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The Influence of Estrogen on Dopamine Metabolites in Schizophrenia (정신분열병에서 도파민 대사물에 대한 에스트로겐의 영향)

  • Cheon, Jin-Sook;Lee, Jang-Hyun;Oh, Byoung-Hoon
    • Korean Journal of Biological Psychiatry
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    • v.6 no.2
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    • pp.209-218
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    • 1999
  • Objectives : The aims of this study were to discriminate the clinical differences, to measure the estrogen and homovanillic acid levels, to evaluate a correlation between estrogen and homovanillic acid, and to identify an association of cognitive deficit with estrogen and homovanillic acid among male and female schizophrenics. Methods : In addition to the structured interviews, the plasma estrogen levels by radioimmunoassay and the homovanillic acid levels by HPLC were measured in 20 male and 21 female schizophrenics as well as 10 healthy male and 9 female controls. Results : 1) The plasma estrogen levels were higher in females than males, and significantly higher in female schizophenics than female controls. The homovanillic acid levels were higher in female schizophrenics than female controls, and were lower in male schizophrenics than male controls. 2) The onset age seemed to be earlier in male schizophrenics, and the frequency of admission, duration of antipsychotic drug administration, dosage of antipsychotics and duration of illnesses were more in males. The estrogen and homovanillic acid levels were significantly higher in female schizophrenics. 3) The estrogen levels had a significant positive correlation with sex, age and onset age, while the homovanillic acid levels did with sex. However, estrogen were not correlated with homovanillic acid levels. 4) The estrogen and homovanillic acid levels were not significantly different between male and female schizophrenics with cognitive deficits. In the schizophrenic patients without cognitive deficits, the estrogen levels were significantly higher in females, while there were no significant sex differences in homovanillic acid. 5) In the male and female schizophrenics predominantly with negative symptoms, there were no significant differences in estrogen and homovanillic acid levels. In those predominantly with positive symptoms, the estrogen levels were significantly higher in females, while there were no sex differences in homovanillic acid levels. 6) In schizophrenics with undifferentiated subtype, the estrogen and homovanillic acid levels were significantly higher in females. In those with paranoid or disorganized subtypes, the estrogen levels were significantly higher in females, while there were no sex differences in the homovanillic acid levels. 7) The mean values of PANSS-negative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels were significantly higher in male schizophrenics with cognitive deficits. The mean values of illness duration, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANSS-CF and MMSE-K were significantly higher in female schizophrenics with cognitive deficits. 8) The variables which showed significant correlation with cognitive deficits were PANSS-negative, PANSS-total, PANSS-CF, MMSE-K and estrogen levels in male schizophrenics. The variables which showed significant correlation with cognitive deficits were subtypes, onset age, illness durataion, CGI, PANSS-positive, PANSS-negative, PANSS-total, PANMSS-CF and MMSE-K in female schizophrenics. The estrogen levels were significantly correlated with admission frequencies, history of antipsychotic administration, duration of antipsychotic administration and cognitive deficits in male schizophrenics, while age were not correlated with in females. The homovanillic acid levels had a significant correlation with subtypes and onset age in male schizophrenics, while there were no correlation among variables in females. Conclusions : Although the plasma concentrations of estrogen and homovanillic acid in female schizophrenics were significantly higher than males, we could not find an association between them. Furthermore, the various factors affecting on the cognitive deficits, estrogen and homovanillic acid levels seemed to be somewhat different according to sex.

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Impact of Computed Tomography Slice Thickness on Intensity Modulated Radiation Therapy Plan (전산화단층촬영 슬라이스 두께가 세기변조방사선치료계획에 미치는 영향)

  • Lee, Seoung-Jun;Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.285-293
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    • 2006
  • $\underline{Purpose}$: This study was to search the optimal slice thickness of computed tomography (CT) in an intensity modulated radiation therapy plan through changing the slice thickness and comparing the change of the calculated absorbed dose with measured absorbed dose. $\underline{Materials\;and\;Methods}$: An intensity modulated radiation therapy plan for a head and neck cancer patient was done, first of all. Then CT with various ranges of slice thickness ($0.125{\sim}1.0\;cm$) for a head and neck anthropomorphic phantom was done and the images were reconstructed. The plan parameters obtained from the plan of the head and neck cancer patient was applied into the reconstructed images of the phantom and then absorbed doses were calculated. Films were inserted into the phantom, and irradiated with 6 MV X-ray with the same beam data obtained from the head and neck cancer patient. Films were then scanned and isodoses were measured with the use of film measurement software and were compared with the calculated isodeses. $\underline{Results}$: As the slice thickness of CT decreased, the volume of the phantom and the maximum absorbed dose increased. As the slice thickness of CT changed from 0.125 to 1.0 cm, the maximum absorbed dose changed ${\sim}5%$. The difference between the measured and calculated volume of the phantom was small ($3.7{\sim}3.8%$) when the slice thickness of CT was 0.25 cm or less. The difference between the measured and calculated dose was small ($0.35{\sim}1.40%$) when the slice thickness of CT was 0.25 cm or less. $\underline{Conclusion}$: Because the difference between the measured and calculated dose in a head and neck phantom was small and the difference between the measured and calculated volume was small when the slice thickness of CT was 0.25 cm or less, we suggest that the slice thickness of CT should be 0.25 cm or less for an optimal intensity modulated radiation therapy plan.

Pattern of Occurrence of Mycoplasma pneumoniae Pneumonia in Admitted Children : Southern Central Korea, from 1989 to 2002 (소아 입원 환자에서 관찰된 Mycoplasma pneumoniae 폐렴의 발생 양상 : 최근 13년간(1989-2002년) 경남 서부지역)

  • Kang, Ki Su;Woo, Hyang-Ok
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.474-479
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    • 2003
  • Purpose : The determination of exposure and prevalence of Mycoplasma pneumoniae pneumonia of any region should be helpful for clinical diagnosis. We studied the pattern of occurrence of M. pneumoniae pneumonia among children living in southern central Korea during the last 13 years. This area has a relatively small population and less mobility compared with metropolitan areas. Methods : We performed a retrospective descriptive study of 143 patients admitted to the pediatrics ward among all the patients aged less than 15 years old diagnosed with M. pneumoniae pneumonia at our hospital, from July 1989 to June 2002. Results : The percentiles of incidence per year compared to the total patients admitted to a pediatric ward per year were 0.52% in 1989, 0.48% in 1990, 0.13% in 1991, 0% in 1992, 1.85% in 1993, 1.00% in 1994, 0.15% in 1995, 0.53% in 1996, 1.75% in 1997, 0.65% in 1998, 0.24% in 1999, 1.14% in 2000, 1.30% in 2001, 0.53% in 2002. In the peak incidence of monthly distribution for two consecutive years with outbreaks, its outbreak in the first year was concentrated in late fall and winter, but its outbreak in the following year was earlier than first year. There was peak incidence of age distribution in 4-5 years. It is shown gradually that age distributions per year of outbreak became earlier in age. Conclusion : The occurrences of M. pneumoniae pneumonia in southern central Korea occurred at 3-4 year intervals, 1-2 years in duration, compared to three year intervals, one year in duration, according to reports from metropolitan areas before 1997.

Short-lasting headaches in children and adolescents (소아청소년에서 short-lasting headaches)

  • Rho, Young-il
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.869-874
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    • 2009
  • Purpose : Short attacks of headache are present in the pediatric age group. Short-lasting headaches (SLH) have been infrequently reported in children and adolescents. This study aims to assess the prevalence, clinical characteristics, treatment, and prognosis of short-lasting headaches in children and adolescents. Methods : One hundred twenty-three consecutive patients attended the Chosun University Hospital Headache Center between March 2006 and July 2007. Among 123 headache patients, 44 patients with one key criterion, namely, recurrent headaches episodes of a few seconds to less than 30 minutes, were selected. Results : Of the 123 headache patients, 44 (35.8%, males 18, females 26) had SLH. The mean age was 9.24 years (range 2.3-14.2). The mean headache frequency was $11.50{\pm}10.30$ per month, mean severity was $4.86{\pm}1.36$ out of 10, and the mean PedMIDAS score was $7.97{\pm}17.51$. SLH was significantly more common in children <6 years old (10/22, 45.5%) than in ${\geq}6$ years old (34/101, 33.7%) (P=0.015). The nature of pain was pressure in 30.2%, stabbing in 27.9%, throbbing in 18.6%, and dull in 11.7%. In 52.4% patients, the pain occurred in the front, one side of the temple in 28.5%, both sides of the temple in 7.1%, and back in 4.8% patients. The duration of attacks was <6 minutes in 38% and ${\geq}6$ minutes in 61.4%. The intensity of the pain was 4-6 out of 10 in 75.0%, in 13.6% 1-3, and in 11.4% 7-10. Treatment was significantly effective in reducing the frequency, duration, and severity of headaches and the PedMIDAS score after 3 months (P<0.05). Conclusion : Short attacks of headache are common (35.8%) in children and adolescents. These are difficult to classify according to International Headache Society criteria. The outcome, after a period of 3 months to 2 years, was favorable in most patients. Further studies are needed to gather more data and to obtain a better description of these forms of headache in the pediatric group.

Burden, Job Satisfaction and Quality of Life of Nurses Caring for Cancer Patients (암 환자를 돌보는 간호사의 부담감, 직무 만족도 및 삶의 질)

  • Park, Mi-Sun;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.8-17
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    • 2005
  • Purpose: This study was performed to investigate burden, job satisfaction and quality of life of nurses who take care of cancer patients. Methods: The subjects were 237 nurses working at the oncology unit of hospitals with over 500 beds in Seoul and Gyeonggi-do. Data were collected using questionnaire from the February to March, 2005. Data were analyzed through t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression using SAS. Results: 1. The item that showed the highest level of burden was 'I feel limited even if I make efforts to reduce patients' pain. 'Burden was high in those group both who were younger than 35 years old and who had clinical experiences caring cancer patients for $3{\sim}4$ years. 2. The item that showed the lowest level of job satisfaction was 'the possibility of promotion'. Job satisfaction was high in those group both who had a spouse and were head nurses or incharge nurses. 3. The item that showed the lowest level of quality of life was 'I am physically exhausted'. Over 35 years old who had a spouse, and over 2,000,000 won monthly income made a high score in the quality of life. 4. There were negative correlations among burden, iob satisfaction and the quality of life. 5. The major factor affecting the quality of life was burden. Conclusion: The results of this study are expected to be utilized as basic data for developing support system to improve nurses' work conditions and quality of life.

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A Study on Awareness of Automated External Defibrillator, Usage Intention and Related Educational Experience in Workers at Public Institutions (공공기관 종사자들의 자동제세동기에 대한 인식과 시행의도 및 교육경험에 관한 연구)

  • Kim, Mu-Nui;Lee, Hyeon-Ji
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.416-424
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    • 2017
  • This study was conducted to examine the awareness of workers in public institutions of automated external defibrillators, their usage intention and related educational experience in an effort to increase the efficiency of education and the rate of automated external defibrillator usage in emergency situations. The subjects in this study were 243 selected. male and female adults who worked in public institutions in Gangwon Province. A survey was conducted from June 13 to August 21, 2016. The statistical analysis was based on the frequency analysis and the $X^2$-test. There were significant differences among the public institution workers awareness of how to use an automated external defibrillator according to gender (${\chi}^2=6.32$, p<0.05) and academic credentials (${\chi}^2=5.91$, p<0.05). Additionally, there were significant differences in usage intention according to academic background (${\chi}^2=5.70$, p<0.05). The most common reason for having no intention to use an automated external defibrillator for patients with cardiac arrest was that the respondents did not know how to use it (31.5%). There were also significant differences in educational experience with automated external defibrillators according to age (${\chi}^2=6.15$, p<0.05), academic credentials (${\chi}^2=11.56$, p<0.01) and career (${\chi}^2=11.92$, p<0.01). The most common form of education that the workers received pertaining to automated external defibrillators was a combination of theoretical and practical education, which represented 55.9%. The findings of the study seem to suggest that workers in public institutions used by many people must receive compulsory standard education regarding automated external defibrillators and try to boost the revival rate of patients with cardiac arrest in real emergency situations.

Alcohol Problems and Related Service Needs in Urban Korean Community (경기도 일지역의 문제음주실태와 알코올 미충족욕구 조사연구)

  • Yang, Jaewon;Whang, Soo Yeon;Hwang, In-Sook;Kim, Sun-Mee;Bae, Gi-Hye;Lee, Hong-Jae;Ko, Young-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.62-71
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    • 2013
  • Objectives : The purpose of this study is to investigate the characteristics of drinking patterns and the prevalence of hazardous drinking and alcohol use disorder with the assessment of alcohol policy needs in community population of urban city in Korea. Methods : Data was collected from 1,000 residents in a single urban city in Korea, from June 1 to July 31, 2011 by a questionnaire. As research tools, socio-demographic characteristics composed of variables based on study purpose, alcohol problems and alcohol use disorder state scales composed with Alcohol Use Disorder Identification Test(AUDIT) and Cut down, Annoyed, Guilty, Eye-opener(CAGE), and the assessment of alcohol policy needs in community population questions were used. Results : The lifetime experience of alcohol drinking was 97.4%. For the frequency of drinking, 21.9% of population responded 2 to 4 times per weekly. 24.4% of male had one time or more high risk drinking, defined as having four or more drinks in a sitting, per week. 51.6% experienced the first time drinking of alcohol in adolescence. The lifetime prevalence of hazardous drinking and alcohol use disorder were 14.9% and 3.3%, respectively using AUDIT. Alcohol use disorder were 9.6% with the CAGE scale. Problem drinking were 8.4% in this study. They requested the program such as prevention education(57.2%), construction of liaison system to treatment facilities(50.1%), alcohol counseling and intervention(41.7%), and rehabilitation program(39.8%). Conclusions : These results demonstrate that alcohol problem and alcohol use disorder were much prevalent, and these problem started in the earlier age. It is necessary to develop an effective alcohol prevention program or policy with considering the needs in community population.

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Prediction Model of Exercise Behaviors in Patients with Arthritis (by Pender's revised Health Promotion Model) (관절염 환자의 운동행위 예측모형 (Pender의 재개정된 건강증진 모형에 의한))

  • Lim, Nan-Young;Suh, Gil-Hee
    • Journal of muscle and joint health
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    • v.8 no.1
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    • pp.122-140
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    • 2001
  • The aims of this study were to understand and to predict the determinent factors affecting the exercise behaviors and physical fitness by testing the Pender's revised health promotion model, and to help the patients with rheumatoid arthritis and osteoarthritis perform the continous exercise program, and to help them maximize the physical effect such as muscle strength, endurance, and functional status and mental effects including self efficacy and quality of life, and improve the physical and mental well being, and to provide a basis for the nursing intervention strategies. Of the selected variables in this study, the endogenous variables included the physical fitness, exercise score, exercise participation, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue) and the exogenous variables included personal sociocultural factor(education level), personal biologic factor(body mass index), personal psychologic factor(perceived health status) and prior related behavior factors(previous participation in exercise, life-style). We analyzed the clinical records of 208 patients with rheumatoid arthritis and degenerative arthritis who visited the outpatient clinics at H university hospital in Seoul. Data were composed of self reported qustionnaire and good of fitness score which were obtained by padalling the ergometer of bicycle for 9 minutes. SPSS Win 8.0 and Window LISREL 8.12a were used for statistical analysis. Of 75 hypothetical paths that influence on physical fitness, exercise participation, exercise score, perceived benefits of action, perceived barriers of action to exercise, activity-related affect(depression) and perceived self-efficacy, interpersonal influences(family support), situational factors(duration of arthritis, fatigue), 40 were supported. The physical fitness was directly influenced by life-style, perceived health status, education level, family support, fatigue, which explained 12% of physical fitness. The exercise participation were directly influenced by life-style, education level, past exercise behavior, perceived benefits of action, perceived barriers of action, depression and duration of arthritis, which explained 47% of exercise participation. Exercise score were directly affected by perceived self efficacy. BMI, life-style, past exercise behavior, perceived benefits of action, family support, perceived health status. perceived barriers of action, and fatigue, which explained 70%. Perceived benefits of action was directly influenced by BMI, life-style, which explained 39%. Perceived barriers of action were directly influeced by past exercise behavior, perceived health status, which explained 7%. Perceived self efficacy were directly influeced by level of education, perceived health status, life-style, which explained 57%. Depression were directly influeced by past exercise behavior, BMI, life-style, which explained 27%. Family support were directly influeced by life-style, perceived health status, which explained 29%. Fatigue were directly influeced by BMI, life-style, perceived health status. which explained 41%. Duration of arthritis were directly influeced by life-style, past exercise behavior, BMI, which explained 6%. In conclusion, important variables for physical fitness were life-style, and variable affecting exercise participation were life-style. Perceived self-efficacy of exercise was a significant predictor of exercise score. BMI, Life-style, perceived benefits of action, family support, past exercise behavior showed direct effects on perceived self-efficacy. Therefore, disease related factor should be minimized for physical performance and well being in nursing intervention for patients with rheumatoid arthritis, and plans to promote and continue exercise should be seeked to reduce disability. In addition, Exercise program should be planned and performed by the exact evaluation of exercise according to the ability of the patients and the contents to improve the importance of exercise and self efficacy in self control program, dedicated educational program should be involved. This study suggest that the methods to reduce the disease related factors, the importance of daily life-style, recognition of benefit of exercise, and educational program to promote self efficacy should be considered in the exercise behavior promotion and nursing intervention for continous performance. The significance of this study is also thought to provide patients with chronic arthritis the specific data for maximal physical and mental well being through exercise, chronic therapeutic procedure, daily adaptation and confrontation in nursing intervention.

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Monte Carlo Simulation of the Carbon Beam Nozzle for the Biomedical Research Facility in RAON (한국형 중이온 가속기 RAON의 의생물 연구시설 탄소 빔 노즐에 대한 Monte Carlo 시뮬레이션)

  • Bae, Jae-Beom;Cho, Byung-Cheol;Kwak, Jung-Won;Park, Woo-Yoon;Lim, Young-Kyung;Chung, Hyun-Tai
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.12-17
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    • 2015
  • The purpose of the Monte Carlo simulation study was to provide the optimized nozzle design to satisfy the beam conditions for biomedical researches in the Korean heavy-ion accelerator, RAON. The nozzle design was required to produce $C^{12}$ beam satisfying the three conditions; the maximum field size, the dose uniformity and the beam contamination. We employed the GEANT4 toolkit in Monte Carlo simulation to optimize the nozzle design. The beams for biomedical researches were required that the maximum field size should be more than $15{\times}15cm^2$, the dose uniformity was to be less than 3% and the level of beam contamination due to the scattered radiation from collimation systems was less than 5% of total dose. For the field size, we optimized the tilting angle of the circularly rotating beam controlled by a pair of dipole magnets at the most upstream of the user beam line unit and the thickness of the scatter plate located downstream of the dipole magnets. The values of beam scanning angle and the thickness of the scatter plate could be successfully optimized to be $0.5^{\circ}$ and 0.05 cm via this Monte Carlo simulation analysis. For the dose uniformity and the beam contamination, we introduced the new beam configuration technique by the combination of scanning and static beams. With the combination of a central static beam and a circularly rotating beam with the tilting angle of $0.5^{\circ}$ to beam axis, the dose uniformity could be established to be 1.1% in $15{\times}15cm^2$ sized maximum field. For the beam contamination, it was determined by the ratio of the absorbed doses delivered by $C^{12}$ ion and other particles. The level of the beam contamination could be achieved to be less than 2.5% of total dose in the region from 5 cm to 17 cm water equivalent depth in the combined beam configuration. Based on the results, we could establish the optimized nozzle design satisfying the beam conditions which were required for biomedical researches.

Postoperative External Beam Radiotherapy for Medulloblastoma (수아세포종의 수술 후 외부 방사선치료)

  • Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.18 no.2
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    • pp.101-106
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    • 2000
  • Purpose : This study was peformed to evaluate the effectiveness and tolerance of craniospinal irradiation for patients with modulloblastoma and to define the optimal radiotherapeutic regimen. Materials and Methods : We retrospectively analyzed the records of 43 patients with modulloblastoma who were treated with external beam craniospinal radiotherapy at our institution between May, 1984 and April, 1998. Median follow up period was 47 months with range of 18 to U months. Twenty seven patients were male and sixteen patients were female, a male to female ratio of 1.7:1. Surgery consisted of biopsy alone in 5 patients, subtotal excision in 24 patients, and gross total excision in 14 patients. All of the patients were treated with craniospinal irradiation. All of the patients except four received at least 5,000 cGy to the posterior fossa and forty patients received more than 3,000 cGy to the spinal cord. Results : The overall survival rates at 5 and 7 years for entire group of patients were 57$\%$ and 56$\%$, respectively. Corresponding disease free survival rates were 60$\%$ and 51$\%$, respectively, The rates of disease control in the posterior fossa were 77$\%$ and 67$\%$ at 5 and 7 years. Gross total excision and subtotal excision resulted in 5 year overall survival rates of 76$\%$ and 66$\%$, respectively, In contrast, those patients who had biopsy alone had a 5 year survival rate of only 40$\%$. Posterior fossa was a component of failure in 11 of the 18 recurrences. Seven recurrences were isolated to the posterior fossa. Four patients had neuraxis recurrences, three had distant metastasis alone and four had multiple sites of failure, all involving the primary site. Conclusion : Craniospinal irradiation for patients with moduiloblastoma is an effective adjuvant treatment without significant treatment related toxicitles. There is room for Improvement in terms of posterior fossa control, especially in biopsy alone patients. The advances in radiotherapy including hypefractionation, stereotactic radiosurgery and 3D conformal radiotherapy would be evolved to improve the tumor control rate at primary site.

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