Along with the aging society, the prevalence of dementia is also increasing. Dementia causes short-term memory loss as well as difficulties of performing daily activities and gradually causes suffering of the patients and their family. In spite of various programs for prevention of dementia of older people are being implemented, there is a lack of developing natural-based program for physical and mental health promotion. Therefore, it is necessary to develop programs for the elderly living alone who are more vulnerable to dementia because of their social and economic isolation. The purpose of this study was to develop a natural-based program and investigate the effects of 10 weeks forest therapy program for dementia prevention to improve the psychological and physical health of the elderly living alone. The experimental subjects were 30 elderly (aged 65 or older) and 31 elderly participated in control group. The Stress response, depressive symptoms, weight, body mass index (BMI), fat mass and muscle mass were measured for pre and post test. The results showed that the experimental group showed subjective stress relief (t=5.249, p=.000), improvement in symptoms of depression (t=4.152, p=.000), and decreases in weight (t=2.686, p=.012), BMI (t=2.629, p=.014) and fat mass (t=2.918, p=.007) after the forest therapy program. The experimental group showed lower stress reactions(t=-7.185, p=.000) and less depressive symptoms (t=-5.303, p=.000) than control group after participating the program. These results suggest that periodic forest exposure can help having less stressful and depressive status than non-forest exposure and the forest therapy program can reduce participants' psychological and physical risk factors of dementia.
Objectives: This study reports a case of Guillain-Barre Syndrome (GBS) in which the patient experienced improved limb weakness, facial paralysis, paresthesia, and systemic pain after Korean medicine treatment. Methods: A 25-year-old female patient diagnosed with GBS received the herbal medicine Banhasasim-tang Soft Ext., acupuncture, electroacupuncture, moxibustion, cupping, and rehabilitation treatment. To confirm the change in symptoms, the manual muscle test (MMT), Korean Version of Modified Barthel Index (K-MBI), Yanagihara grading system (Y-score) and Numeric Rating Scale (NRS) were performed. Results: After Korean medicine treatment, there was a significant improvement in GBS-related clinical symptoms. Conclusions: Korean medicine treatment could be effective in improving symptoms of limb weakness, facial paralysis, paresthesia, and systemic pain related to GBS. However, this study has limitations as a case report, and more studies are needed.
Objectives: This study was conducted to observe the progression of symptoms according to the treatment period of patients with social anxiety disorder who received complex Korean medicine treatment. Methods: The medical records of 25 patients who were diagnosed with social anxiety disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and received complex Korean medicine treatment (herbal medicine, acupuncture, and Korean psychotherapy) for 12 weeks were analyzed. The State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI), the Korean-Social Avoidance and Distress scale (K-SAD), and the Korean-Fear of Negative Evaluation (K-FNE) were measured at the initial hospital visit and during the 4, 8, and 12 weeks of treatment to evaluate the effectiveness of treatment. Missing values were replaced with the average evaluation index value at that time. Results: 1) Statistically significant changes in STAI-X1, STAI-X2, BDI-II, BAI, K-SAD, and K-FNE scores were seen according to the time of treatment. 2) When scores were compared between each treatment time point, STAI-X2 and BDI-II showed statistically significant changes between the initial visit and four weeks of treatment, the initial visit and eight weeks of treatment, and the initial visit and 12 weeks of treatment. STAI-X1 and K-FNE showed statistically significant changes between the initial visit and eight weeks of treatment and the initial visit and 12 weeks of treatment. There was a statistically significant change in BAI scores between the initial visit and the 12th week of treatment. Conclusions: Complex Korean medicine treatment alleviated anxiety, depression, fear, and avoidance of social situation symptoms in patients with social anxiety disorder. The longer the treatment period, the more symptoms tended to be alleviated. However, the evidence should be supplemented with prospective, controlled research.
Purpose: This study aimed to understand the general characteristics and biomarkers of inflammation in adult patients who visited the emergency department with fever and to determine whether the severity of clinical symptoms varies according to cancer diagnosis. Methods: Data were collected retrospectively from 4,002 adult patients with fever who visited the emergency department at a tertiary hospital from January 2018 to December 2018 using medical records. Results: On average, cancer patients were older than non-cancer patients (p < .001), and differences were observed between cancer and non-cancer patients in the origin of fever and biomarkers associated with inflammation. A higher proportion of cancer patients than non-cancer patients had a Korean Triage and Acuity Scale level of 1 to 3 (p < .001), and more cancer patients than non-cancer patients met two or more criteria for systemic inflammatory response syndrome (p = .001). More life-saving interventions in the emergency department were required in cancer patients than in non-cancer patients (p < .001), and cancer patients spent more time in the emergency department than non-cancer patients (p < .001). Conclusion: This study showed that the general characteristics and biomarkers of inflammation differed among adult patients with fever depending on cancer diagnosis. Furthermore, among adult patients with fever, cancer patients had more severe clinical symptoms than non-cancer patients. The results of this study are hoped to be helpful as a basis of nursing knowledge for adult patients with fever in the emergency department and as evidence for the classification of severity in patients with fever according to cancer diagnosis.
Objectives: This study reports the case of a patient with right hemiparesis after a left thalamic infarction, in which the patient experienced improved clinical symptoms (hemiparesis, constipation) after treatment with a complex Korean medicine treatment. Methods: A 81-year-old male patient diagnosed with acute left thalamic infarction was treated with daily acupuncture and herbal medicine (Boyanghwanoh-tang-gagam) three times a day. Jowiseunggi-tang extract granules were administered to treat constipation by adjusting the dosage according to the reported symptoms. The patient's clinical course was assessed using changes in Modified Barthel Index (MBI) score, Manual Muscle Testing (MMT) grade, and defecation frequency . Results: The patient's MBI score improved from 35 to 69 and was discharged with the ability to walk under supervision. The MMT grade also improved from 3/4 to 5/5 in the upper/lower extremities. Other clinical symptoms, including constipation, also improved, leading to the discontinuation of magnesium medication. Conclusion: These findings suggest that complex Korean medicine treatments, including herbal medicine and acupuncture, may be an effective treatment for post-stroke hemiplegic patients.
Sin Hye Park ;Hong Man Yoon ;Keun Won Ryu ;Young-Woo Kim ;Mira Han;Bang Wool Eom
Journal of Gastric Cancer
/
제23권4호
/
pp.561-573
/
2023
Purpose: This study aimed to compare the long-term functional and patient-reported outcomes between intra-corporeal delta-shaped gastroduodenostomy and gastrojejunostomy after laparoscopic distal gastrectomy for gastric cancer. Materials and Methods: We retrospectively reviewed clinicopathological data from 616 patients who had undergone laparoscopic distal gastrectomy for stage I gastric cancer between January 2015 and September 2020. Among them, 232 patients who had undergone delta-shaped anastomosis and another 232 who had undergone Billroth II anastomosis were matched using propensity scores. Confounding variables included age, sex, body mass index, physical status classification, tumor location, and T classification. Postoperative complications, nutritional outcomes, endoscopic findings, and quality of life (QoL) were compared between the 2 groups. Results: No significant differences in postoperative complications or nutritional parameters between the two groups were observed. Annual endoscopic findings revealed more residual food and less bile reflux in the delta group (P<0.001) than in the Billroth II group. Changes of QoL were significantly different regarding emotional function, insomnia, diarrhea, reflux symptoms, and dry mouth (P=0.007, P=0.002, P=0.013, P=0.001, and P=0.03, respectively). Among them, the delta group had worse insomnia, reflux symptoms, and dry mouth within three months postoperatively. Conclusions: Long-term nutritional outcomes and QoL were comparable between the delta and Billroth II groups. However, more residual food and worse short-term QoL regarding insomnia, reflux symptoms, and dry mouth were observed in the delta group. Longer fasting time before endoscopic evaluation and short-term symptom management would have been helpful for the delta group.
목적: 신생아 중환자실(neonatal intensive care unit, NICU)에서 인플루엔자 바이러스 집단 발병의 보고는 흔하지 않으며 그 증상은 다양하다. 저자들은 국내 단일기관 NICU에서 발생한 A형 인플루엔자 바이러스 감염의 집단발병에 대해 보고하고 신생아 특히 미숙아에서의 임상적 특성을 알아보고자 하였다. 방법: 2011-2012년 국내 인플루엔자 바이러스 감염 유행 시기에 고신대학교 복음병원 NICU에 입원한 환자들 중 인플루엔자 바이러스 RT-PCR 검사를 시행한 29명 환자들의 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 중 11명에서 A형 인플루엔자 바이러스 양성이었는데(37.9%), 모두 미숙아였고 이들 중 3명(27%)은 증상이 없었으며 상기도 감염 증상 없이, 발열(18%, 2/11), 호흡곤란(72.7%, 8/11), 소화기 증상(27.3%, 3/11)이 있었다. 증상 소실까지 기간의 중앙값은 5일이었다. 이들은 모두 합병증 없이 생존하여 퇴원하였다. A형 인플루엔자 바이러스 RT-PCR 양성군과 음성군 사이에 검체 채취시 재원기간, CRIB 점수, 기계환기 과거력, 덱사메타손 사용 과거력의 차이가 있었다. 결론: 신생아 특히 미숙아에서 A형 인플루엔자 바이러스 감염의 증상은 비특이적이므로 지역 내 인플루엔자 유행시기에는 NICU 입원 중인 신생아에서 감염질환의 원인 병원체로 인플루엔자 바이러스를 고려해야 한다.
To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.
This study was conducted to determine the important factors in the illness behavior of panic disorder patients. And then, find the best ways to lead the patients who have recurrent panic attacks to the adequate therapeutic situations. We studied 53 patients diagnosed as panic disorder according to DSM-IV among the outpatients who had been followed up at Bong Seng Memorial Hospital for 6 Ms, from May 1997 to October 1997. To evaluate the illness behaviors, we designed a checklist including socio-demographic data, degree of subjective distress from medical and psychiatric treatment, panic symptoms, life events, places of help-seeking, Anxiety Sensitivity Index. Using the checklist, we had semistructured interviews with the panic disorder patients to elucidate their help-seeking behaviors from first panic attack to diagnosing as panic disorder. The results were as follows ; 1) After first panic attack, the patients initially sought help at 1) Emergency room 40%, 2) Rest &/or Personal emergency care 35%, 3) Pharmacy 10%, 4) Outpatient care at hospital 10%, 5) Oriental medicine 5%. 2) Considering the panic symptoms, derealization, paresthesia and the severity of panic symptoms were the most important factors affecting the patient's help-seeking behaviors who had experienced the first panic attack. 3) Most of all the patients (80%) were apt to visit the hospitals within 15 days after experiencing about 3 panic attacks. 4) Before diagnosed as panic disorder, the patients had visited 3-5 health care centers during about 1 year. 5) Primary care physicaians(for example, emergency care physicians, family doctors and internists) had the most important roles in treating or guiding the patients to the adequate therapeutic situations. From the above results, the authors propose that non-psychiatric physicians have to know the panic disorder or attacks exactly. When patients complaint sudden onset physical symptoms e.g. palpitation, dyspnea, dizziness or the cognitive symptoms like the fear of death or insanity, physicians should consider the possibility of panic attack and encourage the patients to be evaluated for psychiatric illness.
There has been a rapid industrial progress in Korea since 1962 by the success of 5-year economic development plan, and the number of industrial work has also made a rapid increase. Consequently, the management of the occupational health for the purpose of promoting the health of industrial workers and improving the working environment is badly needed in these days. Health services on industrial noisy environment have been provided only for noise-induced hearing loss management until now. But gradually, modem diseases and death have come to be related to the stress and mental health, therefore noise-induced mental disorder, like a stress became very important. Thus, this study has been carried out to analyze the relationship between workers' stress symptoms and the perceived working environment and the perceived working conditions. This study included 786 industrial workers selected from II factories in Buchun. The results were as follows: 1. For demographic characteristics, most of the workers were males(75.7%), the 20~29 years old were 33.8% and those who graduated from high school were 56.1%. The workers whose monthly income ranged from 700,000 to 1,500,000 won were 37.9% and who has a religion were 49.0%. 2. For occupational characteristics, workers who had worked 5~10 years in the factories were 35.8%. Those who felt much for them workload were 42.7% and who worked more than 8 hours a day were 73.7%. Those who were dissatisfied with their pay and job were 51.1 % and 31.2%. The workers who responded ventilation condition of their worksites were bad were 50.4% and the dissatisfied with working environment of their worksites were 43.8%. 3. For the noise exposure level in worksite, workers who were exposed to 70∼90㏈ were 37.4%, 90∼100㏈ were 25.2% and 50∼70㏈ were 18.8%. 4. Workers∼ stress symptoms were significantly related to marital status and their monthly income(P〈0.05). Workers who were single and had lower monthly income showed higher PSI(Psychiatric Symptom Index) scores than those who were married and had higher monthly income. Higher PSI scores were also significantly related to the night-work, workload, dissatisfaction with their job, and bad relationship with their bosses or co-workers. 5. The higher noise exposure level in worksite from 80㏈ was, the more severe stress symptoms including PSI subparts were reported; Anxiety, Anger, Depression, and Cognitive disorder symptom(P〈0.001). 6. According to the results of stepwise multiple regression analysis, factors affecting workers' PSI scores were noise exposure level in worksite(R2=0.150), relationship with coworkers, amount of workload, monthly income and relationship with bosses orderly and the total R2 of this 6 factors was 29.7%.
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