• Title/Summary/Keyword: 심리적

Search Result 7,621, Processing Time 0.042 seconds

Rectal Bleeding and Its Management after Irradiation for Cervix Cancer (자궁경부암 환자에서 방사선치료 후에 발생한 직장출혈과 치료)

  • Chun Mison;Kang Seunghee;Kil Hoon-Jong;Oh Young-Taek;Sohn Jeong-Hye;Jung Hye-Young;Ryu Hee Suk;Lee Kwang-Jae
    • Radiation Oncology Journal
    • /
    • v.20 no.4
    • /
    • pp.343-352
    • /
    • 2002
  • Purpose : Radiotherapy is the main treatment modality for uterine cervix cancer. Since the rectum is in the radiation target volume, rectal bleeding is a common late side effect. This study evaluates the risk factors of radiation induced rectal bleeding and discusses its optimal management. Materials and Methods : total of 213 patients who completed external beam radiation therapy (EBRT) and intracavitary radiation (ICR) between September 1994 and December 1999 were included in this study. No patient had undergone concurrent chemo-radiotherapy. Ninety patients received radiotherapy according to a modified hyperfractionated schedule. A midline block was placed at a pelvic dose of between 30.6 Gy to 39.6 Gy. The total parametrial dose from the EBRT was 51 to 59 Gy depending on the extent of their disease. The Point A dose from the HDR brachytherapy was 28 Gy to 30 Gy $(4\;Gy\times7,\;or\;5\;Gy\times6)$. The rectal point dose was calculated either by the ICRU 38 guideline, or by anterior rectal wall point seen on radiographs, with barium contrast. Rectal bleeding was scored by the LENT/SOMA criteria. For the management of rectal bleeding, we opted for observation, sucralfate enema or coagulation based on the frequency or amount of bleeding. The median follow-up period was 39 months $(12\~86\;months)$. Results : The incidence of rectal bleeding was $12.7\%$ (27/213); graded as 1 in 9 patients, grade 2 in 16 and grade 3 in 2. The overall moderate and severe rectal complication rate was $8.5\%$. Most complications $(92.6\%)$ developed within 2 years following completion of radiotherapy (median 16 months). No patient progressed to rectal fistula or obstruction during the follow-up period. In the univariate analysis, three factors correlated with a high incidence of bleeding an icruCRBED greater than 100 Gy $(19.7\%\;vs.\;4.2\%)$, an EBRT dose to the parametrium over 55 Gy $(22.1\%\;vs.\;5.1\%)$ and higher stages of III and IV $(31.8\%\;vs.\;10.5\%)$. In the multivariate analysis, the icruCRBED was the only significant factor (p>0.0432). The total parametrial dose from the EBRT had borderline significance (p=0.0546). Grade 1 bleeding was controlled without further management (3 patients), or with sucralfate enema 1 to 2 months after treatment. For grade 2 bleeding, sucralfate enema for 1 to 2 months reduced the frequency or amount of bleeding but for residual bleeding, additional coagulation was peformed, where immediate cessation of bleeding was achieved (symptom duration of 3 to 10 months). Grade 3 bleeding lasted for 1 year even with multiple transfusions and coagulations. Conclusion : Moderate and several rectal bleeding occurred in $8.5\%$ of patients, which is comparable with other reports. The most significant risk factor for rectal bleeding was the accumulated dose to the rectum (icruCRBED), which corrected with consideration to biological equivalence. Prompt management of rectal bleeding, with a combination of sucralfate enema and coagulation, reduced the duration of the symptom, and minimized the anxiety/discomfort of patients.

The Effects of Self-regulatory Resources and Construal Levels on the Choices of Zero-cost Products (자아조절자원 및 해석수준이 공짜대안 선택에 미치는 영향)

  • Lee, Jinyong;Im, Seoung Ah
    • Asia Marketing Journal
    • /
    • v.13 no.4
    • /
    • pp.55-76
    • /
    • 2012
  • Most people prefer to choose zero-cost products they may get without paying any money. The 'zero-cost effect' can be explained with a 'zero-cost model' where consumers attach special values to zero-cost products in a different way from general economic models (Shampanier, Mazar and Ariely 2007). If 2 different products at the regular prices of ₩200 and ₩400 simultaneously offer ₩200 discounts, the prices will be changed to ₩0 and ₩200, respectively. In spite of the same price gap of the two products after the ₩200 discounts, people are much more likely to select the free alternative than the same product at the price of ₩200. Although prior studies have focused on the 'zero-cost effect' in isolation of other factors, this study investigates the moderating effects of a self-regulatory resource and a construal level on the selection of free products. Self-regulatory resources induce people to control or regulate their behavior. However, since self-regulatory resources are limited, they are to be easily depleted when exerted (Muraven, Tice, and Baumeister 1998). Without the resources, consumers tend to become less sensitive to price changes and to spend money more extravagantly (Vohs and Faber 2007). Under this condition, they are also likely to invest less effort on their information processing and to make more intuitive decisions (Pocheptsova, Amir, Dhar, and Baumeister 2009). Therefore, context effects such as price changes and zero cost effects are less likely in the circumstances of resource depletion. In addition, construal levels have profound effects on the ways of information processing (Trope and Liberman 2003, 2010). In a high construal level, people tend to attune their minds to core features and desirability aspects, whereas, in a low construal level, they are more likely to process information based on secondary features and feasibility aspects (Khan, Zhu, and Kalra 2010). A perceived value of a product is more related to desirability whereas a zero cost or a price level is more associated with feasibility. Thus, context effects or reliance on feasibility (for instance, the zero cost effect) will be diminished in a high level construal while those effects may remain in a low level construal. When people make decisions, these 2 factors can influence the magnitude of the 'zero-cost effect'. This study ran two experiments to investigate the effects of self-regulatory resources and construal levels on the selection of a free product. Kisses and Ferrero-Rocher, which were adopted in the prior study (Shampanier et al. 2007) were also used as alternatives in Experiments 1 and 2. We designed Experiment 1 in order to test whether self-regulatory resource depletion will moderate the zero-cost effect. The level of self-regulatory resources was manipulated with two different tasks, a Sudoku task in the depletion condition and a task of drawing diagrams in the non-depletion condition. Upon completion of the manipulation task, subjects were randomly assigned to one of a decision set with a zero-cost option (i.e., Kisses ₩0, and Ferrero-Rocher ₩200) or a set without a zero-cost option (i.e., Kisses ₩200, and Ferrero-Rocher ₩400). A pair of alternatives in the two decision sets have the same price gap of ₩200 between a low-priced Kisses and a high-priced Ferrero-Rocher. Subjects in the no-depletion condition selected Kisses more often (71.88%) over Ferrero-Rocher when Kisses was free than when it was priced at ₩200 (34.88%). However, the zero-cost effect disappeared when people do not have self-regulatory resources. Experiment 2 was conducted to investigate whether constual levels influence the magnitude of the 'zero-cost effect'. To manipulate construal levels, 4 different 'why (in the high construal level condition)' or 'how (in the low construal level condition)' questions about health management were asked. They were presented with 4 boxes connected with downward arrows. In a box at the top, there was one question, 'Why do I maintain good physical health?' or 'How do I maintain good physical health?' Subjects inserted a response to the question of why or how they would maintain good physical health. Similar tasks were repeated for the 2nd, 3rd, and 4th responses. After the manipulation task, subjects were randomly assigned either to a decision set with a zero-cost option, or to a set without it, as in Experiment 1. When a low construal level is primed with 'how', subjects chose free Kisses (60.66%) more often over Ferrero-Rocher than they chose ₩200 Kisses (42.19%) over ₩400 FerreroRocher. On contrast, the zero-cost effect could not be observed any longer when a high construal level is primed with 'why'.

  • PDF

Minor Stress, Coping Skill and Quality of Life in Patients with Hemodialysis (혈액투석 환자들의 Minor Stress, 대처방식 및 삶의 질)

  • Yang, Jae-Won;Lee, Moon-Soo;Park, Sang-Uk;Oh, So-Young;Ko, Young-Hoon;Kwan, Young-Joo;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.16 no.1
    • /
    • pp.38-46
    • /
    • 2008
  • Objectives : The purpose of this study is to investigate the minor stress in daily life related to undergoing hemodialysis and the relationship between minor stresses, coping skills, and subjective quality of life among the patients with end stage renal disease. Methods : Seventy seven patients on hemodialysis were enrolled in this study. Minor stress was assessed with daily stress inventory-Korean version(K-DSI), ways of coping checklist identified the use of the following coping strategies:problem-focused, seek social support, emotion-focused coping and wishful thinking. Socio-demographic data were obtained and World Health Organization-Quality of Life Scale(brief form) was also administered to subjects. Results : Participants mean age was $55.92{\pm}13.71$ years. The mean of the event, impact and impact/event (I/E) ratio scores of K-DSI were $29.06{\pm}21.57$, $88.69{\pm}75.88$ and $2.92{\pm}1.11$, respectively. These scores were much higher than normative data of K-DSI. Among the 5 categories of this inventory, the scores of cognitive stressors were highest. 5 categories of the inventory showed positive relationship with way of coping subscales, which showed coefficient of correlation between 0.259(p<.01) and 0.495(p<.001). However, no significant correlation was found between minor stress subscales and quality of life. Hemodialysis patients in our study used more emotional-focused coping methods, which was considered as passive way of cope than problem-orientated coping methods. Conclusion : The main findings of this study indicated that patients on hemodialysis showed higher level of perceived minor stress than normal population. The patients treated with hemodialysis tend to use passive way of coping primarily. For assessing the stress in patients on hemodialysis, clinician has to consider both level of perceived minor stress and the ways of coping the patients primarily use.

  • PDF

Prophylactic Cranial Irradiation for Acute Lymphoblastic Leukemia in Childhood (소아 급성 림프모구성 백혈병의 예방적 전뇌 방사선조사)

  • Kim, In-Ah;Choi, Ihl-Bhong;Kang, Ki-Mun;Shinn, Kyung-Sub;Kim, Hack-Ki
    • Radiation Oncology Journal
    • /
    • v.14 no.2
    • /
    • pp.137-147
    • /
    • 1996
  • Purpose : This report is the result f retrospective analysis for children who received prophylactic cranial irradiation combined with intrathecal chemotherapy. Materials and Methods : Ninety children with ALL who had got bone marrow remission after induction chemotherapy received PCI. All but 3 children were treated with a dose of 1800 cGy as a standard regimen. While the PCI was given, all patients received intrathecal chemotherapy. Results : Nine of 90 patients experienced CNS relapse during the duration of follow-up ranged from 36 to 96 months (median 60 months). Three children experienced BM relapse prior to CNS relapse. Therefore, CNS relapse rate as the first adverse event was $6.7\%$. Median time interval of CNS relapse was 16 months from the first day of hematologic complete remission. Eighty-nine percent of patients who had CNS relapse were associated with hematologic relapse. and $78\%$ of CNS relpase occurred during maintenance chemotherapy (on-therapy relapse). The CNS RFS at 2 and 5 years are $68\%$ and $42\%$, respectively with median of 43 months. The Prognostic factors affecting CNS RFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype and CALGB risk criteria. The DFS at 2 and 5 years are 61 and $39\%$, respectively with median of 34 months. The prognostic factors affecting DFS are initial WBC count (cut-off point of 50,000/ul), FAB subtype, POG and CALGB risk criteria. Conclusions : In our study, $6.7\%$ of CNS relapse rate as a first adverse event was comparable with other studies. Various risk criteria was based on age at diagnosis and initial WBC count such as POG and CALGB criteria, had prognostic significance for CNS RFS and DFS. Prospective randomized trial according to prognostic subgroup based on risk criteria and systematic study about neuropsychologic function for long term survivors, are essential to determine the most effective and least toxic form of CNS prophylaxis.

  • PDF

DEVELOPMENTAL AND CLINICAL CHARACTERISTICS IN CHILDREN WITH NOCTURNAL ENURESIS : RESULTS OF A MULTICENTER STUDY (야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 발달학적 및 임상적 특성을 중심으로)

  • Cho Soo-Churl;Shin Min-Sup;Hwang Jun-Won;Han Sang-Won;Park Kwan-Hyun;Lee Sang-Don;Kim Kyung-Do;Kim Kun-Suk;Suh Hong-Jin;Lee Yoo-Sik;Chung Jae-Yong;Kim Young-Kyoon;Kim Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.17 no.1
    • /
    • pp.32-39
    • /
    • 2006
  • Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

  • PDF

DIAGNOSTIC VALIDITY OF THE K-ABC AND THE K-LDES FOR CHILDREN WITH LEARNING DISORDER AND LEARNING PROBLEM (학습장애를 가진 아동에 대한 K-ABC와 K-LDES의 진단적 타당도)

  • Shin, Min-Sup;Cho, Soo-Churl;Kim, Boong-Nyun;Jeon, Sun-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.14 no.2
    • /
    • pp.209-217
    • /
    • 2003
  • Object:This study examined the diagnostic validity of the K-ABC and the K-LDES for identifying the cognitive deficits and the learning difficulty of children with learning disorder and to diagnose the learning disorder. Method:The clinical group consisted of 15 children with learning disorder or attention deficit hyperactivity disorder accompanying learning problem(LP) and 14 children with attention deficit hyperactivity disorder. They were diagnosed either learning disorder or attention deficit hyperactivity disorder based on DSM-IV criteria by child psychiatrists and clinical psychologists visiting Seoul National University Children’s Hospital. The normal group was composed of 15 children be going to an elementary school. All groups were between the age of 7 and 12. The K-ABC was administered to the clinical and the normal group. The K-LDES was also administered to mothers of all groups. Result:There were no significant differences on sequential, simultaneous, mental processing subscales of the K-ABC in three groups. However, The LP group showed slightly lower scores on Achievement scale and significant low scores on Reading/Decoding than the other groups. On K-LDES, LP group showed significant low scores on Listing, Thinking, Reading, Writing, Spelling, Mathematical calculation, Learning quotient(LQ) than the other groups. Also there were significant correlations between K-ABC and K-LDES subscales. Conclusion:The result of present study showed that the K-ABC and the K-LDES are a valid and effective instruments for evaluating and diagnose the learning disorder.

  • PDF

The usefulness of diagnostic tests in children with language delay (언어 발달지연 환아에서 진단적 검사의 유용성)

  • Oh, Seung Taek;Lee, Eun Sil;Moon, Han Ku
    • Clinical and Experimental Pediatrics
    • /
    • v.52 no.3
    • /
    • pp.289-294
    • /
    • 2009
  • Purpose : To assess the usefulness of magnetic resonance imaging (MRI), karyotyping, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG), tandem mass screening test, and newborn metabolic screening test in children with language delay for diagnosing underlying diseases. Methods : From January 2000 to June 2007, a retrospective chart review was performed for 122 children with language delay who visited the Child Neurology Clinic at Yeungnam University Hospital and who underwent neuropsychologic tests and other diagnostic evaluations for underlying diseases. They were grouped into phenomenological diagnostic categories, and test results were analyzed according to the underlying diseases. Results : Of 122 patients, 47 (38.5%) had mental retardation, 40 (32.8%) had developmental language disorders, 23 (18.9 %) had borderline IQ, and 12 (9.8%) had autism spectrum disorder. In 26 (21.3%) cases, the causes or relevant clinical findings to explain language delay were found. Eight (10.4%) of 77 MRIs, 6 (8.0%) of 75 EEGs, and 4 (5%) of 80 BAEPs showed abnormal results. Results directly attributed to diagnosing underlying diseases were 2 hearing defects in BAEPs and 1 bilateral perisylvian cortical dysplasia in MRIs. No abnormal results were found in karyotyping, tandem mass screening tests, and new-born screening tests. Conclusion : Commonly used tests to diagnose the cause of language delay are not very effective and should only be used selectively, according to patient characteristics. However, despite the low diagnostic yields from these tests, because many patients show abnormal results, these tests are useful when conducted in complete evaluation.

The Eating-Related Characteristics Questionnaire and Its Correlations with Anthropometry, Nutrient Intakes, Depression, and Personality Dimensions : the Validity of Its Use on Korean College Students (대학생을 대상으로 한 섭식특성 질문지의 타당성 연구 - 체격, 영양소 섭취, 우울 및 성격차원과의 상관성에 의한 -)

  • 신동순;조옥귀
    • Journal of Nutrition and Health
    • /
    • v.35 no.4
    • /
    • pp.489-497
    • /
    • 2002
  • This study was conducted to determine if Mehrabian's eating-related characteristics questionnaire could be effectively applied in predicting obesity and eating disorders among Korean college students by examining the correlations between eating-related characteristics and anthropometry, nutrient intakes, psychological aspects of depression, and personality dimensions. The data were collected from 151 female students in classes of nutrition or psychology in Kyungnam University. Measurements of height, weight and triceps skinfold thickness (TSf) were made by well-trained interviewers, and BMI was calculated. Daily nutrient intakes were obtained from the self-reported three-day dietary records for the kinds and the amounts of foods consumed by the student subjects. The students were also asked to complete three questionnaires : Mehrabian's eating-related characteristics questionnaire, Eysenck Personality Questionnaire, and the Berk Depression Inventory. The results of the study were as follows : 1) Reliability of factored homogeneous item dimensions (FHIDS) of the translated version of the eating-related characteristics questionnaire showed a similar profile compared with the original. Moreover, the loading values of Cronbach-$\alpha$ for some FHIDs, which were excluded in order to constitute primary-level factors (for example, 'predisposition to obesity' etc) with a high reliability, were much lower than Mehrabian's. Therefore the eating-related characteristics questionnaire could be effectively used for Korean students for predicting predisposition to obesity and eating disorders. 2) With regard to the relationship between anthropometric indices and eating-related characteristics, BMI measurements showed a high and a positive correlation with 'predisposition to obesity' and 'uncontrollable urges to eat', and a negative correlation with a 'predisposition to anorexia'. The heavier body weight and the more fat mass that the subjects had, the higher the probability that the subjects were overeating. 3) The intakes of some minerals (Fe, K, Na) and Vitamin C showed significantly negative correlations with a 'predisposition to obesity' and a 'predisposition to anorexia'. But the intakes of vitamin B$_2$, niacin, and retinol were positively correlated with'uncontrollable urges to eat'. 4) Among personality dimensions, neuroticism had a positive correlation with a 'predisposition to obesity', 'uncontrollable urges to eat', and 'predisposition to anorexia'. 5) Neuroticism was negatively correlated with intakes of calories, carbohydrates, K, Fe, Vitamin C, etc. On the contrary, all personality dimensions were positively correlated with intakes of retinol. In conclusion, the translated version of Mehrabian's eating-related characteristics questionnaire appears to be effective for nutritional or psychological assessments of any predisposition to eating disorders among Korean college students.

The Validity and Reliability of 'Computerized Neurocognitive Function Test' in the Elementary School Child (학령기 정상아동에서 '전산화 신경인지기능검사'의 타당도 및 신뢰도 분석)

  • Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Shin, Hyoun-Jin;Bai, Dai-Seg;Lee, Hye-Lin
    • Korean Journal of Psychosomatic Medicine
    • /
    • v.11 no.2
    • /
    • pp.97-117
    • /
    • 2003
  • Objective: This study is to examine the validity and reliability of Computerized Neurocognitive Function Test among normal children in elementary school. Methods: K-ABC, K-PIC, and Computerized Neurocognitive Function Test were performed to the 120 body of normal children(10 of each male and female) from June, 2002 to January, 2003. Those children had over the average of intelligence and passed the rule out criteria. To verify test-retest reliability for those 30 children who were randomly selected, Computerized Neurocognitive Function Test was carried out again 4 weeks later. Results: As a results of correlation analysis for validity test, four of continues performance tests matched with those on adults. In the memory tests, results presented the same as previous research with a difference between forward test and backward test in short-term memory. In higher cognitive function tests, tests were consist of those with different purpose respectively. After performing factor analysis on 43 variables out of 12 tests, 10 factors were raised and the total percent of variance was 75.5%. The reasons were such as: 'sustained attention, information processing speed, vigilance, verbal learning, allocation of attention and concept formation, flexibility, concept formation, visual learning, short-term memory, and selective attention' in order. In correlation with K-ABC to prepare explanatory criteria, selectively significant correlation(p<.0.5-001) was found in subscale of K-ABC. In the test-retest reliability test, the results reflecting practice effect were found and prominent especially in higher cognitive function tests. However, split-half reliability(r=0.548-0.7726, p<.05) and internal consistency(0.628-0.878, p<.05) of each examined group were significantly high. Conclusion: The performance of Computerized Neurocognitive Function Test in normal children represented differ developmental character than that in adult. And basal information for preparing the explanatory criteria could be acquired by searching for the relation with standardized intelligence test which contains neuropsycological background.

  • PDF

Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
    • /
    • v.27 no.3
    • /
    • pp.5-12
    • /
    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

  • PDF