• Title/Summary/Keyword: 불안증상

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Resilience and Characteristics of Sleep and Defense among Shift Work Nurses (교대근무자의 회복력과 수면 및 방어 특성)

  • Lee, So-Jin;Park, Chul-Soo;Kim, Bong-Jo;Lee, Cheol-Soon;Cha, Boseok;Lee, Dongyun;Seo, Ji-Yeong
    • Sleep Medicine and Psychophysiology
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    • v.21 no.2
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    • pp.74-79
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    • 2014
  • Objectives: Shift work is a stressful situation. It is important to know the factors associated with the ability to adapt to a shift work schedule. The aim of the present study was to investigate the association between sleep, as well as personality variables, and the resilience of shift work nurses. Method: Self-report questionnaires were administered to 95 nurses who worked in one national university hospital. Connor-Davidson resilience scale, hospital anxiety and depression scale, morningness-eveningness scale, Pittsburgh sleep quality index, other sleep-related questionnaires, and Korean defense style questionnaires were used. Results: Age, shift work duration, off-day oversleep, depression, anxiety, adaptive defense style, and self-suppressive defense style were significantly associated with resilience (p < 0.05). Multiple regression analysis showed that age (${\beta}=0.34$, p < 0.05), depression (${\beta}=-0.25$, p < 0.05), adaptive defense style (${\beta}=0.45$, p < 0.001), and self-suppressive defense style (${\beta}=-0.19$, p < 0.05) significantly predicted the resilience of shift work nurses. Concerning individual defense mechanisms, resignation (${\beta}=-0.20$, p < 0.05), sublimation (${\beta}=0.19$, p < 0.05), omnipotence (${\beta}=0.19$, p < 0.05), and humor (${\beta}=0.20$, p < 0.05) significantly predicted the resiliency. Conclusion: The findings indicate that a specific defense style and other mechanisms were associated with the resilience of shift work nurses. A future prospective study with more participants could further clarify the relationship between sleep-related variables, as well as personality factors, and resilience of shift work nurses.

Surgical Closure of the Patent Ductus Arteriosus in Premature Infants by Axillary Minithoracotomy (액와 소개흉술에 의한 미숙아 동맥관 개존증의 외과적 치료)

  • Cho, Jung-Soo;Yoon, Yong-Han;Kim, Joung-Taek;Kim, Kwang-Ho;Hong, Yung-Jin;Jun, Yong-Hoon;Shinn, Helen Ki;Baek, Wan-Ki
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.837-842
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    • 2007
  • Background: Closure of the ductus arteriosus is often delayed in premature infants, which creates a hemodynamically significant left to right shunt that exerts an adverse effect on the normal development and growth of these babies. We reviewed out experience on surgical closure of patent ductus arteriosus via axillary minithoracotomy in premature infants. Material and Method: From April 2002 to October 2006, 20 premature infants whose gestation was under 37 weeks underwent surgical closure of patent ductus arteriosus as a result of complications or contra-indications for the use of indomethacin. Their mean gestational age was 28.8+3.4 weeks, ranging from 25+3 to 34+6 weeks, and the average age at operation was $15.6{\pm}6.3$ days. The mean body weight at operation was $1,174{\pm}416\;g$, ranging from 680 to 2,100g; 16 infants were under 1,500 and 9 infants were under 1,000 g. The procedures were performed in the newborn intensive care unit via $2{\sim}3\;cm$ long axillary minithoracotomy with the infant in the lateral position with left arm abduction. The mean size of the patent ductus arteriosus was $3.8{\pm}0.3\;mm$. For the most part, the ductus was closed with clips; 2 infants in whom the ductus was ruptured while dissection was being performed underwent ductal division. Result: Ten of twelve infants who had been ventilator dependent preoperatively could be successfully weaned from the ventilator at a mean duration of 9.7 days after the operation. There was no procedure-related complication or death. Two infants eventually died of the conditions not related to the operation; one from sepsis at postoperative 131 days and the other from pneumonia at postoperative 41 days, respectively. Conclusion: Surgical closure of the patent ductus arteriosus improved the hemodynamic instability and so promoted the successful growth and normal development of premature infants. Considering the low surgical risk along with the reduced invasiveness, early and aggressive surgical intervention is highly recommended.

Percutaneous Radiofrequency Therapy of Benign Bone Tumors in the Femoral Head (대퇴골두 부위에 발생한 양성 골 종양에 대한 경피적 고주파치료 (증례보고))

  • Seo, Jai-Gon;Kim, Eung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.84-92
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    • 2003
  • Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.

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Evaluation of Family Adaptability and Cohesion as Risk Factor of Postpartum Depression : Preliminary Study (산후우울증에서 위험인자로서의 가족응집성-적응력 평가 : 예비적 연구)

  • Kim, Bo-Rah;Suh, Shin-Young;Chang, Sung-Woon;Lee, Sang-Hyuk;Choi, Tae-Kyou;Kim, Yong-Woo;Cho, Sung-Joon;Yook, Keun-Young;Ryu, Mi;Kim, Myo-Jung;Kim, Keun-Hyang;Yook, Ki-Hwan
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.1
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    • pp.15-22
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    • 2009
  • Objectives : Prevalence of postpartum depressive disorders reaches approximately 10-15% of childbearing women. This preliminary study was intended to explore the relationships between postpartum depressive disorders and family adaptability and cohesion. Methods : Childbearing women(n=24) were assessed for risk factors for postpartum depression before and after childbirth prospectively. At gestational age between 36th and 40th week, the questionnaire about various factors before childbirth, Edinburgh postnatal depression scale(EPDS), Family adaptability-cohesion evaluation scale (FACES), and Beck anxiety inventory(BAI) were assessed. After childbirth, for the diagnosis of postpartum depressive disorders, a structured diagnostic interview according to MINI International Neuropsychiatric Interview was performed, furthermore, the questionnaire about various factors after childbirth, EPDS, and BAI were assessed at 4-6 weeks postpartum. Results : Among various factors and scales, family adaptability and cohesion, mood symptom and change during pregnancy were associated with postpartum depressive disorder in comparison with non-postpartum depressive disorder subjects. In addition, low family adaptability and cohesion and mood change during pregnancy were significantly associated factors with postpartum depressive disorder using logistic regression analysis. Conclusion : The results suggest the postpartum depressive disorder could be related with prenatal low family adaptability and cohesion. This preliminary study, however, includes only a few subjects, so that further large-sized study will be needed to replicate our results.

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Effects of Stressful Life Events on Patients with Recurrent Ahthous Ulcer. (SRRS를 이용한 재발성 아프타성 구내궤양 환자의 생활변화에 관한 연구)

  • Ko, Myung-Yun;Kim, Young-Ae;Ok, Soo-Min;Heo, Jun-Young;Jeong, Sung-Hee;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.195-203
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    • 2012
  • Recurrent aphthous ulcer(RAU) is the most frequent form of oral ulceration with a prevalence in the general population ranging between 5% and 60%. The peak age of onset is between 10 and 19 years of age, and it can persist into adulthood and throughout the patient's lifespan, with no gender predilection. The disease is characterized clinically into three types: minor aphthous ulcer, major aphthous ulcer and herpeticform ulcers. The cause of RAU is unknown and thought to be multifactorial with many triggers or precipitating factors that include familial tendency or genetic predisposition, allergy, medications, hormones, stress or anxiety, and immunologic abnormalities. The need for consideration of psychological factors in the pathogenesis of oral disease has been increasingly acknowledged over the last decades and many studies have highlighted the psycho-social impact of oral conditions. In this study, we tried to evaluate the influence of emotional stress in RAU. There were thirty patients with a clinical diagnosis of RAU and other subjects who did not show any signs of systemic disorders include RAU. They are evaluated by using modified Holmes and Rahe's Social Readjustment Rating Scale (SRRS). As a result, a significantly higher level of stress was found in the RAU patients than the control group. Therefore it can be concluded that psychological stressors play an important role in the RAU.

A CASE-ANALYSIS OF THE PSYCHIATRIC SEQUELAE IN ADOLESCENTS VICTIMIZED BY SCHOOL VIOLENCE (학교폭력 피해 청소년의 정신의학적 후유증에 관한 사례 연구)

  • Yook, Ki-Hwan;Lee, Ho-Bun;Noh, Kyung S.;Song, Dong-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.232-241
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    • 1997
  • The psychological problems following the experiences of school-violence could be more important than the physical problems. Victims could suffer from fear, depression, anger, lowered self-esteem, suicidal thought, and personality changes. To study the risk factors for school violence and the psychiatric problems after the experiences to school-violence provide us important informations to prevent and solve the problems of school violence. We examined clinical characteristics and psychosocial backgrounds of 13 adolescents who visited the psychiatric clinic after exposures to school violence from September, 1996 to May, 1997. The clinical data included intensity, motivations, durations, and methods of violence, psychiatric symptoms following exposure, findings of psychological test, and treatment course. The socioeconomic data included developmental characteristics of subjects, family characteristics, school life, and peer relationships. Of the 13 adolescents who experienced exposure to violence, 8 have experienced chronic psychiatric disturbances, 5 experienced transient psychiatric symptoms such as anxiety, depression, suicidal attempt who eventually returned to home and school life. Of the 8 adolescents who experienced chronic psychiatric disturbances, 4 experienced PTSD and depression lasting 3-6 months more, otherwise 4 showed converted features, such as aggressive behavioral disorder or perpetrator by strong compensatory effects after psychological shock. The subjects who have experienced chronic psychiatric disturbance have clinical characteristics such as physical or emotional abuse, physical illness or handicap, defects of ego functionings, and lack of family support. In summary, victims by school-violence manifested serious psychiatric disturbances, and they had clinically significant risk factors and some of them became perpetrators of school-violence.

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COMPUTER GAME PLAYING PATTERNS, PARENTAL REARING PATTERNS AND INDIVIDUAL PSYCHOPATHOLOGY IN ADOLESCENTS (청소년의 컴퓨터게임 이용실태, 부모양육방식, 개인의 정신병리)

  • Ryu, Jeoung-Whan;Kim, Young-Mi;Jeong, Hong-Kyung;Jo, A-Ra;Lee, Jung-Ho;Choi, Young-Min;Lee, Gi-Chul;Jeon, Seong-Ill
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.11 no.1
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    • pp.27-41
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    • 2000
  • Objects:This study was designed for studying of current Korean adolescents computer game playing habits and exploring associations with parental rearing patterns and individual psychopathology. Methods:One hundred twenty four adolescents(age 13-15) who reside in urban area completed self-report questionnaires containing Questionnaires designed by authors, Symptom Checklist-90-Revision of Korean Version(SCL-90-R) and Parental Bonding Instrument(PBI). Results:1) Computer game playing appears to be one of the social and leisure phenomena in these days. Although Adolescents spend a lot of times on computer game, Many of them perceive not problematic. 2) Compared with females, Male play computer games more regularly, more longer, spent more times in gamebang. 3) There was positive relationship between anxiety subscale in SCL-90-R and detrimental effects of computer game. 4) There was positive relationship between game frequency and maternal overprotection. 5) The main reasons for playing are 'for an avoidance of stressful life events', academic burden was the most troublesome issues in korean adolescents. 6) Many adolescents use gamebang as a social place, but they thought that gamebang is not good places to have a good time. Conclusion:This papers shows that computer game playing is a popular social leisure activity in Korean adolescents. And, Most of korean adolescents reported that they are suffered from pressure of academic achievements. They use computer game mainly by means of relieving academic pressures. In a heavy game users who have many conflicts with parents, teacher and who has frequent truancy and social withdrawal show significant anxiety. Maternal overprotection was observed in heavy game users. Authors recommended that clinicians should be careful in examining heavy computer game behaviors. Both underlying affective states and environmental influences, including family situations should be vicariously examined.

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Autologous Bone Marrow Cell Transplantation Combined with Off-pump Coronary Artery Bypass Grafting in Ischemic Myocardium (허혈성 심근에 관상동맥우회술과 병행한 자가 골수줄기세포 이식)

  • 김현옥;곽영란;강석민;장양수;임상현;안지영;이창영;강면식;유경종
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.547-552
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    • 2004
  • Recently, autologous bone marrow cell transplantation (CTx) for angiogenesis and myogenesis in ischemic myocardium has been extensively investigated to improve heart functions. This study was designed to evaluate the effects of CTx with off-pump coronary artery bypass grafting (OPCAB) in patients who were not feasible for complete revascularization. Material and Method: Four male patients underwent CTx and OPCAB simultaneously. Bone marrow was aspirated from iliac bone. Mean 1.5 ${\times}$ 10$^{9}$ mononuclear cells including mean 6.7 ${\times}$ 10$^{6}$ CD34 + cells and 3.7 ${\times}$ 10$^{6}$ AC133 + cells were obtained and concentrated with 10 cc. These cells were transplanted into non-graftable ischemic myocardium after OPCAB. The heart function of all patients were evaluated using the MIBI scan, echocardiogram and MRI preoperatively. The effects of CTx was evaluated using MIBI scan and echocardiogram at 1 month postoperatively. Result: An average of 2 grafts were bypassed to left anterior descending artery territory. Other territories were transplanted with isolated mononuclear cell. All patients had uncomplicated postoperative course. After 1 month follow up, there were improvement in symptom, ejection fraction (from 49% to 55%) on echocardiogram and myocardial perfusion on MIBI scan in all patients. Conclusion: These preliminary data showed improvement of heart function and myocardial perfusion and also showed the feasibility and safety of combined therapy with OPCAB and CTx in ischemic myocardium. However, the effectiveness of CTx alone cannot be readily assessed. Further randomized, controlled studies are required to evaluate the effectiveness of CTx alone.

Heart Rate Variability and Lipid Profile in Patients with Major Depressive Disorder (주요우울장애 환자에서의 심박변이도와 혈중 지질 농도와의 연관성)

  • Ahn, Eun-Jung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.27-34
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    • 2012
  • Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

A Comparison Study on the Internet Addiction and Health Problems of Middle School Students between Urban and Rural Area (도농간 중학생의 인터넷 중독과 건강문제 비교연구)

  • Yeon, Mi-Jung;Kim, Keon-Yeop;Lee, Moo-Sik;Hong, Jee-Young;Bae, Seok-Hwan;Hwang, Hye-Jeong
    • Journal of the Korea Convergence Society
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    • v.1 no.1
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    • pp.41-47
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    • 2010
  • This study was conducted to investigate determinent factors of the internet addiction that have influenced on middle school students. We randomly selected each one middle school in urban and rural areas, and conducted survey in 862 students of 2nd and 3rd grade from September 1 to 15, 2005. By using a statistical program called SPSS10.0, the data collected thereby were analyzed through a series of statistical methods including $x^2$-test, logistic regression analysis. The result of logistic regression analysis showed that the significant variables in urban area were resting time and using time a day. In rural area, sex, economic level, resting time and using time a day were significant variables. Higher status of internet addiction showed significant relationship with physical problems, anxiety, maladjustment to school, insufficient sleep time, fatigue in eyes, headache, pain in neck or shoulder, chronic fatigue, reduced vision, weight reduction, indigestion, xeroderma and adjustment to school. Especially, resting time and using time a day have dominant influence on internet addiction. And in case that the groups who showed high addiction tendency, there were negative health problem by physical, mental and social problem. To prevent internet addiction health education programs of right internet use and time, importance of rest, and health problems must be considered in internet addiction prevention policy.