• Title/Summary/Keyword: influencing factors

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The Resting and Exercise Related Oxygen Desaturation as the Associated Factor for Sleep Related Oxygen Desaturation in Patients with Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환 환자의 수면 중 산소포화도 감소에 대한 예측인자로서 안정시 및 운동시 산소포화도)

  • Shin, Chang-Jin;Lee, Kwan-Ho;Park, Hye-Jung;Shin, Kyeong-Cheol;Chung, Jin-Hong;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.2
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    • pp.231-238
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    • 1999
  • Background: Nocturnal hypoxemia occurs in patients with chronic obstructive pulmonary disease(COPD) and the detection and treatment of nocturnal hypoxemia should be part of the management of COPD patients. We performed this study to evaluate the factors influencing to sleep related arterial oxygen desaturation($SaO_2$) in patients with COPD. Methods: Resting and exercise cardiopulmonary function test, polysomnography, and $SaO_2$ during resting, exercise and sleep were measured in 12 patients with COPD. Results: The $SaO_2$ fell twice as much during sleep as during maximal exercise($13.1{\pm}9.3%$ fall in nocturnal $SaO_2$ vs. $6.4{\pm}3.3%$, p<0.05). Fall in nocturnal $SaO_2$ was well correlated with mean exercise $SaO_2$(r=-0.78, p<0.05), minimum exercise $SaO_2$(r=-0.90, p<0.01), and resting $SaO_2$(Cr=-0.82, p<0.05). Lowest sleep $SaO_2$ was well correlated with mean exercise $SaO_2$(r=0.80, p<0.05), lowest exercise $SaO_2$(r=0.90, p<0.01), and resting $SaO_2$(r=0.84, p<0.05). Conclusion: Resting and exercise $SaO_2$ was well correlated with nocturnal $SaO_2$, but exercise study add no additional information to predicting the nocturnal oxygen desaturation in patients with COPD.

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Clinical Significance of the Ghrelin Concentrations in Plasma and Tumor Tissue from Patients with Gastric Cancer (위암 환자의 혈장 및 종양 조직에서 측정된 그렐린 농도의 임상적 의의)

  • An, Ji-Yeong;Choi, Min-Gew;Hong, Seong-Kweon;Baik, Yong-Hae;Noh, Jae-Hyung;Sohn, Tae-Sung;Kim, Sung
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.238-245
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    • 2005
  • Purpose: Ghrelin, produced primarily in the gastrointestinal tract, including the stomach, has been reported to reflect nutritional status and to control homeostasis by influencing food intake and adiposity. The purpose of this study is to evaluate nutritional status, as well as plasma and gastric tissue ghrelin levels, in patients with gastric cancer who underwent a gastrectomy. Materials and Methods: Eighty patients were analyzed by the degree of weight loss $(weight\;loss{\geq}5%\;or\;<5%)$ and the extent of gastrectomy (subtotal or total gastrectomy). Blood samples were collected from all patients preoperatively and postoperatively especially at seven days. Gastric tissues, including tumor and normal tissues, were obtained from the resected stomach. levels of plasma and tissue ghrelin were measured with a commercial ELISA kit. Results: There were no significant differences in the clinical characteristics and ghrelin levels of plasma, gastric tumor tissue and normal tissue by the degree of weight loss. The ghrelin levels in plasma and tumor tissue showed no correlations with each other while the ghrelin level in tumor tissue was significantly lower than that in normal tissue. The degree of cellular differentiation also had an association with ghrelin production. A gastrectomy proved to decrease significantly plasma ghrelin levels, body mass index, and biochemical markers, regardless of the extent of gastric resection. Conclusion: These results show that gastric cancer affects the production of ghrelin in the gastric mucosa and that ghrelin is mainly produced in stomach even though it could be partially covered by endogenous ghrelin from other organs following a gastrectomy. However, we should further investigate which other factors have an impact on energy consumption, ghrelin secretion, and changes in ghrelin levels after a gastrectomy.

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Effects of a Self-Help Program including Stretching Exercise on Reduction of Symptom in Patients with Fibromyalgia (신장운동을 포함한 자조관리프로그램이 섬유조직염환자의 증상완화에 미치는 효과)

  • Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.5 no.1
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    • pp.39-56
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    • 1998
  • This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

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The Gains To Bidding Firms' Stock Returns From Merger (기업합병의 성과에 영향을 주는 요인에 대한 실증적 연구)

  • Kim, Yong-Kap
    • Management & Information Systems Review
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    • v.23
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    • pp.41-74
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    • 2007
  • In Korea, corporate merger activities were activated since 1980, and nowadays(particuarly since 1986) the changes in domestic and international economic circumstances have made corporate managers have strong interests in merger. Korea and America have different business environments and it is easily conceivable that there exists many differences in motives, methods, and effects of mergers between the two countries. According to recent studies on takeover bids in America, takeover bids have information effects, tax implications, and co-insurance effects, and the form of payment(cash versus securities), the relative size of target and bidder, the leverage effect, Tobin's q, number of bidders(single versus multiple bidder), the time period (before 1968, 1968-1980, 1981 and later), and the target firm reaction (hostile versus friendly) are important determinants of the magnitude of takeover gains and their distribution between targets and bidders at the announcement of takeover bids. This study examines the theory of takeover bids, the status quo and problems of merger in Korea, and then investigates how the announcement of merger are reflected in common stock returns of bidding firms, finally explores empirically the factors influencing abnormal returns of bidding firms' stock price. The hypotheses of this study are as follows ; Shareholders of bidding firms benefit from mergers. And common stock returns of bidding firms at the announcement of takeover bids, shows significant differences according to the condition of the ratio of target size relative to bidding firm, whether the target being a member of the conglomerate to which bidding firm belongs, whether the target being a listed company, the time period(before 1986, 1986, and later), the number of bidding firm's stock in exchange for a stock of the target, whether the merger being a horizontal and vertical merger or a conglomerate merger, and the ratios of debt to equity capital of target and bidding firm. The data analyzed in this study were drawn from public announcements of proposals to acquire a target firm by means of merger. The sample contains all bidding firms which were listed in the stock market and also engaged in successful mergers in the period 1980 through 1992 for which there are daily stock returns. A merger bid was considered successful if it resulted in a completed merger and the target firm disappeared as a separate entity. The final sample contains 113 acquiring firms. The research hypotheses examined in this study are tested by applying an event-type methodology similar to that described in Dodd and Warner. The ordinary-least-squares coefficients of the market-model regression were estimated over the period t=-135 to t=-16 relative to the date of the proposal's initial announcement, t=0. Daily abnormal common stock returns were calculated for each firm i over the interval t=-15 to t=+15. A daily average abnormal return(AR) for each day t was computed. Average cumulative abnormal returns($CART_{T_1,T_2}$) were also derived by summing the $AR_t's$ over various intervals. The expected values of $AR_t$ and $CART_{T_1,T_2}$ are zero in the absence of abnormal performance. The test statistics of $AR_t$ and $CAR_{T_1,T_2}$ are based on the average standardized abnormal return($ASAR_t$) and the average standardized cumulative abnormal return ($ASCAR_{T_1,T_2}$), respectively. Assuming that the individual abnormal returns are normal and independent across t and across securities, the statistics $Z_t$ and $Z_{T_1,T_2}$ which follow a unit-normal distribution(Dodd and Warner), are used to test the hypotheses that the average standardized abnormal returns and the average cumulative standardized abnormal returns equal zero.

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Study of Utilization of Dental High School and according to the Pain Experienced Dental Fear (고등학생의 치과이용실태와 통증 경험에 따른 치과공포에 대한 연구)

  • Jun, Bo-Hye;Choi, Young-Suk
    • Journal of dental hygiene science
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    • v.14 no.1
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    • pp.59-66
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    • 2014
  • The purpose of this study was to study of utilization of dental high school and according to the pain experienced dental fear and anxiety. This survey was conducted on 370 high school students in Suwon from November 21 to 23, 2011. A total of 352 questionnaires were collected and analyzed. The collected data was analyzed using the statistical package SPSS 15.0 using frequency, mean and standard deviation analysis, t-test, one-way ANOVA, Duncan's test correlation analysis and Stepwise multiple regression analysis. The results state that students feel fear and anxiety were feeling anesthetic needle ($3.19{\pm}1.43$), seeing anesthetic needle ($3.14{\pm}1.44$). We found that students feel more rear and anxiety from caries treatment than scaling. It influence that having dental fear with past dental pain experienced during dental treatment and also hearing dental treatment of pain from their family and friends. We found out that there are some influencing factors on dental fear and anxiety, gender, oral health condition, smoking, pain experienced during dental treatment. We need to care dental fear and anxiety continuously and have prevention program. We have to try understanding students have dental fear and anxiety. So it's better they have good experience visiting dental clinic. We should develop the system and specially treat well while they have dental treatment with anesthesia and some sharp instruments.

Modified Blalock-Taussig Shunt for the Patients with Complex Congenital Heart Defects in Early Infancy (조기 영아기에 시행된 복합 심기형 환자들에서의 변형 Blalock-Taussig 단락술)

  • Lim Hong Gook;Kim Woong-Han;Hwang Seong Wook;Lee Cheul;Kim Chong Whan;Lee Chang-Ha
    • Journal of Chest Surgery
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    • v.38 no.5 s.250
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    • pp.335-348
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    • 2005
  • Background: This retrospective review examines the preoperative condition, postoperative course, mortality and cause of death for the patients who underwent modified Blalock-Taussig shunt for complex congenital heart defects in early infancy. Material and Method: Fifty eight patients underwent modified Blalock-Taussig shunts from January 2000 to November 2003. The mean age at operation was $23.1\pm16.2$ days ($5\~81\;days$), and the mean body weight was $3.4\pm0.7\;kg\;(2.1\~4.3\;kg)$. Indications for surgery were pulmonary atresia with ventricular septal defect in 12 cases, pulmonary atresia with intact ventricular septum in 17, single ventricle (SV) in 18, and hypoplastic left heart syndrome (HLHS) in 11. Total anomalous pulmonary venous return (TAPVR) was associated with SV in 4 cases. Result: There were 11 ($19.0\%$) early, and 5 ($10.6\%$) late deaths. Causes of early death included low cardiac output in 9, arrhythmia in 1, and multiorgan failure in 1. Late deaths resulted from pneumonia in 2, hypoxia in 1, and sepsis in 1. Risk factors influencing mortality were preoperative pulmonary hypertension, metabolic acidosis, use of cardiopulmonary bypass, HLHS and TAPVR. Twenty four patients ($41.4\%$) had hemodynamic instability during the 48 postoperative-hours. Six patients underwent shunt revision for occlusion, and 1 shunt division for pulmonary overflow. Conclusion: Modified Blalock-Taussig shunt for complex congenital heart defects in early infancy had satisfactory results except in high risk groups. Many patients had early postoperative hemodynamic instability, which means that continuous close observation and management are mandatory in this period. Aggressive management may appear warranted based on understanding of hemodynamic changes for high risk groups.

The Influence of Private Health Insurance on Admission among Some Patients with Cervical or Lumbar Sprain (민영의료보험 가입이 일부 경·요추부 염좌 환자의 입원에 미치는 영향)

  • Jang, Dong-Ryul;Kang, Myung-Geun
    • Journal of agricultural medicine and community health
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    • v.37 no.2
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    • pp.84-95
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    • 2012
  • Background: In Korea, private health insurance has neglected to induce externality on national health insurance by moral hazard. Therefore, we conducted this study in order to explore the influence of private health insurance on unnecessary medical utilization among patients with cervical or lumbar sprain. Method: The study examined a population of 449 patients (admission, 384; out-patient; 85) diagnosed with simple cervical or lumbar sprain without neurological symptoms at 20 small hospitals or clinics in Gwangju and Jeollanam provinces from Jul. 1 to Aug. 31 2008. The data were collected using structured, self-administrated questionnaire which collected information such as whether or not the patient was admitted (as a dependent variable), whether or not they had private health insurance (as a independent variable), and covariates such as socio-demographic characteristics, the factors related to the sprain, and characteristics of the insurance provider. Results: From hierarchical multiple logistic regression analysis, it was found that the admission rate of patient with private health insurance was higher than that those without it (Odds ratio=3.31, 95% Confidence interval; 1.14-9.58), meaning that private health insurance was an independent factor influencing the admission of patients with these conditions. Other determinants of admission were patient age and physician referral. Conclusions: This study is the first empirical study to explore the influence of private health insurance on inducing moral hazard in admission services, specifically among patients with cervical or lumbar sprain. Regulation of benefits provided by private health insurance may be necessary, as the effect of this moral hazard may mean existence of externality.

Study on perception and eating attitude towards vegetables among elementary school children and their parents in Gangwon area (강원지역 초등학생과 학부모의 채소류 섭취에 대한 인식 및 섭취태도 연구)

  • Kim, Mi Kyeong;Oh, Hae Sook;Lee, Myung Hee
    • Journal of Korean Home Economics Education Association
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    • v.27 no.3
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    • pp.19-34
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    • 2015
  • Current study aimed to evaluate elementary school children's perception and eating attitude towards vegetables and analyze environmental factors influencing it. Survey was conducted among elementary school students and their parents in Gangwon district, 410 subjects each(Total 742, 391 students, 351 parents). The results are as follows. Both the children(64.3%) and the parents(84.9%) showed high concern over health. 46.6% of children and 52.4% of parents admitted unbalanced eating behavior, and commonly avoided foods were mostly vegetables such as mushroom, carrot, garlic, sweet pepper-green, welsh onion, kimchi, pumpkin, or beans. Unbalanced eating habit was significantly related to health consideration in choosing what to eat(p<0.01) and interest in health(p<0.05). 70.9% of children with unbalanced eating habit showed intention for correction, and those with high interest in health had stronger intention (p<0.01). Regarding children's perception of 20 kinds of vegetables frequently used in school lunch, swiss chard leaf beet, amaranthus magistratus, and curled mallow were rarely heard of or hardly eaten before. Korean chinese cabbage, radish(62.7%), cucumber(62.1%), perilla leaves(60.4%), lettuce(58.1%), and spinach(54.5%) were among the most frequently eaten. Survey result on children's preference for the vegetables shows lettuce, cucumber, Korean chinese cabbage, perilla leaves, spinach, and radish were highly preferred and stem of garlic, crown daisy, sweet pepper-green, pepper, and curled mallow were the least preferred. There was a significant positive correlation(p<0.01, p<0.001) between children's and their parent's preference for each vegetables, implying that children's preference towards vegetables is greatly influenced by their parent's choice. Children showed negative attitude towards vegetables with strong flavor and tended to avoid vegetables that they remember as not tasty. This suggest that strong flavor and negative prior experience is what determines children's attitude in vegetable consumption. Many children said they try to eat vegetables even if they haven't had it before, and this tendency was significantly correlated with the degree of interest in health(p<0.05) and the degree of consideration of health in choosing what to eat(p<0.001).

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Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 환자의 지속적 상기도 양압술 순응도)

  • Choi, Jong-Bae;Lee, Seung-Hee;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.13 no.1
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    • pp.27-32
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    • 2006
  • Objectives: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. Methods: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. Results: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. Conclusions: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.

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The effect of subject awareness level of oral health on the quality of life for adult patients who visit hospitals and neighborhood clinics in Busan (부산지역 병의원을 내원하는 성인의 구강건강인식수준이 삶의 질에 미치는 영향)

  • Yoon, Hyun-Seo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.505-512
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    • 2017
  • The purpose of this study was to determine the quality of life according to the level of subjective perception as well as to analyze the influencing factors and improve the subjective perception to improve the quality of life. The results of the survey for adult patients in hospitals and neighborhood clinics in the region of Busan for nine months from December 2015 were as follows. Regarding the total symptoms, the women had a score of 1.41, and the younger respondents felt they suffered from no symptoms. An analysis of the quality of life by the general characteristics showed that the respondents who were better educated and had no systemic diseases had a higher score of 54.71 on the OHIP-14. The respondents who were better educated and had no systemic diseases had a higher score of 6.48 when a single item was used to determine their happiness index, and the respondents who were better educated and had no systemic diseases had a higher score of 3.82 when five items were used to rate their happiness index. The factor with the greatest influence on their scores on the OHIP-14 was the total symptoms, followed in order by the happiness index and self-rated oral health status. The variable that exerted the largest influence on the happiness index was the OHIP-14, followed by the self-rated health status, high-school or lower education, and the presence or absence of one or more chronic disease. Therefore, an improvement in the subjective awareness level is required to boost the quality of life, and a variety of health education programs should be prepared to raise the awareness level. In addition, there should be a chance to convey accurate information.