The study was aimed at investigating the relationship between biomechanical properties of cervical muscles and smartphone addiction score in fifty healthy males using smartphone more than 60 minutes each day. The usage of smartphone was evaluated by smartphone addiction survey developed from Korean International Society Agency. Biomechanical properties of three major cervical muscles; splenius capitis, sternocleidomastoid and upper trapezius, were measured by Myoton, and conducted five parameters; frequency, decrement, stiffness, creep, and relaxation time. As results, all parameters had less than 2% of coefficient of variation(CV) between measurement intervals. Also, intra-class correlation coefficient(ICC) indicated a high reliability(ICC>.9, p<.01). Moreover, the smartphone addiction score was significantly different in frequency(r=.353, p<.05) and stiffness(r=.346, p<.05) on upper trapezius; in addition, in decrement(r=-.284, p<.05) and creep(r=.288, p<.05) on sternocleidomastoid. Especially, splenius capitis was closely related with the overuse of smartphone(frequency, r=-.368, p<.01; decrement, r=-.405, p<.01; stiffness, r=-.424, p<.01). In conclusion, this study implied that the overuse of smartphone is significantly related with the damage of cervical muscles, cervical pain, and headache; furthermore, Myoton can be used as an effective device to assess mechanical properties of cervical muscles.
Background: We assessed the relationship between patient age and remifentanil dosing rate in patients managed under general anesthesia with spontaneous breathing using low-dose remifentanil in sevoflurane. Methods: The participants were patients with an American Society of Anesthesiologists Physical Status of 1 or 2 maintained under general anesthesia with low-dose remifentanil in 1.5-2.0% sevoflurane. The infusion rate of remifentanil was adjusted so that the spontaneous respiratory rate was half the rate prior to the induction of anesthesia, and γH (㎍/kg/min) was defined as the infusion rate of remifentanil under stable conditions where the respiratory rate was half the rate prior to the induction of anesthesia for ≥ 15 minutes. The relationship between γH and patient age was analyzed statistically by Spearman's correlation analysis. Results: During dental treatment under general anesthesia using low-dose remifentanil in sevoflurane, a significant correlation was detected between γH and patient age. The regression line of y = - 0.00079 x + 0.066 (y-axis; γH, x-axis; patient's age) was provided. The values of γH provide 0.064 ㎍/kg/min at 2 years and 0.0186 ㎍/kg/min at 60 years. Therefore, as age increases, the dosing rate exhibits a declining trend. Furthermore, in the dosing rate of remifentanil when the patient's respiratory rate was reduced by half from the preanesthetic respiratory rate, the dosing rate provided was around 0.88 mL/h in all ages if the remifentanil was diluted as 0.1 mg/mL. EtCO2 showed 51.0 ± 5.7 mmHg, and SpO2 was controlled within the normal range by this method. In addition, all dental treatments were performed without major problems, such as awakening and body movement during general anesthesia, and the post-anesthetic recovery process was stable. Conclusion: General anesthesia with spontaneous breathing provides various advantages, and the present method is appropriate for minimally invasive procedures.
The purpose of this study is to examine the association between resistance exercise frequency, muscular strength, and health-related quality of life in Korean cancer patients. We performed complex sample general linear model and logistic regression analysis using data from a total of 647 cancer patients in the 2014~2016 Korean National Health and Nutrition Examination Survey (KNHANES). Participants who were participating in resistance exercise 0~1 day per week had lower EQ-5D index (0.852±0.016 vs. 0.890±0.020; p=0.006) and a significantly higher risk of having problems in mobility (Odd ratio[OR]=4.07; 95% confidence interval [CI]=1.31-12.63) compared to those who were participating in resistance exercise ≥ 5 days per week. Participants with low hand-grip strength had lower EQ-5D index (0.850±0.018 vs. 0.911±0.016; p<0.001) and a significantly higher risk of having problems in mobility (OR=4.94, 95% CI=2.14-11.41), usual activities (OR=5.18, 95% CI=1.56-17.14), and pain/discomfort (OR=2.46, 95% CI=1.33-4.55) compared to those with high hand-grip strength. This study showed that resistance exercise frequency and muscular strength were associated with health-related quality of life in Korean cancer patients.
The purpose of this study was to empirically verify the effects of spousal bereavement and complicated grief level on death anxiety of the elderly. The sample consisted of 1,998 adults who were aged 65 or older. Dependent variable was measured with the Death Anxiety Scale-Korean version (DAS-K). Independent variable was measured with both spousal bereavement and the Inventory of Complicated Grief-Korean version (ICG-K). Multiple regression analysis was performed using SPSS 23.0, adjusting for demographics, psycho-social and health variables. The results indicated that death anxiety level was lower among the bereaved with normal grief (p<.01) than non-bereaved. In contrast, death anxiety level was higher among the bereaved with complicated grief than non-bereaved (p<.01). The study result suggests that the most risky factor for death anxiety is complicated grief rather than the bereavement. Although the bereavement can be a universal experience, the severity and duration of symptoms after the bereavement may not be general. The unhealed emotional and physical pain after the bereavement stimulates death anxiety, and senior citizens who suffer from complicated grief often fail to integrate the bereavement and loss into reality, therefore, may not accept the death phenomenon itself. Anxiety and fear of death can emerge when they cannot acknowledge the bereavement. To manage complex sorrows and mitigate death anxiety, intervention programs should be provided to increase adaptability to the bereavement.
Punyawat Apiwatanakul;Prashant Meshram;Andrew B. Harris;Joel Bervell;Piotr Lukasiewicz;Ridge Maxson;Matthew J. Best;Edward G. McFarland
Clinics in Shoulder and Elbow
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v.26
no.4
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pp.343-350
/
2023
Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications. Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported. Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both). Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.9
no.2
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pp.138-147
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1998
Authors surveyed intrafamilial child sexual abuse in the children under 15years old in clinical. We sent the semi-structured child sexual abuse questionnaires to 7055 board certified pediatrics, obstetrics and gynecology, family medicine and emergency medicine. Total respondents were 1205. The results from these respondents were as follows. 1) The numbers of respondents who have had the experience of treating victims of intrafamilial child sexual abuses were 157(13.0% of total respondents). 2) Among the perpetrators, 58(36.9%) were siblings and 32(20.4%) 26(16.6%) were step-fathers, and respectively. The most common age bracket was 10s(39.5%), and the next was 40s and 50s (33.7%) Almost all(98.7%) of the perpetrators were male. 3) The mean age of victims was $12.1{\pm}3.3$ years old, and all of the victims were female, and the number of victims who had previous mental or physical handicaps and behavior problems were 5(3.2%) and 8(5.1%) respectively. 4) The ways by which intrafamilial child sexual abuses were found were abnormal behaviors 45(28.7%), victim's own report 40(25.5%), pregnancy 18(11.5%), pain complaint 13(8.3%), other person's report 13(8.3%), and detection during examination 12(7.6%). 5) Time lags between intrafamilial child sexual abuses and hospital visits were after 1 month 97(61.8%), from 1 day to 1 week 29(18.5%), within 1 day 21(13.4%), and from 1 week to 1 month 10(6.4%). 6) Physical complications were perineal wound 93(59.2%), hymen rupture 90(57.3%), pregnancy 68(43.3%), wound of other part of body 11(7.0%), and sexually transmitted disease 4(4.5%). 7) Treatment for victims were discharge 92(58.6%), admission, operation or transfer to a bigger hospital 25(15.9%), psychiatry consult 19(12.1%), report to police(10.9%) and social work consult 3(1.9%). These results suggest that considerable numbers of physicians have had the experience of treating victims of intrafamilial child sexual abuses, and intrafamilial child sexual abuses are the major medical as well as social issue in children in Korea.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.9
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pp.203-215
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2017
Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.
When consulting with senior service user or his or her family members, employees of senior welfare facilities face a vertical relationship due to age rather than a horizontal relationship. Despite few cases reported, service users and the families afflict physical and mental pain on the employees through irrational demands, physical abuses, and verbal abuses. In particular, the Korean society has advocated the notion of respecting elders and thus emphasized members of society to provide unconditional support to those of old age. In reality, however, people who work at senior welfare facilities report the difficulty of providing supports to heavy demands in selfish complaints that are often impossible to fulfill. Starting from May 2018, there has been a petition to the Korean Blue House, seeking protective measures for 'Senior welfare facility professions who are exposed to violence'. The study conduct researches on the effect of job stress on the organizational commitment for senior welfare facility employees from suffering emotional labor. Furthermore, it also aims to point the difficulties that the professions face and the solutions that alleviate the conflicts between the rights of services users of senior welfare facilities and its staffs. The study surveyed 178 staffs who work in senior welfare facilities in Seoul and Gyeonggi Province as its research method. The collected data was analyzed by using IBM SPSS Statistics 24.0 to derive the general characteristics of the sample, reliability, feasibility analysis, correlation analysis, and verification of the research hypothesis. The study was able to conclude the following: First, the frequency of emotional expression of senior welfare facility staffs had negative(-) influences on job stress. Second, the incongruity of emotions of senior welfare facility staffs had negative(-) influences on job stress. Third, the incongruity of emotions of senior welfare facility staffs had negative (-) influences on job stress. Fourth, the job stress showed mediating effects between emotional labor factors and organizational commitment
Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.
Jang, Seung-Ho;Lee, Dae-Bo;Choi, Un Jong;Lee, Kwang-Man;Lee, Sang-Yeol
Korean Journal of Psychosomatic Medicine
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v.21
no.1
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pp.11-17
/
2013
Objectives : This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. Methods : Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. Results : The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age(55.8%) were significant explanation variables for health related quality of life. Conclusions : The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.
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