• Title/Summary/Keyword: high risk groups

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Delirium after Head Trauma at Psychiatric Consultation (두부 외상 후 섬망의 자문 정신 의학적 고찰)

  • Kim, Hyon-Chul;Lee, Sang-Chul;Kim, Do-Hoon;Lee, Sang-Kyu;Hong, Seung-Gwan;Son, Bong-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.15-22
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    • 2004
  • Objectives: Delirium after head trauma results in various cognitive and behavioral dysfunction. This study aimed at developing and validating a predicitive model for clinical improvement after delirium based on precipitating factors during hospitalization Method: Data were collected on 45 patients who developed delirium after head trauma using 5 year retrospective design, based on reviews of medical charts including psychiatric consultation reports. The differences of the group who sustained residual symptoms of delirium(The RS group) and the group of full recovery(The FR group) at 4 week follow-up visits were compared by motoric type of delirium, socio-demographic variables, neuroimaging variables and clinical variables of interest. Result: There was significant difference in reason for initial consultation between two groups, in terms of hyperactivity(p<.01). The presence of compensation claim, subcortical gray matter lesion was significantly associated with the RS group(p<.05). Total length of intensive care unit(ICU) admission and of hospital stay were significantly longer in RS group than FR group(p<.01). Conclusion: This study shows that hyperactivity on initial consultation, compensation claims, specific brain lesion were altogether significant factors in explaining prolonged duration of delirium after head trauma. A simple predictive model based on the presence of precipitating factors might be used to identify delirious patients at high risk for prolonged cognitive dysfunction. Early psychiatric intervention would be required for evaluating efficacious management and shortening admission period.

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Etiology, Management, and Prognosis of Severe Hyperbilirubinemia (Serum Bilirubin Level=25 mg/dL) in Newborn (중증 고빌리루빈혈증(혈청 빌리루빈 >25 mg/dL)의 발병 원인과 치료 및 예후)

  • Hwang, Jong Hee;Lee, Ji Hyun;Kim, Yu Jin;Koo, Su Hyun;Lee, Jang Hun;Choi, Chang Won;Chang, Yun Sil;Park, Won Soon
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1102-1106
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    • 2005
  • Purpose : The present study examined the etiology, management, and the difference of prognosis according to methodology of treatment in severe hyperbilirubinemia with total serum bilirubin levels of more than 25 mg/dL. Methods : Medical records of severe hyperbilirubiemia in newborns(serum level=25 mg/dL) admitted to the NICU of Samsung Medical Center between October 1994 and June 2004 were reviewed retrospectively. Infants were grouped according to methodology of treatment : Group I(phototherapy only, n=42), Group II(exchange transfusion, n=6). And In addition, we evaluated the etiology and the difference of prognosis. Results : A total of 48 documented cases of severe hyperbilirubinemia were identified. Birth weight was significantly lower in Group 2($2,852{\pm}1,085g$) compared to Group 1($3,137{\pm}437g$)(P<0.05). There were no significant differences in gestational age, sex, mode of delivery, inborn, age at presentation, and age at first examination and admission between the two study groups. Maximal bilirubin level was significantly higher in Group 2($45{\pm}16mg/dL$) compared to Group 1($29{\pm}6mg/dL$) (P<0.05). But there were no significant differences in neurologic outcome. Conclusion : Our study suggests that the present guidelines for managing hyperbilirubinemia in newborns should be effective but follow-up with the first postnatal week would be necessary for each detection and treatment in the newborn infants with high risk of severe hyperbilirubinemia.

IMPACT OF PARENTAL PSYCHIATRIC DISORDER ON OFFSPRING'S DEPRESSION, ANXIETY, SELF CONCEPT AND PERCEPTION OF FAMILIAL RELATIONSHIP (정신과 환자 자녀의 우울, 불안, 자기 개념 그리고 가정환경의 특성에 대한 연구)

  • Lee, Jung-Bum;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.1
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    • pp.54-66
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    • 1998
  • Objectives:This study was to investigate the impact of parental psychiatric disorder on offspring's depression, anxiety, self concept, perception of familial relationship compared with offspring of normal control. In offsprings of parents with psychiatric disorder, this study explored whether their psychopathology, self concept, and perception of familial relationship were influenced by parent’s sex, onset time of parent’s psychiatric disorder and parent’s psychiatric diagnosis. Methods:52 offsprings aged 10-18 years of 39 psychiatric outpatient were surveyed from June, 1997 to April, 1998 and completed several questionnaaire, including Korean from of the Family Environment Scale, Korean form of the State-Trait Anxiety Inventory for Children, Korean form of Kovac’s Children’s Depression Inventory, and Korean form of Piers-Harris Children’s Self-Concept Scale. Their score was compared with offsprings’ of normals. In offsprings of parents with psychiatric disorder, they were compared according to parent’s sex, onset time of parent's psychiatric disorder and parent’s psychiatric diagnosis. Results:The results were as follows:1) Offsprings of parents with psychiatric disorder reported higher level of state anxiety and lower level of the FES expressive subscale than offsprings of normals(p<0.05). But they reported higher level of PHCSCS intellectual & school status subscale and popularity subscale than normals(p<0.05). 2) There were no differences in anxiety, depression, self concept, and perception of familial relationship between patient’s sex. 3) Offsprings less than 3 years old when parent’s psychiatric disorder had developed showed higher level of trait anxiety and lower level of FES control subscale than offsprings more than 3 years old (p<0.05). 4) There were no diferences in anxiety, depression, self concept, and perception of familial relationship between patient’ diagnostic groups(schizophrenia spectrum disorder-mood disoderneurosis). Conclusion:The finding indicated that self reported scale of anxiety and depression showed no significant difference between offsprings of psychiatric patients and offsprings of normals. In offsprings of parents with psychiatric disorder, parent’s sex and psychiatiric diagnosis had no influence on offspring’s psychopathology. But the offspring’s age(before 3 years old) when the parent’s psychiatriric disorder developed had influence on higher level of offspring’s trait anxiety. For further high risk group study, direct interview and evaluation of parent-child agreement or teacher-child agreement will be needed in longitudinal study.

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Study on Dietary Habit and Effect of Onion Powder Supplementation on Serum Lipid Levels in Early Diagnosed Hyperlipidemic Patients (초기진단 고지혈증 환자의 식습관 조사와 양파가루 섭취가 혈중지질에 미치는 영향 연구)

  • Lee, Kyung-Hea;Kim, Yang-Ha;Park, Eun-Ju;Cho, Sung-Rae
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.5
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    • pp.561-570
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    • 2008
  • This study aimed to determine the effects of freeze-dried onion powder (OP) which contains rich in quercetin (22 mg/10 g) on hyperlipidemic participants. Fourteen participants (total cholesterol level in plasma $270.8{\pm}21.4mg/dL$) $40{\sim}59$ years of age who were diagnosed as hyperlipidemia by a physician at Fatima Hospital in Changwon took part in this study for 12 weeks. We investigated the anthropometric data and dietary habit by using questionnaires. Also, blood samples were collected from the patients in fasting before and after this 12 weeks intervention study. 78.6% of the patients showed interest in health diet management and weight control; however, they also showed some problems in their dietary habit (meal irregularity, food choice, calorie nutrient balance, high fat and cholesterol etc.) and life style (smoking, eating out, alcohol intake) that could have adverse effect on hyperlipidemic therapy. Most participants (85.7%) thought that OP was good for their health. The total cholesterol and LDL-cholesterol significantly decreased with OP intake. The HDL-cholesterol increased and the Atherogenic index (AI) significantly decreased. Regarding the correlations of dietary habit and life style with anthropometric and biochemical factors, the alcohol intake level was significantly correlated with the frequency of eating out and body mass index (BMI). Exercise level showed positive correlation with HDL-cholesterol and negative correlation with atherogenic index (AI). These results suggest that the intake of polyphenol rich onion may decrease the risk of hyperlipidemia by reducing cholesterol level. We consider these hypolipidemic effects of OP as a possible functional food. However, further research such as a well designed longterm clinical study with experimental and placebo groups is needed.

A Study on Business Diversification and Business Performance of Korean Mass Media Enterprises (국내 매스미디어 기업의 사업다각화와 경영성과에 관한 연구)

  • Chang, Yun-Hi
    • Korean journal of communication and information
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    • v.43
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    • pp.173-208
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    • 2008
  • This study analyses the business performance according to the business diversification of Korean mass media enterprises from year 2003 to 2006. The conclusions drawn which could be divided into five main parts are the followings: First, newspaper companies pursue unrelated diversification in various industrial areas, in order to gain maximum profit while broadcasting companies exert themselves to provide better service by diversifying the major contents. Second, overall the interviewed companies display a constant decline in profit gained from their major business area thus establishing strategies to broaden their focus on diversification of any sort. Third, the researcher completed group analysis in regard of diversification measure resulting in division of three groups. The group which had the most immense diversification range gained the highest ROE, the lowest ROE volatility, and lesser probability of risk taking. The analysis adresses the companies broadening their business areas by researching and focusing on diversification are relatively stable in terms of the profit they gain. Fourth, the middle level group in terms of sales scale, debts, enterprise history, major share rate and high ROE group carry out diversification progressively. The sales scale affects positively to diversification, while the major share rate affects negatively to diversification. Fifth, in accordance to the research, diversification overall contributes to obtainance of successful outcome. Since there was not an immense amount of studies to be referred in the media area, the researcher interviewed and did panel discussion with numerous strategists and managers who are in charge of diversification of media companies. However, collection of only 4 years of data limits the research to be considered to be a generalized study, and does not reflect time gap between business diversification and business performance. Development is required in future studies to be established regarding the media companies' specificity different to other industries, classified the media companies into media types, and consider the time gap in the diversification activities and business performance.

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Expiration-Day Effects: The Korean Evidence (주가지수 선물과 옵션의 만기일이 주식시장에 미치는 영향: 개별 종목 분석을 중심으로)

  • Choe, Hyuk;Eom, Yun-Sung
    • The Korean Journal of Financial Management
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    • v.24 no.2
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    • pp.41-79
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    • 2007
  • This study examines the expiration-day effects of stock index futures and options in the Korean stock market. The so-called 'expiration-day effects', which are the abnormal stock price movements on derivatives expiration days, arise mainly from cash settlement. Index arbitragers have to bear the risk of their positions unless they liquidate their index stocks on the expiration day. If many arbitragers execute large buy or sell orders on the expiration day, abnormal trading volumes are likely to be observed. If a lot of arbitragers unwind positions in the same direction, temporary trading imbalances induce abnormal stock market volatility. By contrast, if some information arrives at market, the abnormal trading activity must be considered a normal process of price discovery. Stoll and Whaley(1987) investigated the aggregate price and volume effects of the S&P 500 index on the expiration day. In a related study, Stoll and Whaley(1990) found a similarity between the price behavior of stocks that are subject to program trading and of the stocks that are not. Thus far, there have been few studies about the expiration-day effects in the Korean stock market. While previous Korean studies use the KOSPI 200 index data, we analyze the price and trading volume behavior of individual stocks as well as the index. Analyzing individual stocks is important for two reasons. First, stock index is a market average. Consequently, it cannot reflect the behavior of many individual stocks. For example, if the expiration-day effects are mainly related to a specific group, it cannot be said that the expiration of derivatives itself destabilizes the stock market. Analyzing individual stocks enables us to investigate the scope of the expiration-day effects. Second, we can find the relationship between the firm characteristics and the expiration-day effects. For example, if the expiration-day effects exist in large stocks not belonging to the KOSPI 200 index, program trading may not be related to the expiration-day effects. The examination of individual stocks has led us to the cause of the expiration-day effects. Using the intraday data during the period May 3, 1996 through December 30, 2003, we first examine the price and volume effects of the KOSPI 200 and NON-KOSPI 200 index following the Stoll and Whaley(1987) methodology. We calculate the NON-KOSPI 200 index by using the returns and market capitalization of the KOSPI and KOSPI 200 index. In individual stocks, we divide KOSPI 200 stocks by size into three groups and match NON-KOSPI 200 stocks with KOSPI 200 stocks having the closest firm characteristics. We compare KOSPI 200 stocks with NON-KOSPI 200 stocks. To test whether the expiration-day effects are related to order imbalances or new information, we check price reversals on the next day. Finally, we perform a cross-sectional regression analysis to elaborate on the impact of the firm characteristics on price reversals. The main results seem to support the expiration-day effects, especially on stock index futures expiration days. The price behavior of stocks that are subject to program trading is shown to have price effects, abnormal return volatility, and large volumes during the last half hour of trading on the expiration day. Return reversals are also found in the KOSPI 200 index and stocks. However, there is no evidence of abnormal trading volume, or price reversals in the NON-KOSPI 200 index and stocks. The expiration-day effects are proportional to the size of stocks and the nearness to the settlement time. Since program trading is often said to be concentrated in high capitalization stocks, these results imply that the expiration-day effects seem to be associated with program trading and the settlement price determination procedure. In summary, the expiration-day effects in the Korean stock market do not exist in all stocks, but in large capitalization stocks belonging to the KOSPI 200 index. Additionally, the expiration-day effects in the Korean stock market are generally due, not to information, but to trading imbalances.

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pT1N3 Gastric Cancer (pT1N3 위암)

  • Ahn, Dae-Ho;Kwon, Sung-Joon;Yun, Hyo-Yung;Song, Young-Jin;Mok, Young-Jae;Han, Sang-Uk;Kim, Wook
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.109-113
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    • 2006
  • Purpose: Various minimally invasive surgical techniques, such as an endoscopic mucosal resection and a laparoscopic gastrectomy, are becoming common practice for some cases of early gastric cancer (EGC) defined in terms of the depth of invasion being limited to the mucosa or submucosa. However, there are rare cases of early gastric cancer with massive lymph-node metastasis. Materials and Methods: From 6 university hospitals of Korea, 2,772 EGC cases were resected during the various period of analysis (1,432 cases of mucosal cancer and 1,340 of submucosal cancer). Results: As control data, we used the data from a single institute, CHA University Hospital. There were nine cases of early gastric cancer (9/2,772, 0.32%) with N3 lymph node metastasis defined by more than 15 lymph nodes being metastasized according to the UICC-TNM classification (pT1N3, stage IV). Two cases were mucosal cancer (2/1,432, 0.1 4%), and seven cases were submucosal cancer (7/1,340, 0.52%). Metastasized lymph nodes varied in number from 18 to 52. There were three male and six female patients with a mean age of 57. This is a totally reversed sex ratio compared to the usual gastric cancer or EGC. Among the total of 9 EGC patients, there were 5 who had superficial spreading carcinomas with surface areas larger than $25\;cm^2$. This is a significantly higher proportion compared to the general EGC population. When we compared the tumor size according to the LN status, the N3 group was definitely larger than the other groups. 78% of the pT1N3 cases showed lymphatic invasion, which is very high compared to the 4.7% in general EGC cases. Among the 9 cases, 6 patients had too short a follow-up period to evaluate the correct prognosis, but there was one patient with a non-curative resection and two patients with early recurrence. Although the sample size is small and the follow-up period is short, we can expect a very poor prognosis when we consider the common prognosis of EGC that is widely known and accepted. Conclusion: From these results, we can a conclude that the risk factors for pT1N3 gastric cancer are female patients, submucosal invasion, larger tumor size, and lymphatic invasion. However rare, the existence of pT1N3 gastric cancer needs to be taken into consideration, especially during the diagnosis. Furthermore, minimally invasive treatment for EGC needs to be chosen with great precaution. Since the prognosis of pT1N3 gastric cancer is expected to be poor, aggressive adjuvant chemotherapy may be necessary. (J Korean Gastric Cancer Assoc 2006;6:109-113)

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Prospective Randomized Study of Six Months' Chemotherapy and Nine Months' Chemotherapy for Cervical Lymph Node Tuberculosis (결핵성 경부 임파선염의 6개월 대 9개월 요법에 대한 전향적 비교 연구)

  • Lee, Jae Hee;Cha, Seung Ik;Jang, Sang Su;Jung, Chi Young;Park, Jae Yong;Park, Jun Sik;Jung, Tae Hoon;Kim, Chang Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.274-282
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    • 2003
  • Background : Tuberculous lymphadenitis is one of the most common forms of extrapulmonary tuberculosis. It was recently reported that the treatment for tuberculous lymphadenitis could be shortened to 6 months without increasing the risk of a relapse. However, there is no report of a prospective randomized study on the use of 6-month chemotherapy with HERZ for cervical lymphadenitis, which is regimen recommended in the areas concerned with the initial drug resistance. The aim of this study is to evaluate the efficacy of the 6-month regimen with HERZ for cervical lymphadenitis in areas where there is a high prevalence of drug resistance in Korea. Method : From January 1997 to February 2002, 92 patients with cervical tuberculous lymphadenitis were recruited from Kyungpook national university hospital. Forty-six patients were given the 6-month regimen(2HERZ/4HER) and the other forty-six patients were given the 9-month regimen(2HERZ/7HER). Result : Of the 46 patients given the 6-month regimen, 5 had residual lymph nodes greater than 5 mm after the completion of treatment and 3 had new lymph nodes or an increased lymph node size during the follow-up period. Of the 46 patients in the 9-month regimen, 9 had residual lymph nodes and 8 had new events during the follow-up period. There were no significant differences between the two groups. Conclusion : These results suggest that the 6-month HERZ regimen can be used safely as the initial treatment for tuberculous lymphadenitis in areas with a similar prevalence of drug resistance.

The Gender difference of Nutritional Status by Health Practice on the University Freshmen in Metropolitan Area (남녀 대학 신입생의 건강실천에 따른 영양상태)

  • Rhie, Seung-Gyo;Lee, Young-Hee;Won, Hyang-Rye
    • The Korean Journal of Community Living Science
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    • v.17 no.4
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    • pp.151-161
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    • 2006
  • This study was made to find out how health practice affect on nutrition status of the college freshmen in male and female. 400 freshmen students in 4year colleges were surveyed. Questionnaire and blood analysis were made. The contents of questionnaire contained general characteristics, health practice behavior, and food intake. The physical measurement included height, weight and blood pressure. The questions for health practice were about drinking, smoking, BMI, skipping breakfast and sleeping. Nutrient intake was expressed by DDS(Dietary Diversity Score by 5 food groups) and DVS (Dietary Variety Score) and 24-hrs recall method was used to find out the quantity of daily food intake. EAR% was calculated and NAR and MAR were produced. The results are as follows: 1) BMI was $22.77kg/m^2$ for males and $20.42kg/m^2$ for females. The ratio maintaining normal weight indicated by BMI of 18.5-23 was higher(p<0.001) for female students(63.2%) than males(56.5%). The ratio of overweight with over $23kg/m^2$ of BMI was 28.5% for males and 8.8% for females(p<0.001). 2)The ratio of drinking students was 59.4% for males and 40.6% for female(p<0.001). And the ratio of smoking students was 95.2% for males and 4.8% for females(p<0.001). 3) The ratio of poor health practice group was 35.7% for males and 25.5% for females, and that of excellent one was 25.4% for males and 33.1% for females(p<0.05). 4) In NAR, the lowest ratio was observed for the intake of Ca, Fe, Vitamin C and Vitamin $B_2$. The intake of Fe, Vitamin $B_2$ and phosphorus were different significantly according to sexuality. For Fe, female students showed lower level than male students(p<0.001). For Vitamin $B_2$, and phosphorus female students showed higher level(p<0.001). 5) In MAR, there was no difference according to sexuality in almost all of the ingredients. 6) For energy intake, male and female students showed 59% and 66% of EAR and it was insufficient for them. 7) For protein, more than 100% was obtained. The lowest ratio was observed for the intake of vitamin C 50.8%, Ca 53.6% and Fe 65.1% of EAR were obtained. The lowest intake ratio and for the intake of Fe female students obtained just 37.5% of EAR showing high risk of anemia. The intake of energy(p<0.001), phosphorus(p<0.01), niacin(p<0.05), Fe(p<0.001), and Vitamin $B_2$ (p<0.001) were different significantly according to sexuality. For Fe, female students showed lower level than male students(p<0.001). For energy, phosphorus, niacin, and Vitamin $B_2$ female students showed higher level(p<0.001) than male students. 8) For blood pressure, male students showed normal level of 120.7/79.1 mmHg, however, female students showed 114.5/75.4 mmHg lower than male (p<0.001). 9). In blood, for hemoglobin female students showed significantly lower level than that of male(p<0.001). T-Cholesterol and HDL-Cholesterol female students showed higher level than males (p<0.001), And for triglyceride male students showed higher level than females(p<0.001). Ca and Fe female students showed lower level (p<0.001).

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Prevalence of Antibodies to Hepatitis A in the Healthy Children in Inchon-Kyunggi Prefecture (경인 지역 소아의 A형 간염 항체 보유율)

  • Kwon, Young Se;Hong, Young Jin;Choe, Yon Ho;Kim, Soon Ki;Son, Byong Kwan;Kang, Moon Su;Pai, Soo Hwan;Hong, Kwang Sun
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.239-244
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    • 1998
  • Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

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