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Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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Factors affecting hematologic recovery and infection in high-dose chemotherapy and autologous stem cell transplantation in patients with high-risk solid tumor (소아 고형종양의 고용량 화학요법 후 자가 조혈모세포이식에서 혈액학적 회복과 감염에 영향을 주는 요인)

  • Lee, Jung Hyun;Lee, Bo Lyun;Lee, Soo Hyun;Yoo, Keon Hee;Sung, Ki Woong;Jung, Hye Lim;Cho, Eun Joo;Koo, Hong Hoe
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1079-1085
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    • 2006
  • Purpose : The purpose of this study was to evaluate factors affecting hematologic recovery and infection in high-dose chemotherapy(HDCT) and autologous stem cell transplantation(ASCT) in patients with high-risk solid tumor. Methods : From January 2004 to December 2005, 72 HDCTs and ASCTs were applied to children with high-risk solid tumor at Samsung Medical Center. Medical records of these 72 HDCTs and ASCTs were retrospectively analyzed. Results : The single most powerful predictor of neutrophil and platelet recovery was the number of transplanted $CD34^+$ cells. The duration of high fever was significantly longer in young patients, in patients treated with total body irradiation and/or thiotepa, and in patients transplanted with lower $CD34^+$ cell dose(<$2{\times}10^6/kg$). However, the difference in the duration of high fever according to the number of $CD34^+$ cells was not clinically significant. Conclusion : Findings in this study suggest that HDCT and ASCT with low $CD34^+$ cell dose is clinically feasible despite delayed hematologic recovery, especially at a dose >$1{\times}10^6/kg$ per transplantation. Therefore, it is important not to defer the appropriate time for HDCT for an additional collection of hematopoietic stem cells if the number of collected $CD34^+$ cells is >$1{\times}10^6/kg$ per transplantation.

The Significances of Chest X-ray Findings and Serum IFN-γ, IL-5, ECP as Predictors of Prognosis of Bronchiolitis and Bronchopneumonia in Infants (영아의 세기관지염과 기관지 폐렴의 예후 지표로서 혈청 IFN-γ, IL-5 및 ECP치와 흉부 방사선 소견의 의의)

  • Cho, Su Hyun;Lee, Hyun Seung;Lee, Mi Hee;Lee, Joon Sung
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.230-235
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    • 2003
  • Purpose : Lower respiratory tract infections in infant and young children are often due to a virus, especially the Respiratory syncytial(RS) virus. Chest X-ray findings in bronchiolitis and bronchopneumonia are different. The radiographic hallmark of bronchiolitis is pulmonary hyperinflation and similar to that of bronchial asthma. Bronchiolitis is predisposed to later development of bronchial asthma. To evaluate the difference of immuno-pathophysiology between bronchiolitis and bronchopneumonia, we measured $IFN-{\gamma}$(Th1 cytokine), IL-5(Th2 cytokine) and ECP. We also investigated whether X-ray findings in infants with viral infected respiratory disease are useful in predicting the development of asthma. Methods : We measured IL-5, ECP, $IFN-{\gamma}$ levels in serum from 21 infants with bronchiolitis and 21 infants with bronchopneumonia and 16 infants without pulmonary viral diseases. Results : IL-5 levels of bronchiolitis and bronchopneumonia were significantly higher than those of the control(P=0.02, P=0.042). IL-5 levels of bronchiolitis were higher than those of bronchopneumonia but there was no significant difference. $IFN-{\gamma}$ levels of bronchopneumonia were higher than those of bronchiolitis but there was no significant difference. ECP levels of bronchiolitis and bronchopneumonia were higher than those of the control but only those of bronchiolitis were significantly higher than those of the control(P=0.045). IL-5 and ECP levels did not show any significant correlation in bronchiolitis, bronchopneumonia and control groups. Conclusion : We cannot prove the distinct differences in serum Th1/Th2 cytokine profiles between bronchiolitis and bronchopneumonia in infants. These results suggest that the different findings on chest X-ray between bronchiolitis and bronchopneumonia could not be a predictor of later development of asthma.

Serum Leptin Levels and Changes in Body Weight and Obesity Index in Gwacheon Elementary School Children (과천지역 초등학생의 Leptin 수준과 열량섭취, 체중 및 비만도 변화와의 관계)

  • Kim, In-Kyoung;Kang, Jae-Heon;Song, Ji-Hyun
    • Journal of Nutrition and Health
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    • v.40 no.8
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    • pp.736-744
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    • 2007
  • Leptin, as an adipocyte-derived hormone, is an important regulator of food intake and energy expenditure. In the cross-sectional study, leptin was shown to be positively related to body adiposity and metabolic disorders in adults. However, there were very few studies which reported the leptin as a predictor of weight gain over time. We examined whether serum leptin can be used as an indicator of the present and 1-year past weight status in very young children. First grade students from elementary schools in Gwacheon City were enrolled in the study since 2005. The study subjects(total 375 students; 195 boys and 180 girls) participated in the investigation of both 2005 and 2006. Physical examinations including height, weight, waist circumference were done. To examine the prevalence of obesity, obesity index was used. Serum leptin was measured, and their nutritional status was also evaluated based on 3-Day dietary records. Serum leptin levels were strongly positively related with the value of the present BMI and with the value of the BMI one year before. We found no association with leptin levels and amount of energy intake and macronutrient intake in this children population. Children were divided into three groups according to leptin tertiles. The highest leptin tertile group showed highest prevalence of obesity in year 2006 as well as in year 2005. Serum leptin levels can reflect the weight status now and as well as 1-year before. Possibly serum leptin levels can predict the weight gain of year later. Without an action against the obesity on children with high leptin level, those children would maintain the excess adiposity growth and progress into the obesity-related metabolic disorders. Further studies are needed to predict the obesity as early as possible and preventive system then after.

Effect of Simple VSD Repair on Doppler-Derived Right Ventricular Systolic Time Interval (심실중격결손 봉합이 우심실 수축기 시간 간격에 미치는 영향)

  • 정태은;이영환
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.124-129
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    • 1999
  • Background: Ventricular septal defect(VSD) that causes pulmonary hypertension increase right ventricular workload. Echocardiographic assessment of right ventricular systolic time interval (RVSTI) has been used to predict pulmonary artery pressure in various cardiopulmonary diseases. This study was undertaken in infants with simple VSD to observe the alteration of the right ventricular workload through the changes of RVSTI after repair of VSD. Material and Method: We evaluated heart rate, the ratio of the left atrium/aortic root diameter (LA/Ao), right ventricular pre-ejection period(RVPEP), right ventricular ejection time(RVET), and its ratio(RVPEP/RVET) as a predictor of right ventricular workload in 12 children with simple VSD. These were measured three times at the preoperative period, at the 3 month and between 6 month and 1 year(average 9.5${\pm}$1.8month) after repair of VSD by M-mode & Doppler echocardiograph from the pulmonic valve echogram. Result: Heart rate was decreased significantly after repair(137.1${\pm}$13.7 vs 114.4${\pm}$21.1 and 104.1${\pm}$10.2, p<0.01). LA/Ao ratio was decreased significantly after repair(1.71${\pm}$0.32 vs 1.47${\pm}$0.33 and 1.39${\pm}$0.23, p<0.05). RVPEP/RVET were decreased after repair (0.38${\pm}$0.09 vs 0.32${\pm}$0.08 and 0.29${\pm}$0.09, p<0.01). Heart rate corrected RVPEP/RVET were significantly decreased only after 6 months(0.32${\pm}$0.03 vs 0.30${\pm}$0.05 and 0.28${\pm}$0.06, p<0.05). Conclusion: We found elevated right ventricular workload was progressively decreased until more than 6 months after repair and the RVSTI may serve a useful guide in postoperative care for children with VSD.

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An Exploratory Study on Fashion Retail Borrowing in Korea (대우한국시상령수차대적연구(对于韩国时尚零售借贷的研究))

  • Lee, Mi-Young;Kim, K.P. Johnson
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.1
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    • pp.70-79
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    • 2010
  • There has been some research conducted that addressed immoral consumer behaviors in Korea; however, most of this research focused on purchasing counterfeits or shoplifting. High return rates of apparel and used apparel returns have been acknowledged as problem areas within the fashion industry. However, very few researchers have addressed this issue. Therefore, the goal of this research was to explore consumer's retail borrowing experience using a mixed methods approach. In study 1 Korean consumer's retail borrowing experiences was explored through focus group interviews. Findings informed study 2 an examination of apparel consumers' attitudes toward retail borrowing behavior via an online survey. Findings assist both researchers' and practitioners' understanding of retail borrowing behaviors and provide insight into retail borrowing issues in the apparel retail industry. For study 1, five focus-group interviews were conducted with seven panels of individuals that had retail borrowing experience within the past year. Thirty-five Korean consumers who lived in a metropolitan area participated in the focus group interviews. Most of consumers were in their 20's (n=21) and were women (n=24). Most participants purchased apparel items from a retail store and returned the worn items for either a full refund or exchanged the worn item for another item. Motives underlying retail borrowing behavior included social needs, job-related needs, fashion needs, and "smart shopping." Similar to existing research findings from other countries, social needs were the most frequently mentioned cause of retail borrowing in fashion stores. Consumers' moral values, attitude toward large corporations, and prior retail borrowing experience were mentioned as possible factors affecting consumers' retail borrowing behavior. For study 2, the questionnaire used to gather the data was developed based on the findings of part I and existing research. Questions concerning consumers' moral beliefs, sensation seeking tendencies, self-worth, past retail job experience, retail borrowing experience, and some demographic characteristics were included in the questionnaire. The data were collected via an online survey using an online panel provided by a commercial online research company located in Seoul, Korea. In order to obtain various consumers, a quota sample was (male: female=1:1, 20's:30's:40's=1:1:1, retail experience: no retail experience=1:3) obtained from the company. A total of 401 consumers who had shopped for apparel items during the prior 6 months participated in the online survey. The results indicated that 19.7% of the respondents reported they had experience borrowing fashion merchandise. Among these individuals, male borrowers (57%) outnumbered female borrowers. In terms of age distribution, x2 revealed that there was a statistical difference between respondents with and without retail borrowing experiences: 41.8% of the respondents with retail borrowing experience were in their 40's, while respondents without retail borrowing experience were evenly distributed between their 20's to 40's. There was also a significant difference between respondents with and without retail borrowing experience in terms of income: respondents with retail borrowing experience tended to have higher incomes than those without retail borrowing experience. T-tests were performed to compare respondents' fashion shopping behavior, moral beliefs, sensation-seeking tendencies, and attitudes toward retail borrowing behavior between participants with and without retail borrowing experience. As compared to those with no borrowing experience, respondents with experience tended to shop for fashion items more frequently and spent more on shopping for fashion items. Consumers with experience borrowing tended to have higher sensation-seeking tendencies than consumers without retail borrowing experience. A regression analysis revealed that attitudes toward fashion retail borrowing were negatively related to consumers' moral beliefs, but positively related to monthly fashion shopping frequency, sensation-seeking tendencies, and past fashion retail borrowing experience. Among these variables, past retail borrowing experience was the most significant predictor, followed by moral beliefs. This research serves as an initial attempt to address the motives that underlie retail borrowing behaviors and the factors affecting those behaviors. The findings of this study may facilitate an understanding of the consumer's retail borrowing, which will provide a basis for approaches that may help decrease retail borrowing and inappropriate returns at fashion retail stores. The findings may also provide materials for consumer education over the long term. In order to better understand fashion retail borrowing behavior, more research is needed in the future.

A Study on the Performance & Job Satisfaction of Visiting Nurses of district health centers in Seoul (서울시 각 구 보건소간호사의 방문간호 업무수행과 직무만족에 관한 연구)

  • Yang, Mi-Jin
    • Journal of Home Health Care Nursing
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    • v.4
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    • pp.30-40
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    • 1997
  • The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.

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Evaluation of Patients with Hemoptysis and A Normal Chest Roentgenogram (정상 흉부 X-선 소견을 가진 객혈환자의 관찰)

  • Han, Chun-Duk;Kim, Yeon-Jae;Lee, Yeung-Suk;Park, Jae-Yong;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.42-49
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    • 1995
  • Background: Hemoptysis always merits thorough investigation because even minimal bleeding may be an early indicator of the presence of significant bronchopulmonary disease. But in patients with hemoptysis & a normal chest roentgenogram, there are no clear guidelines for a diagnostic approach, including the indications of bronchoscopy. Methods: Eighty patients with hemoptysis and a normal chest roentgenogram were involved in this study. We evaluated the cause of hemoptysis in these patients by bronchoscopy and/or bronchogram or high-resolution CT of the lung and we analyzed the relationship of clinical features, such as age, sex, smoking and properties of hemoptysis, to the cause of hemoptysis. Results: 1) They were 34 men and 46 women, with the mean age of 46.7 and 41.8 years old, respectively. 2) Initial bronchoscopy provided a diagnosis in 8 patients - bronchogenic carcinoma in 3 patients (3.8%), metastatic cancer in 1 patient(1.3%) and endobronchial tuberculosis in 4 patients(5.0%). 3) Two clinical findings of patients over 50 years and/or with more than 30 pack-year smoking history were associated with bronchogenic carcinoma, and among these two factors, a more than 30 pack-year smoking history was the best predictor for diagnosis of bronchogenic cancer. 4) The 72 patients in whom no specific cause of hemoptysis was identified by initial bronchoscopy underwent bronchogram and/or high resolutional CT of the lung. Then, 6 patients were diagnosed as bronchiectasis and 5 patients rebleeded in the follow up period of 9 to 90 weeks. Of the remaining 66 patients, 33 were followed for 7 to 80 weeks. Among these patients, only 5 patients had recurrent episodes of hemoptysis & they were diagnosed as bronchiectasis in 1 patient, tuberculosis in 2 patients and catamenial hemoptysis in 2 patients. Conclusion: We conclude that patients with hemoptysis and a normal chest roentgenogram who are more than 50 years old or have more than 30 pack-year smoking history should undergo bronchoscopy to exclude possible bronchogenic carcinoma. In patients without these clinical features, a conservative approach with observation appears justified. If hemoptysis recurs to these patients, bronchogram or high-resolutional CT of the lung with sputum examination are necessary.

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Inflammatory Markers as Prognostic Factors for Patients with ARDS (급성 호흡곤란 증후군 환자에서 염증 표지자의 예후 예측인자로서의 역할)

  • Chung, Chae Uk;Hwang, Jae Hee;Park, Ji Won;Shin, Ji Young;Jung, Sun Yuong;Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.99-104
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    • 2008
  • Background: Acute respiratory distress syndrome (ARDS) is ultimately an inflammatory state. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are inflammatory markers. The aim of this study was to evaluate the value of the ESR, CRP and APACHE II score as prognostic factors for patient with ARDS. Methods: We retrospectively analyzed the medical records of 87 ARDS patients. The predictors (APACHE II score, ESR and CRP) and outcomes (mortality and length of the total hospital stay, the ICU stay and mechanical ventilator care) were obtained from the patients' records. The patients were grouped according to survival as the Survivor and Non survivor groups. We compared the APACHE II score, the ESR and the CRP level between the survivor group and the nonsurvivor group. We evaluated the correlation between the predictors and the outcomes. The initial ESR, CRP level and APACHE II score were checked at the time of ICU admission and the second ESR and CRP level were checked $3.3{\pm}1.2$ days after ICU admission. Results: Thirty-eight (43.7%) patients remained alive and 49 (56.3%) patients died. The APACHE II score was significantly lower for the survivor group than that for the non survivor group ($14.7{\pm}7.6$ vs $19.6{\pm}9.1$, respectively, p=0.006). The initial ESR and CRP level were not different between the survivor and non-survivor groups (ESR $64.0{\pm}37.8mm/hr$ vs $63.3{\pm}36.7mm/hr$, respectively, p=0.93, CRP $15.5{\pm}9.6mg/dl$ vs $16.3{\pm}8.5mg/dl$, respectively, p=0.68). The decrement of the CRP level for the survivor group was greater than that for the non survivor group ($-8.23{\pm}10.0mg/dl$ vs $-1.46{\pm}10.1mg/dl$, respectively, p=0.003). Correlation analysis revealed the initial ESR was positively correlated with the length of the total hospital stay and the ICU stay (correlation coefficient of the total hospital days: R=0.43, p=0.001, correlation coefficient of the ICU stay: R=0.39, p=0.014). Conclusion: The initial APACHE II score can predict the mortality of ARDS patients, and the degree of the early CRP change can be a predictor of mortality for ARDS patients. The initial ESR has positive correlation with the ARDS patients' duration of the total hospital stay and the ICU stay.

Positive Rate of Tumor Marker according to Sites of Recurrence in Gastric Cancer (위암 재발부위에 따른 종양표지자의 양성률)

  • Jang, Jin-Seok;Lee, Sung-Wook;Lee, Jong-Hun;Roh, Myung-Hwan;Han, Sang-Young;Kim, Min-Chan;Jeong, Gap-Jung;Choi, Seok-Reyol
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.222-227
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    • 2005
  • Purpose: There are several reports suggested the usefulness of serum tumor markers, AFP, CEA and CA19-9 as prognostic factors or indicators for recurrence in gastric cancer. This clinical study was peformed to evaluate positive rate of tumor markers according to site of recurrence in gastric cancer. Materials and Methods: From the database of patients who underwent radical gastrectomy for gastric cancer between January 1999 and January 2004, 52 patients who showed recurrence were included in this retrospective study. Serum levels of tumor markers were measured at the time of preoperative diagnosis of the gastric cancer and at the time of postoperative recurrence during follow up, respectively. Results: The overall positivity of tumor markers at the time of recurrence was found to be significantly higher than that of prior to surgery in the recurred group for the single test as well as the combination tests. For the peritoneum, the most common recurrent site, the positivity of CA19-9 was higher at the time of recurrence. And the significant positivity of CEA at the time of recurrence was detected in the liver cases. Conclusion: Having a preoperative positive tumor marker may identify the patient as having an increased chance of a recurrence. Although tumor markers continue to have limited diagnostic significance in gastric cancer, CA19-9 may be useful as a predictor for peritoneal recurrence of the gastric cancer, and CEA for recurrence to liver.

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