• Sleep Medicine and Psychophysiology
• /
• v.8 no.1
• /
• pp.37-44
• /
• 2001

Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

• Sleep Medicine and Psychophysiology
• /
• v.8 no.2
• /
• pp.107-112
• /
• 2001

Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

• Sleep Medicine and Psychophysiology
• /
• v.4 no.2
• /
• pp.172-180
• /
• 1997

Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

• Journal of Korean Society of Forest Science
• /
• v.89 no.3
• /
• pp.440-451
• /
• 2000

This study was conducted in order to provide essential data and relevant management proposal to conserve and maintain big and old trees in a rational way. For the field survey, 77 big and old trees preserved by the laws in Chollabuk-do, Korea were investigated. The study results are summarized as follows : 1. To conserve and manage big and old trees, the valuable trees have been designated as natural monument trees and protection-needed trees. There are 141 individuals of 37 species designated as natural monuments and 10,049 individuals of 102 species designated as protection-needed trees. 2. Management budget for natural monument trees was devoted at 70% from the national expenditure, but that for protection-needed trees was devoted at 98% from the local expenditure. 3. Standardized sign boards and sign stones for natural monument trees were well placed and other protection facilities such as fences, branch supports and branch holdings were established. On the other hand, management of protection-needed trees was deficient overall. 4. Problems for designation process and management of protection-needed trees could include items such as insufficient management budget, various development activities, land ownership, misjudgement of tree age and species identification, unsatisfaction of sign board placement, insufficient surgery for damaged trees, pavement around tree root system and environmental pollution around the trees. 5. In order to improve the existing management methods of big and old trees, the following schemes were suggested : the development of practical criteria for natural monument and protection-needed trees, nationwide surveys of big and old tree resources, the security of national budget, securing sufficient spaces for the tree growth, specialization of management systems, extended practices of tree form management, establishment of permanent standard signs and consideration of opinions of village residents.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.37 no.3
• /
• pp.325-332
• /
• 2008

The human population is mainly exposed to dioxins through the diet. The purpose of this study was to estimate the daily dietary intake of PCDDs and PCDFs in Korean adults residing in different regions. Subjects were recruited and divided into three groups according to the districts where they lived: rural (n=213), coastal (n=193), and urban district (n=187). Subjects were interviewed using a general questionnaire and 24-hour recall for dietary intake. The daily intake of dioxins was estimated through the use of the database of dioxins contents in 35 Korean foods. The average age of the subjects were 61.5 years for coastal district, 57.6 years for rural district, and 49.4 years for urban district. Daily energy intake was 1707.7 kcal for rural district, 1596.5 kcal for urban district, and 1493.8 kcal for coastal district. There was no significant difference in total food intake by regions. The intakes from fishes of coastal district, those from cereals, vegetables, meats, and seasonings of rural district, and those from sugars, pulses, eggs, seaweeds, milks, oils of urban area were higher than those of the other two districts. The daily dioxins intake of coastal district (0.70 pgTEQ/kg/day) was significantly higher than those of rural district (0.32 pgTEQ/kg/day) and urban district (0.46 pgTEQ/kg/day). The dioxins intake from cereals, pulses, vegetables, fishes of coastal district and those from eggs and milks of urban area were the highest among the districts. The daily dioxins intake was positively correlated with the intakes of meats, eggs, fishes, oils, and seasonings. Therefore, it could be concluded that the daily dioxins intake of coastal district is higher than that in other districts and the fish is one of the main sources in dioxin intakes. However, daily dioxins intakes of the three regions were below the level of tolerable daily intake (TDI).

• Journal of agricultural medicine and community health
• /
• v.25 no.1
• /
• pp.113-131
• /
• 2000

Transtheoretical model of change has been proven very effective in explaining both the acquisition and cessation of many health related behaviors. The objectives of this study were to describe the distribution of smokers by stage of change of smoking, alcoholic drinking, and exercising in rural residents and to develope health promotion strategies. This study was done in Okchun County of Chungbuk Province. The representative sample were 892 residents over 30 years old. The questionnaires of interview included socio-demographic, the six stage distribution of smoking, alcoholic drinking, and exercising. In male, 50.6% of smokers were in the precontemplation stage, 32.5% in the contemplation. In female, corresponding figures were 60.6% and 28.8%. Precontemplation and contemplation stage of drinker were 72.8%, 19.3% in male and 80.3%, 15.5%. Distribution of exercise were 80.6%, 1.8% in male, 87.6%, 1.2% in female, respectively. The stage distribution of smoker, alcoholic drinker, and exerciser was shift to left of the distribution. And the stage distribution was slightly differ with each health behavior. The stage of change with smoking, drinking and exercising was correlated with each other but not concordant. So interventions in rural residents need to take into account the large proportion of precontemplators repeatedly observed among smoker, drinker, and non-exerciser. And intervention strategies of each risk behavior should be different approach. Result of concordance analysis suggest reconstruct validity of the transtheoretical model in our country due to ethnic and sociocultural difference. This results and theory should be tested in prospective intervention studies for seeking the possible gateway of health behavior.

• Journal of the Korean Institute of Landscape Architecture
• /
• v.45 no.2
• /
• pp.109-123
• /
• 2017

Due to the positive effect of forest space for child development, the creation and operation of forest activity space of various organizations is increasing in quantity; however, the research on practical space design and management program is insufficient. Therefore, the purpose of this study is to evaluate the space and management programs of the forest experience centers through the post-occupancy evaluation of teachers and preschoolers participating in forest activities. To do this, we analyzed the selected twelve sites through field survey, class observation, and interviews with forest education specialists, and then surveyed 115 forest education experts and childcare teachers for importance, performance, overall satisfaction, and space preference. In addition, we accessed overall satisfaction and space preference of twenty-nine preschoolers through interviews, photo-simulation, and questionnaires. As a result, the importance and performance of management program area was rated higher than the spatial characteristics area. In terms of group comparison, the group with active structured program rated two areas higher than the groups with free play. Preschoolers with structured programs preferred facility space, but preschoolers with free play preferred nature. Two preschooler groups rated forest activity as satisfactory. Based on the analysis results: 1) The composition of the forest activity space should ensure accessibility, safety, diversity of diversity, water space, connect to the forest road, and secure various terrains, trees, and natural materials; 2) The management program should ensure that forest activity programs have the proportional balance of structural programs and free play; also. management programs should plan for sufficient free playtime and a high share of play in the forest; and 3) Ensure the role and expertise of forestry specialists and run a program to increase the autonomy of preschoolers.

• Korean Journal of Psychosomatic Medicine
• /
• v.24 no.2
• /
• pp.165-173
• /
• 2016

Objectives : Since the awareness of autism spectrum disorders(ASD) is growing, as a result, it is increasing numbers of infants and toddlers being referred to specialized clinics for a differential diagnosis and the importance of early autism spectrum disorders detection is emphasized. This study is to know the difference between ASD and intellectual disability(ID) from comparison of the demographics, clinical characters and obstetric complications. Methods : The participants are 816 toddlers who visited the developmental delay clinic(DDC) in National Health Insurance Ilsan hospital. The number of toddlers diagnosed as ASD and ID was 324 and 492. 75 toddlers out of 114 who returned to DDC were diagnosed as ID at the first visit but 7 of them had changed diagnosis to ASD at the second visit. After compared ASD with ID from the first visit, we analyzed characters of toddlers who had the changed diagnosis to ASD at the second visit. Results : As a result, the comparison between ASD and ID at the first visit shows that the boys have higher ratio, lower obstetric complication and lower language assessment score in ASD. The toddlers who had the changed diagnosis at the second visit were all boys and they had more cases of family history of developmental delay and had lower score of receptive language developmental quotient. Conclusions : These findings suggest that sex, language characteristics and obstetric complication could be useful in the early detection of ASD.

• Journal of The Korean Association For Science Education
• /
• v.41 no.5
• /
• pp.371-390
• /
• 2021

The purpose of this study is to develop a neuropsychological model for the spatial ability factor and to divide the brain active area involved in the light & shadow problem solving process into the domain-general ability and the domain-specific ability based on the neuropsychological model. Twenty-four male college students participated in the study to measure the synchronized eye movement and electroencephalograms (EEG) while they performed the spatial ability test and the light & shadow tasks. Neuropsychological model for the spatial ability factor and light & shadow problem solving process was developed by integrating the measurements of the participants' eye movements, brain activity areas, and the interview findings regarding their thoughts and strategies. The results of this study are as follows; first, the spatial visualization and mental rotation factors mainly required activation of the parietal lobe, and the spatial orientation factor required activation of the frontal lobe. Second, in the light & shadow problem solving process, participants use both their spatial ability as a domain-general thought, and the application of scientific principles as a domain-specific thought. The brain activity patterns resulting from a participants' inferring the shadow by parallel light source and inferring the shadow when the direction of the light changed were similar to the neuropsychological model for the spatial visualization factor. The brain activity pattern from inferring an object from its shadow by light from multiple directions was similar to the neuropsychological model for the spatial orientation factor. The brain activity pattern from inferring a shadow with a point source of light was similar to the neuropsychological model for the spatial visualization factor. In addition, when solving the light & shadow tasks, the brain's middle temporal gyrus, precentral gyrus, inferior frontal gyrus, middle frontal gyrus were additionally activated, which are responsible for deductive reasoning, working memory, and planning for action.

• Journal of Nutrition and Health
• /
• v.52 no.4
• /
• pp.332-341
• /
• 2019

Purpose: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. Methods: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. Results: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. Conclusion: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.