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Dissociative Symptoms in Patients with Somatization Disorder (신체화 장애 환자의 해리 증상)

  • Kim, Seong-Hwan;Choe, Byeong-Moo;Kim, Yoon-Won;Hahn, Hong-Moo
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.1
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    • pp.116-123
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    • 1999
  • Objectives : The authors attempted to assess how much the mechanism of dissociation affects somatization disorder patients psychopathologically, and explore the relationship between sexual or physical abuse and somatic symptoms in somatization disorder patients. Methods : The authors administered the Dissociative Experiences Scales-Korean version(DESK) and Dissociative Disorders Interview Schedule to 25 patients with somatization disorder and 51 normal subjects. Results : There were no significant demographic differences between patient and control groups. The mean score of DES-K for patient group was 18.2, and 10.0 for the control group. The percentage of the individuals with high scores(20 and over) was 36.0 in the patient group and 7.8 in the control group, respectively. The percentage of the individuals with sexual and/or physical abuse was 16.0 in the patient group and zero in the control group. Our results showed that DES-K scores were not influenced by the factor of age or religion in either group, but the scores of the patients with somatization disorder were significantly higher than those in the normal subjects. Conclusion : There was an implication that the mechanism of dissociation affects issues of psychopathogenesis and psychopathology in Korean patients with somatization disorder, even though they have different sociocultural backgrounds in comparison to Western patients. The authors suggest it is useful to focus attention on childhood abuse and dissociation in the evaluation and dynamic psychotherapy of patients with somatization disorder.

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The Evaluation of Potential Invasive Species in the Gangneungnamdae Stream in Korea using a Fish Invasiveness Screening Kit (FISK (Fish Invasiveness Screening Kit)를 이용한 강릉남대천의 잠재적 침습 이입종 평가)

  • Kim, Jeong Eun;Lee, Hwang Goo
    • Korean Journal of Environmental Biology
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    • v.36 no.1
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    • pp.73-81
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    • 2018
  • This study was conducted to understand the current status of the translocated species using a precede study and a model to evaluate the potential invasiveness that could adversely affect the aquatic ecosystem in the Gangneungnamdae Stream. A total of 12 translocated species were investigated and identified from 9 sites in a precede study, and steadily increased since 1982. For the study, which utilized research based on the total FISK (Fish Invasivenss Screening Kit) scores, all of the non-native fishes in Gangneungnamdae Stream were classified into two groups: namely as a high and a medium risk of becoming invasive. It was determined that there were two species (Zacco platypus and Pseudorasbora parva) that were determined to have posed the highest risk. The study determined that the mean scores were shown to have ranged from $3.06({\pm}0.16)-3.42({\pm}0.13)$. Consequently, the habitat analysis showed that the determined QHEI (Qualitative Habitat Evaluation Index) values in the stream averaged 146 (88-171), indicating that an optimal habitat condition did exist in that locale. It can be inferred that compared to land use in the surrounding watersheds, the QHEI values and frequency of translocated species showed the lower the altitude of stream, the QHEI values were decreased and in case of land use pattern, a noted decreased forest and grassland area, and gradually increased urbanized area was seen to exist in the region. The correlation between the fish assemblage, QHEI, land use pattern of surrounding watershed and number of translocated species was identified and analyzed when the stream altitude decreased, and the number of species was increased (r= - 0.782, p=0.0127), the number of species was decreased (r= - 0.737, p=0.0234), and finally when the QHEI values were decreased, it was noted that the urbanized area was increased (r=0.292, p=0.446). In the case of the number of translocated species, when the number of translocated species was increased, the associated urbanized area was increased.

Evaluation of accuracy in the ExacTrac 6D image induced radiotherapy using CBCT (CBCT을 이용한 ExacTrac 6D 영상유도방사선치료법의 정확도 평가)

  • Park, Ho Chun;Kim, Hyo Jung;Kim, Jong Deok;Ji, Dong Hwa;Song, Ju Young
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.109-121
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    • 2016
  • To verify the accuracy of the image guided radiotherapy using ExacTrac 6D couch, the error values in six directions are randomly assigned and corrected and then the corrected values were compared with CBCT image to check the accurateness of ExacTrac. The therapy coordination values in the Rando head Phantom were moved in the directions of X, Y and Z as the translation group and they were moved in the directions of pitch, roll and yaw as the rotation group. The corrected values were moved in 6 directions with the combined and mutual reactions. The Z corrected value ranges from 1mm to 23mm. In the analysis of errors between CBCT image of the phantom which is corrected with therapy coordinate and 3D/3D matching error value, the rotation group showed higher error value than the translation group. In the distribution of dose for the error value of the therapy coordinate corrected with CBCT, the restricted value of dosage for the normal organs in two groups meet the prescription dose. In terms of PHI and PCI values which are the dose homogeneity of the cancerous tissue, the rotation group showed a little higher in the low dose distribution range. This study is designed to verify the accuracy of ExacTrac 6D couch using CBCT. It showed that in terms of the error value in the simple movement, it showed the comparatively accurate correction capability but in the movement when the angle is put in the couch, it showed the inaccurate correction values. So, if the body of the patient is likely to have a lot of changes in the direction of rotation or there is a lot of errors in the pitch, roll and yaw in ExacTrac correction, it is better to conduct the CBCT guided image to correct the therapy coordinate in order to minimize any side effects.

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Effect on Myopia Progression Wearing Eye-glasses for School Children (학령기 아동의 안경착용이 근시진행에 미치는 영향)

  • Lee, Seok-Ju;Park, Seong-Jong;Chun, Young-Yun
    • Journal of Korean Ophthalmic Optics Society
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    • v.16 no.2
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    • pp.195-200
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    • 2011
  • Purpose: We analyzed the influence of myopic's eye-glasses wearing on myopia progress after cycloplegic refraction. Methods: The 33 people (66 eyes) were school children from 8 years to 12 years having no experience eye-glasses wearing, they were taken cycloplegic refraction at the 100th, the 200th and 300th days in order to evaluate myopia progression. We investigated the eye-glasses wearing group (experimental group, 32 eyes) and the non-eye-glasses wearing group (control group, 34 eyes). The eye-glasses power of the experimental group were -0.50 D, -0.75 D, -1.00 D, -1.25 D and -1.50 D. We compared experimental group with control group for myopia progress according to period, age, and refraction error and investigated the myopia progress according to the eye-glasses power of experimental group. Results: At the 300th day from the first cycloplegic refaction, spherical equivalent for the experimental group increased as -1.03${\pm}$0.43 D (t=13.36, p<0.001) and for the control group increase as -0.61${\pm}$0.35 D (t=10.05, p<0.001) and two groups were statistical difference. Myopia power for experimental group increased 60.75%, for control group increased 56.66% at the 300 days. According to eye-glasses power increased 41.19${\pm}$15.25% at -1.50 D, 36.74${\pm}$19.29% at -1.25 D, 56.57${\pm}$20.21% at -1.00 D, 87.26${\pm}$49.38% at -0.75 D and 106.69${\pm}$59.60% at -0.50 D. Conclusions: The myopia power for the eye-glasses wearing group was 0.46 D faster than the non-eye-glasses wearing group at the 300th day from the first cycloplegic refraction. We will consider the effect of non-eye-glasses wearing to protect the progressing myopia and prescribe the under correction for school children having no experience eye-glasses wearing.

Clinical Study of Acute Pyogenic Osteomyelitis in Children (소아 급성 화농성 골수염의 임상적 고찰)

  • Park, Ji Sook;Yeom, Jeong Suk;Hwang, Sun Chul;Park, Eun Sil;Seo, Ji Hyun;Lim, Jae Young;Park, Chan Hoo;Woo, Hyang Ok;Youn, Hee Shang
    • Clinical and Experimental Pediatrics
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    • v.48 no.7
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    • pp.731-736
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    • 2005
  • Purpose : Acute pyogenic osteomyelitis is uncommon in children. Delayed diagnosis and inappropriate treatment are leading to growth failure and deformation. We review the clinical manifestations and treatment of acute osteomyelitis in children according to age. Methods : A retrospective analysis was made of 32 patients who underwent antibiotic management or operation between Aug 1989 and Dec 2003 for acute pyogenic osteomyelitis in age from 0 to 15 years old. Results : The study group was composed of 21 boys and 11 girls. The subjects were divided into four groups according to age : 0-1 yr(n=6), 1-5 yr(n=11), 6-10 yr(n=8), and 11-15 yr(n=7). Nineteen cases were diagnosed in Winter. Femur was the most common infected site(37.5%). There were no predisposing factor in 17 patients, and 7 of 15 patients had trauma history. Sepsis was important predisposing factor in neonates. The chief complaints were pain, swelling and fever. S. aureus(61%) is the most common organism. Twenty-nine patients were treated with operation and concomitant antibiotics. Two cases had sequelae in follow-up period : One is avascular necrosis of femur and the other is discrepancy of leg length. Conclusion : In our review, because of poor prognosis in septic neonates, we recommend to treat actively neonatal sepsis and prevent or detect osteomyelitis early. Because most of patients were diagnosed and treated in orthopedic surgery, the rate of operation was too high. So, protocol for further evaluation and management of acute osteomyelitis in pediatric patients were needed.

Utility of a forced expiratory flow of 25 to 75 percent as a predictor in children with asthma (소아 천식에서 최대호기중간유량의 기관지 과민성 예측인자로서의 의의)

  • Kang, Jung Wan;Kim, Kyung Won;Kim, Eun Soo;Park, Jun Young;Sohn, Myung Hyun;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.51 no.3
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    • pp.323-328
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    • 2008
  • Purpose : Asthma is defined as chronic inflammation of the lower small airways, and bronchial hyperreactivity (BHR) is a pathophysiologic feature of asthma. It has been proposed that although there is no direct variable capable of assessing the small airways, a forced expiratory flow of between 25 and 75 percent ($FEF_{25-75}$) might be considered a more sensitive early marker of small airway obstruction than the forced expiratory volume in 1 second ($FEV_1$). Thus, we proposed that the presence and degree of positive responses to bronchial methacholine testing were related to the difference (DFF) and ratio (RFF) between $FEV_1$ and $FEF_{25-75}$ in asthmatic children. Methods : The subjects were 583 symptomatic children, including 324 children with BHR and 259 controls. Pulmonary function tests, methacholine challenge tests, and skin prick tests were performed, and the total eosinophil count, total serum IgE, and serum eosinophil cationic protein level were measured in all subjects. From a concentration-response curve, the methacholine concentration required to produce a decrease of 20% from post-saline $FEV_1$ was calculated ($PC_{20}$). Results : The median DFF and RFF values decreased in controls compared to subjects with bronchial hyperresponsiveness, and this trend was found in groups ranked by its severity. $PC_{20}$ had a negative correlation with DFF and RFF. Cutoff values of 0.5 for DFF and 1.042 for RFF were identified, and sensitivity and specificity were calculated. Conclusion : This study revealed that DFF and RFF might be predictive of bronchial hyperresponsiveness in the context of normal $FEV_1$ in children.

Usefulness of auditory brainstem response as early predictor of kernicterus in early breast-feeding jaundice (조기 모유 황달에서 핵황달의 조기 예측도구로서의 청성 뇌간유발 반응 검사의 유용성)

  • Jang, Jae Won;Lee, Gil Sang;Song, Dae Keun;Kim, Sung Hee;Kim, Won Duck;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.848-854
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    • 2007
  • Purpose : The present study examined the etiology and risk factors of the early breast-feeding jaundice and the usefulness of auditory brainstem response test as early predictor of kernicterus. Methods : Medical records of neonatal jaundice in newborn admitted to Daegu Fatima Hospital between September 2005 and May 2006 were analyzed prospectively. Infants were grouped according to feeding method : breast feeding group (breast feeding only, n=23), mixed feeding group (breast feeding mainly plus addition of fomula feeding, n=13). Results : There were no significant differences in gestational age, birth weight, sex, duration of phototherapy, serum bilirubin and hemolytic evidence between the two study groups. First visiting day of life at out patient department was significantly delayed in breast feeding group ($8.7{\pm}3.6day$) compared to mixed feeding group ($6.0{\pm}1.9$) (P=0.009). Weight loss was significantly severe in breast feeding group compared to mixed feeding group (P<0.05). In auditory brainstem response test, loss of Wave V in 3 cases was observed and recoverd after blood exchange transfusion in follow up test.Wave III latency had significant correlation to serum bilirubin in auditory brainstem response test (70 dB) (P=0.002). Conclusion : Our study suggest that further education about breast feeding and follow up within the first postnatal week would be necessary for early detection and prevention of early breast-feeding jaundice. Test of serum bilirubin and auditory brainstem response would be helpful in determination of blood exchange transfusion.

Attitudes of Physician, Nurse and Patient towards Physician's and Nurse's Uniform (의사와 간호사의 복장에 대한 의사, 간호사 및 환자의 견해)

  • Jung, Youn-Heui;Kim, Seok-Beam;Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.13 no.2
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    • pp.324-346
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    • 1996
  • A survey was conducted to study attitudes of physician, nurse and patient towards physician's and nurse's uniform, from March 1 to March 31, 1996. The study population was 130 physicians and 147 nurses engaged in Yeungnam University Medical Center and 211 inpatients of Yeungnam University Medical Center. A questionnaire method was used to collect data. The following are summaries of findings: In the respect of physician's uniform, both physicians and nurses preferred other type of gown to the traditional coat-typed one and especially, nurses preferred more than physicians. Patients showed no difference in the preference of the traditional one and other form of gown as a whole but those who had higher educational level preferred other form of gown(p<0.01). Regarding the color of physician's gown, 73.6% of physicians and nurses liked white color, and 86.3% of the patients also liked the white color. Male physicians preferred the white color more than female physicians and nurses(p<0.01). Patients showed no meaningful difference for the color. The opinion of insisting on wearing a necktie when physician see patients was given by male physicians, physicians of fifty or more, physicians working in the field of medicine and professors, which showed significantly higher percentage than other groups(p<0.01). In the group of patiens, the same opinion was given by female, the group of sixty or more, the group of elementary school graduates or less and people residing in other cities and counties more than male, the group of other ages, the group of having higher educational level and people of Taegu city(p<0.01). It tended to agree wearing casual wear of physician during the working time of weekend and holiday as a whole. Younger physicians showed significantly higher preference for it(p<0.05). Regarding the nurse's uniform, both physicians and nurses preferred trousers, and 96% of the nurses did. Especially, nurses who were forty years old or more and who served at outpatient department and administrative and aid parts expressed 100 percent partiality to trousers. For the patients, those who had lower educational level preferred skirt and those who had higher educational level preferred trousers. As to the color of nurse's gown, 46.7% of the physicians and nurses liked white color. The physicians preferred white and nurses preferred other color(p<0.01). Of the patients, 79.1% liked white color. Regarding the wearing cap, 95.9% of the nurses replied it didn't have to wear the cap. The nurses who were fifty or more and who served at outpatient department and special parts gave whole answers of not having to wear the cap. On the other hand, 77.7% of the patients answered nurse had to wear the cap. From the above findings, it would be advisable to give a change to the forms and colors of the gowns to match with the trend and sense of the time instead of insisting on the traditional typical ones.

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Studies on Feed Intake and Nutrient Utilization of Sheep under Two Housing Systems in a Semi-arid Region of India

  • Bhatta, Raghavendra;Swain, N.;Verma, D.L.;Singh, N.P.
    • Asian-Australasian Journal of Animal Sciences
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    • v.17 no.6
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    • pp.814-819
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    • 2004
  • An investigation was carried out to study the effect of two housing systems on feed intake and nutrient utilization of sheep in a semi-arid region of India. Two types of housing managements were adopted. The first was a shed- 20'${\times}$10' structure with all the four sides of 6' chain link fencing with central height of 10'. The roof was covered with asbestos sheets, with mud floorings. The second was an open corral- 20'${\times}$10' open space with all the four sides covered with 6' chain link fencing. Thirty-four (32 ewes and 2 rams) sheep were grazed together on a 35 ha plot of native range. All the sheep were grazed as a flock from 08:00 to 17:00 h during the yearlong study. The flock was divided into two groups (16 ewes+1 ram) in the evening and housed according to two housing systems (Shed and Open Corral). Three digestion trials were conducted during three defined seasons of monsoon, winter and summer seasons to determine the effect of housing on nutrient intake and utilization. Blood samples were collected in three seasons for the estimation of hemoglobin and glucose. Dry and wet bulb temperatures were recorded at 06:00 A.M. and 09:00 P.M. using suitable thermometers both inside the shed and in the open corral and temperature humidity index (THI) was calculated. There was significant (p<0.05) difference in the THI between shed and open corral in all the seasons, indicating that the shed was always warmer compared to open corral. The daily dry matter intake (DMI, g/d) was 965, 615 and 982 in sheep housed under shed and 971, 625 and 1,001 in those housed in open corral during monsoon, winter and summer season, respectively. These differences were however non-significant (p>0.05). The digestibility of DM was 45.92, 45.13 and 50.30 in sheep housed under shed and 43.64, 45.02 and 55.02 in sheep housed in open corral during monsoon, winter and summer seasons, respectively. There was no significant (p>0.05) difference in the digestibility of nutrients in sheep maintained under shed and in open corral. Blood Hb concentration was 13.97, 14.13 and 13.15 in sheep housed under shed and 15.27, 13.63 and 14.82 in those kept in open corral, whereas blood glucose concentration was 59.67, 59.70 and 52.33 in sheep under shed and 61.00, 61.00 and 57.83 in open corral, during monsoon, winter and summer, respectively. There was also no significant effect of housing on the body weight changes, wool yield and survivability in ewes. Although housing had no significant effect on nutrient intake, their utilization and blood parameters, there was significant effect on the physiological responses and energy expenditure of sheep maintained under the two housing systems (Bhatta et al., 2004). It can be concluded from this study that the housing systems didn't have any significant effect on the nutrient intake and utilization of native breed like Malpura, which were well adapted to the hot semi-arid conditions of India. However, while deciding provisions for housing of different breeds of sheep (both crossbred and native) parameters like physiological responses, energy expenditure, health conditions and overall economics of the systems should be taken into consideration.

The Characteristics of Pain Coping Strategies in Patients with Chronic Pain by Using Korean Version-Coping Strategies Questionnaire(K-CSQ) (한국판 대처 전략 질문지 (K-CSQ)를 이용한 만성 통증 환자의 통증대처 특성)

  • Song, Ji-Young;Kim, Tae;Yoon, Hyun-Sang;Kim, Chung-Song;Yeom, Tae-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.110-119
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    • 2002
  • Objectives : Numbers of patients who have chronic pain seem to be increasing in the psychiatric practice. Many investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. Coping strategies appear to be associated with adjustment in chronic pain patients. The objectives of this study were to develop a self-report questionnaire which is the most widely used measures of pain coping strategies, Coping Strategies Questionnaire (CSQ) into Korean version and to study the different coping strategies with which chronic pain patients frequently use when their pain reaches a moderate or greater level of intensity. Methods : One hundred twenty-eight individuals with chronic pain conditions and two hundred fifty-two normal controls were administered the Korean version-Coping Strategies Questionnaire(KCSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. We also obtained their clinical features in chronic pain patients. Reliability of the questionnaire were analyzed and evaluated differences of coping strategies between two groups. Results : Data analysis revealed that the questionnaire was internally reliable. Chronic pain patients reported frequent use of a variety of pain coping strategies, such as coping self-statements, praying and hoping, catastrophizing, and increase behavior scales which were higher compared to the normal controls. Conclusion: K-CSQ revealed to be a reliable self-report questionnaire which is useful for the assessment of coping strategies in clinical setting on chronic pain. And analysis of pain coping strategies may be helpful in understanding pain for chronic pain patients. The individual K-CSQ may have greater utility in terms of examining coping, appraisals, and pain adjustment. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the individual chronic pain patient. Further research is needed to determine whether cognitive-behavioral intervention designed to decrease maladaptive coping strategies can reduce pain and improve the physical and psycho-social functioning of chronic patients.

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