outer part. This suggests that the rhodolith grew to a certain stage by rolling, but it grew in more quiet condition without rolling as it became larger. Aragonite and calcite cements can be found in the pores within rhodoliths (conceptacle, intraskeletal pore in bryozoan, and boring), and this means that shallow marine cementation has occurred during their growth. Growth of numerous rhodoliths in shallow marine environment near the Seogwang-ri coast indicates that this area has suitable oceanographic conditions for their growth such as warm water temperature (about 19$^{\circ}C$ in average) and clear water condition due to the lack of terrestrial input of volcanoclastic sediments. Fast tidal current and high wave energy in the shallow water setting can provide suitable conditions enough for their rolling and growth. Typhoons passing this area every summer also influence on the growth of rhodoliths.

Hydro-meteorological Effects on Water Quality Variability in Paldang Reservoir, Confluent Area of the South-Han River-North-Han River-Gyeongan Stream, Korea (남·북한강과 경안천 합류 수역 팔당호의 수질 변동성에 대한 기상·수문학적 영향)

  • Hwang, Soon-Jin;Kim, Keonhee;Park, Chaehong;Seo, Wanbum;Choi, Bong-Geun;Eum, Hyun Soo;Park, Myung-Hwan;Noh, Hye Ran;Sim, Yeon Bo;Shin, Jae-Ki
    • Korean Journal of Ecology and Environment
    • /
    • v.49 no.4
    • /
    • pp.354-374
    • /
    • 2016
  • This study explored spatiotemporal variability of water quality in correspondence with hydrometeorological factors in the five stations of Paldang Reservoir located in the Han River during 4 years from May 2012 to December 2015. Variability of basic water quality factors were largely related with seasonal fluctuations of hydrology. Temperature stratification occurred in the deep dam station, and prolonged hypoxia was observed during the draught year. Nitrogen nutrients were increased with decreasing inflow in which changing pattern of $NH_4$ reversed to $NO_3$ by the effect of treated wastewater effluent. Phosphorus increase was manifest during the period of high inflow or severe drought. Chl-a variation was reversely related with both flow change and AGP(algal growth potential) variations. Our study demonstrated that water quality variability in Paldang Reservoir was largely attributed to both natural and operational changes of inflow and outflow (including water intake) based on major pollution source of the treated wastewater (total amount of $472{\times}10^3m^3d^{-1}$) entering to the water system from watershed. In the process of water quality variability, meteorological (e.g., flood, typhoon, abnormal rainfall, scorching heat of summer) and hydrological factors (inflow and discharge) were likely to work dynamically with nutrients pulse, dilution, absorption, concentration and sedimentation. We underline comprehensive limnological study related to hydro-meteorolology to understand short- and long-term water quality variability in river-type large reservoir and suggest the necessity of P-free wastewater treatment for the effective measure of reducing pollution level of Paldang drinking water resource.

Changes in Components and Peptides during Fermentation of Cheonggookjang (청국장 발효시의 성분 변화 및 펩티드의 생성)

  • Ann, Yong-Geun
    • The Korean Journal of Food And Nutrition
    • /
    • v.24 no.1
    • /
    • pp.124-131
    • /
    • 2011
  • We analyzed content and peptides in order to investigate the productivity from Cheonggookjang(fast-fermented soybean paste), fermenting it for 180 hours at $40^{\circ}C$. Results showed that pH was 7.07 at the start and became 7.41 in 24 hours, it eventually increased to 8.63 after 180 hours. Acidity was 0.2 in 12 hours, 0.5 in 12 hours, and then remained on 0.1 thereafter. Total sugar was 1.54 mg/$m\ell$ at the start, but it gradually decreased to 0.76 mg/$m\ell$ after the lapse of 48 hours, and 1.0 mg/$m\ell$ in 120 hours, and finally 0.8 mg/$m\ell$ in 180 hours. Reducing sugar was 0.14 mg/$m\ell$ at the start, and 0.88 mg/$m\ell$ after the lapse of 24 hours, 0.64 mg/$m\ell$ in 48 hours, 0.26 mg/$m\ell$ in 72 hours, and showed no definite change untill 180 hours. The amount of free amino acid was $0.19\;{\mu}M/\ell$ at the start, and $4.88\;{\mu}M/\ell$ after the lapse of 72 hours, $4.5\;{\mu}M/\ell$ in 120 hours, and then it rapidly decreased to $0.23\;{\mu}M/\ell$ after180 hours. Absorbance of soluble protein and peptide at 280 nm was 12.4 in 48 hours, 31.12 in 120 hours, and 31.12 in 180 hours. HPLC revealed that in the fermentation process, large molecular proteins are hydrolyzed into small peptides and amino acids, and after the lapse of 48 hours the pattern became almost the same. The protease activity of Cheonggookjang was 0.011 unit/$m\ell$ after the lapse of 36 hours and then it decreased. The result shows as Cheonggookjang started its deamination of amino acid in 100 hours, it is desirable to produce peptide within 100 hours of its fermentation.

The Comparison of Characteristics of Korean, Chinese and Japanese Traditional Flower Arts Used in Royal Court Ceremonies (한국과 중국 및 일본의 궁중 전통 꽃꽂이 특징비교)

  • Hong, Hoon Ki;Lee, Jong Suk
    • FLOWER RESEARCH JOURNAL
    • /
    • v.18 no.2
    • /
    • pp.125-135
    • /
    • 2010
  • To discover the main characteristics of Korean traditional flower arrangement, they were compared with different articles and old paintings used in royal court ceremonies. The primary research involved principle of design. The times periods used were the Joseon Dynasty era of Korea, the Ming era of China, and the Edo eras of Japan. The result, which shows both the similarities and differences, of the research is summarized as follows. The similarities were that they all respect the features of nature, and their image expresses their creator's thinking. There was one technique, called 'Suje', in which a part of the stem is coming out from one branch. Also, each three eras preferred flowering trees and ornamental trees more than annuals or foliage plants. one of the differences was that korea used a simple number of materials. The work had volume and appeared mild by using a soft curved line which was repetitive and massive. The Joseon Dynasty era advanced a sense of beauty with artistic symmetry and balance. The work seemed soft and natural because of the little change in blank space, with almost no angle of line. The form had a characteristic preference of being taller than the typical Japanese arrangement. It appeared simple, calm, and rustic by using only one kind of material. In contrast, the Chinese style was gorgeous and displayed volume in a non-symmetrical tripodal form, which incorporated various colors and materials. Also, they avoided processing the materials in order to emphasize the original beauty of nature. Chinese flower arts did not become formalized because they did not consider the formality seriously the formal. The Japanese style was also gorgeous because it incorporated various materials and angles. It included an extreme technique in which an artificial line divided the blank space delicately. The line was both strong and delicate in an established form. The restriction of the main branch gave a light feeling, as well as more strain as in a balance sense. The Japanese eras emphasized more the use of line and a sense of blank space.

Analysis of Quality and Processing Suitability of Mixed Seeding and Flour Blending between Wheat Varieties (밀 품종 혼파와 밀가루 혼합에 따른 품질 및 가공적성 분석)

  • Kim, Kyeong-Min;Kim, Kyeong-Hoon;Kang, Chon-Sick;Jeong, Han young;Choi, Chang-Hyun;Park, Jinhee;Son, Jae-Han;Yang, Jinwoo;Kim, Young-Jin;Park, Tae-Il;Kweon, Meera
    • KOREAN JOURNAL OF CROP SCIENCE
    • /
    • v.64 no.3
    • /
    • pp.225-233
    • /
    • 2019
  • This study was conduct to investigate the effect of mixed seed sowing and flour blending on the uniformity of flour quality of Korean domestic wheat. Two wheat varieties (Keumkang and Baegjoong) were selected for sowing mixed seeds, and their growth characteristics and flour quality were analyzed. Quality of flour blending with the same varieties was also evaluated. The ratios for mixed seed sowing and flour blending were from 0 to 100% with a 10% increase of interval for each treatment. On increasing the portion of Baegjoong in mixed seed sowing, the heading time was a little delayed, however, yield increased. The results of the flour quality showed lower damaged starch content and sodium carbonate SRC (solvent retention capacity) value for Keumkang than for Baegjoong. Protein quantity by protein content and quality by SDSS (Sodium Dodecyle Sulfate-Sedimentation) volume, lactic acid SRC, and mixograph pattern of Keumkang were superior to those of Baegjoong. Compared with mixed seed sowing, overall quality characteristics of flours with different ratios showed predictable and proportional change by flour blending. This demonstrated the successful application of flour blending, compared with mixed seed sowing, for improving the uniformity of flour quality.

The Records and Archives Administrative Reform in China in 1930s (1930년대 중국 문서당안 행정개혁론의 이해)

  • Lee, Won-Kyu
    • The Korean Journal of Archival Studies
    • /
    • no.10
    • /
    • pp.276-322
    • /
    • 2004
  • Historical interest in China in 1930s has been mostly focused on political characteristic of the National Government(國民政府) which was established by the KMT(中國國民黨) as a result of national unification. It is certain that China had a chance to construct a modern country by the establishment of the very unified revolutionary government. But, it was the time of expanding national crises that threatened the existence of the country such as the Manchurian Incident and the Chinese-Japanese War as well as the chaos of the domestic situation, too. So it has a good reason to examine the characteristic and pattern of the response of the political powers of those days. But, as shown in the recent studies, the manifestation method of political power by the revolutionary regime catches our attention through the understanding of internal operating system. Though this writing started from the fact that the Nationalist Government executed the administrative reform which aimed at "administrative efficiency" in the middle of 1930s, but it put stress on the seriousness of the problem and its solution rather than political background or results. "Committee on Administrative Efficiency(行政效率委員會)", the center of administrative reform movement which was established in 1934, examined the plan to execute the reform through legislation by the Executive Council(行政院) on the basis of the results of relevant studies. They claimed that the construction of a modern country should be performed by not political revolution anymore but by gradual improvement and daily reform, and that the operation of the government should become modern, scientific and efficient. There were many fields of administrative reform subjects, but especially, the field of records and archives adminstration(文書檔案行政) was studied intensively from the initial stage because that subject had already been discussed intensively. They recognized that records and archives were the basic tool of work performance and general activity but an inefficient field in spite of many input staff members, and most of all, archival reform bring about less conflicts than the fields of finance, organization and personnel. When it comes to the field of records adminstration, the key subjects that records should be written simply, the process of record treatment should be clear and the delay of that should be prevented were already presented in a records administrative meeting in 1922. That is, the unified law about record management was not established, so each government organization followed a conventional custom or performed independent improvement. It was through the other records administrative workshop of the Nationalist Government in 1933 when the new trend was appeared as the unified system improvement. They decided to unify the format of official records, to use marker and section, to unify the registration of receipt records and dispatch records and to strengthen the examination of records treatment. But, the method of records treatment was not unified yet, so the key point of records administrative reform was to establish a unified and standard record management system for preventing repetition by simplifying the treatment procedure and for intensive treatment by exclusive organizations. From the foundation of the Republic of China to 1930s, there was not big change in the field of archives administration, and archives management methods were prescribed differently even in the same section as well as same department. Therefore, the point at issue was to centralize scattered management systems that were performed in each section, to establish unified standard about filing and retention period allowance and to improve searching system through classification and proper number allowance. Especially, the problem was that each number system and classification system bring about different result due to dual operation of record registration and archives registration, and that strict management through mutual contrast, searching and application are impossible. Besides, various problems such as filing tools, arrangement method, preservation facilities & equipment, lending service and use method were raised also. In the process this study for the system improvement of records and archives management, they recognized that records and archives are the identical thing and reached to create a successive management method of records and archives called "Records and Archives Chain Management Method(文書檔案連鎖法)" as a potential alternative. Several principles that records and archives management should be performed unitedly in each organization by the general record recipient section and the general archives section under the principle of task centralization, a consistent classification system should be used by classification method decided in advance according to organizational constitution and work functions and an identical number system should be used in the process of record management stage and archive management stage by using a card-type register were established. Though, this "Records and Archives Chain Management Method" was developed to the stage of test application in several organizations, but it was not adopted as a regular system and discontinued. That was because the administrative reform of the Nationalist Government was discontinued by the outbreak of the Chinese-Japanese War. Even though the administrative reform in the middle of 1930s didn't produce practical results but merely an experimentation, it was verified that the reform against tradition and custom conducted by the Nationalist Government that aimed for the construction of a modern country was not only a field of politics, but on the other hand, the weak basis of the government operation became the obstacle to the realization of the political power of the revolutionary regime. Though the subject of records and archives administrative reform was postponed to the future, it should be understood that the consciousness of modern records and archives administration and overall studies began through this examination of administrative reform.

Effect of micro-environment in ridge and southern slope on soil respiration in Quercus mongolica forest

  • Lee, Jae-Seok
    • Journal of Ecology and Environment
    • /
    • v.42 no.4
    • /
    • pp.210-218
    • /
    • 2018
  • Background: Soil respiration (Rs) is a major factor of the absorption and accumulation of carbon through photosynthesis in the ecosystem carbon cycle. This directly affects the amount of net ecosystem productivity, which affects the stability and sustainability of the ecosystem. Understanding the characteristics of Rs is indispensable to scientifically understand the carbon cycle of ecosystems. It is very important to study Rs characteristics through analysis of environmental factors closely related to Rs. Rs is affected by various environmental factors, such as temperature, precipitation, soil moisture, litter supply, organic matter content, dominant plant species, and soil disturbance. This study was conducted to analyze the effects of micro-topographical differences on Rs in forest vegetation by measuring the Rs on the ridge and southern slope sites of the broadly established Quercus mongolica forest in the central Korean area. Method: Rs, Ts, and soil moisture data were collected at the southern slope and ridge of the Q. mongolica forest in the Mt. Jeombong area in order to investigate the effects of topographical differences on Rs. Rs was collected by the closed chamber method, and data collection was performed from May 2011 to October 2013, except Winter seasons from November to April or May. For collecting the raw data of Rs in the field, acrylic collars were placed at the ridge and southern slope of the forest. The accumulated surface litter and the soil organic matter content (SOMC) were measured to a 5 cm depth. Based on these data, the Rs characteristics of the slope and ridge were analyzed. Results: Rs showed a distinct seasonal variation pattern in both the ridge and southern slope sites. In addition, Rs showed a distinct seasonal variation with high and low Ts changes. The average Rs measurements for the two sites, except for the Winter periods that were not measured, were $550.1\;mg\;CO_2m^{-2}h^{-1}$ at the ridge site and $289.4\;mg\;CO_2m^{-2}h^{-1}$ at the southern slope, a difference of 52.6%. There was no significant difference in the Rs difference between slopes except for the first half of 2013, and both sites showed a tendency to increase exponentially as Ts increased. In addition, although the correlation is low, the difference in Rs between sites tended to increase as Ts increased. SMC showed a large fluctuation at the southern slope site relative to the ridge site, as while it was very low in 2013, it was high in 2011 and 2012. The accumulated litter of the soil surface and the SOMC at the depth range of 0~5 cm were $874g\;m^{-2}$ and 23.3% at the ridge site, and $396g\;m^{-2}$ and 19.9% at the southern slope site. Conclusions: In this study, Rs was measured for the ridge and southern slope sites, which have two different results where the surface litter layer is disturbed by strong winds. The southern slope site shows that the litter layer formed in autumn due to strong winds almost disappeared, and while in the ridge site, it became thick due to the transfer of litter from the southern slope site. The mean Rs was about two times higher in the ridge site compared to that in the southern slope site. The Rs difference seems to be due to the difference in the amount of litter accumulated on the soil surface. As a result, the litter layer supplied to the soil surface is disturbed due to the micro-topographical difference, as the slope and the change of the community structure due to the plant season cause heterogeneity of the litter layer development, which in turn affects SMC and Rs. Therefore, it is necessary to introduce and understand these micro-topographical features and mechanisms when quantifying and analyzing the Rs of an ecosystem.

Real-time CRM Strategy of Big Data and Smart Offering System: KB Kookmin Card Case (KB국민카드의 빅데이터를 활용한 실시간 CRM 전략: 스마트 오퍼링 시스템)

  • Choi, Jaewon;Sohn, Bongjin;Lim, Hyuna
    • Journal of Intelligence and Information Systems
    • /
    • v.25 no.2
    • /
    • pp.1-23
    • /
    • 2019
  • Big data refers to data that is difficult to store, manage, and analyze by existing software. As the lifestyle changes of consumers increase the size and types of needs that consumers desire, they are investing a lot of time and money to understand the needs of consumers. Companies in various industries utilize Big Data to improve their products and services to meet their needs, analyze unstructured data, and respond to real-time responses to products and services. The financial industry operates a decision support system that uses financial data to develop financial products and manage customer risks. The use of big data by financial institutions can effectively create added value of the value chain, and it is possible to develop a more advanced customer relationship management strategy. Financial institutions can utilize the purchase data and unstructured data generated by the credit card, and it becomes possible to confirm and satisfy the customer's desire. CRM has a granular process that can be measured in real time as it grows with information knowledge systems. With the development of information service and CRM, the platform has change and it has become possible to meet consumer needs in various environments. Recently, as the needs of consumers have diversified, more companies are providing systematic marketing services using data mining and advanced CRM (Customer Relationship Management) techniques. KB Kookmin Card, which started as a credit card business in 1980, introduced early stabilization of processes and computer systems, and actively participated in introducing new technologies and systems. In 2011, the bank and credit card companies separated, leading the 'Hye-dam Card' and 'One Card' markets, which were deviated from the existing concept. In 2017, the total use of domestic credit cards and check cards grew by 5.6% year-on-year to 886 trillion won. In 2018, we received a long-term rating of AA + as a result of our credit card evaluation. We confirmed that our credit rating was at the top of the list through effective marketing strategies and services. At present, Kookmin Card emphasizes strategies to meet the individual needs of customers and to maximize the lifetime value of consumers by utilizing payment data of customers. KB Kookmin Card combines internal and external big data and conducts marketing in real time or builds a system for monitoring. KB Kookmin Card has built a marketing system that detects realtime behavior using big data such as visiting the homepage and purchasing history by using the customer card information. It is designed to enable customers to capture action events in real time and execute marketing by utilizing the stores, locations, amounts, usage pattern, etc. of the card transactions. We have created more than 280 different scenarios based on the customer's life cycle and are conducting marketing plans to accommodate various customer groups in real time. We operate a smart offering system, which is a highly efficient marketing management system that detects customers' card usage, customer behavior, and location information in real time, and provides further refinement services by combining with various apps. This study aims to identify the traditional CRM to the current CRM strategy through the process of changing the CRM strategy. Finally, I will confirm the current CRM strategy through KB Kookmin card's big data utilization strategy and marketing activities and propose a marketing plan for KB Kookmin card's future CRM strategy. KB Kookmin Card should invest in securing ICT technology and human resources, which are becoming more sophisticated for the success and continuous growth of smart offering system. It is necessary to establish a strategy for securing profit from a long-term perspective and systematically proceed. Especially, in the current situation where privacy violation and personal information leakage issues are being addressed, efforts should be made to induce customers' recognition of marketing using customer information and to form corporate image emphasizing security.

The Changing Patterns and Predisposing Factors of Delirium at End of Life in Palliative Care Unit (완화 병동에서 임종기 섬망의 변화 양상과 선행 요인)

  • Rim, Mi-Roo;Kang, Sang-Gu;Choi, Seo-Hyeon;Cho, Jinhyun;Lee, Moon-Hee;Kim, Hye-Young;Bae, Jae-Nam;Lee, Jeong-Seop;Kim, Won-Hyoung
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.26 no.2
    • /
    • pp.94-101
    • /
    • 2018
  • Objectives : The purpose of this study is to investigate the change pattern and the leading factors of delirium in the palliative ward from 2 weeks before to the end of life. Methods : From October 2015 to August 2017, a retrospective chart review was conducted on the final 180 patients of 207 patients with terminal cancer patients at the Inha University Hospital. Clinical records were collected during palliative care hospitalization. Patients were diagnosed with three subtypes of delirium through the Richmond Agitation Sedation Scale and the Nursing Delirium Screening Scale, which were evaluated daily. Results : The prevalence of delirium 13 days before death was 46%, of which 18.3% were hyperactive subtypes, 13.8% were hypoactive subtypes, and mixed subtypes were 13.8%. And hyperactive delirium gradually decreased with the approach to the end of the day, and the mixed subtype gradually increased until 4 days before the end of life. Of the patients, the day before death, 86.9% were diagnosed with delirium. In multivariate analysis, hematologic malignancy was associated with a lower rate of delirium at the end of life than gastrointestinal cancer. Overweight was associated with hyperactive, mixed, and hypoactive delirium. Conclusions : Most palliative care patients experienced delirium at the end of life. Overweight was considered as a protective factor that reduced the all subtypes of delirium at the end of life. Further prospective studies are needed to reveal the prevalence of terminal delirium, and their risk factors.