Purpose: The purpose of this study was to examine the prevalence and factors on Irritable Bowel Syndrome (IBS) symptoms in university students. Methods: This study was descriptive survey research. The subjects were 187 university students from one university. The exclusion criteria were 1) had GI surgery 2) had severe physiologic or psychologic problems 3) had liver, bile duct, pancreatic, and intestinal disease that required treatment. The ROME III was used to diagnose IBS. Sociodemographic characteristics, general health state by SF-36, psychological health by SCL-90-R, stress by perceived stress scale, sleep disturbance by Korean sleep scale, and diet habits were measured. Data were analyzed by using SPSS 17.0. Results: Seventeen students (9.1%) had IBS by ROME III criteria, but 46% had some GI problems at that time. Abdominal pain or discomfort continued for last six months or more in 14.3%. Fiber intake, obsessive-compulsiveness, hostility, psychoticism, global severity index, positive symptom distress, role physical, bodily pain, social functioning, and mental health were significantly different between IBS group and Non IBS group. Conclusion: Over nine percent of the students were diagnosed by Rome III criteria, and almost half of them had some GI problems. Diet, personality, general health state, and psychological health were factors of IBS.
Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50% to 70% of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20% to 30% range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.
The Purpose of this study was to identify characteristics of fatigue and the relationship between fatigue and related factors in patients on hemodialysis. This study was a survey study using a cross-sectional design. The subjects for this study were 101 patients on hemodialysis who were registered in the six hemodialysis clinics among a total of eleven clinics in Seoul. The period of data collection was from February 28, 1995 to May 2, 1995. Data were collected through an interview with a structured packet and the physiological data. The tools used in this study were the Visual Analogue Scale-Fatigue developed by Lee et al(1990) and translated by Lee(1991), the fatigue interview schedule developed by this researcher, Zung's self rating depression scale(Zung, 1965), the self-efficacy scale developed by Sherer et al(1982) and the Norbeck Social Support Questionnaire(NSSQ) translated by Oh(1984). The collected data were analyzed using descriptive statistics(mean, standard deviation, frequency, range), Pearson correlation coefficients and Stepwise multiple regression. The results were as follows ; 1. Characteristics of Fatigue of hemodialysis patients : 1) 79 of 101 hemodialysis patients complained fatigue. 2) The mean fatigue score as measured by the VAS-F was 36.2mm. 3) The mean duration of fatigue was 2.9 hours 2. Characteristics of fatigue related factors : 1) The physiologic factor which included Hgb, Hct, BUN, creatinine, potassium and interdialytic weight gain deviated from normal range. 2) The psychological factor which included depression and self-efficacy was about the same level as for patients with other chronic diseases. 3) The environmental factor which included social support had wide variation. 3. The relationship between fatigue and related factors : 1) Interdialytic weight gain in the physiologica factor was the only valuable with fatigue (p<.05) 2) The relationship between fatigue and the psychological factor of depression showed a positive and strong correlation(p<.05). According to the findings of this study, fatigue was highly correlated with the depression. This indicates that nurses should try to assess and control psychological factors when patients complain of fatigue rather than just considering physiological factors. Nursing has to develop effective nursing interventions to reduce fatigue in patients with chronic diseases using the relationship between fatigue and physiological, psychological and environmental factors.
Purpose: This study was undertaken to investigate bio-medical and behavioral risk factor of stroke according to the level of blood pressure among the prospective tele-health users. Method: A descriptive study was conducted using interviews with a structured questionnaire. Of the households in the village, 24 households were selected for inclusion in the study. Among all of the residents from these households, a total of 48 residents who completed all the blood tests as well as the questionnaire. Results: Among bio-medical risk factors including demographic characteristics, physiologic variables, and health history, only triglyceride(TG) was significantly different among normal, prehypertension, and hypertension groups(F=3.78, p<.05). However, regarding behavioral variables, those who were classified as prehypertension and hypertension group reported more frequent drinking, those who were in prehypertension group reported highest scores of stress and lowest frequency of exercise, and those who were in normal and hypertension group showed higher scores of interest on health and lower scores of perceived seriousness of disease and health knowledge than those who were in prehypertension group. Conclusion: Identification and implementation of modifiable risk factors of stroke according to the level of blood pressure are crucial for health care utilizing tele-medicine.
Journal of The Korean Dental Society of Anesthesiology
/
v.10
no.1
/
pp.27-33
/
2010
The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.
Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy that occurs in the ankle. Previous studies reported that this disease was due to physiologic factors and structural lesions in the ankle or foot. The authors investigated the causative factors of TTS and their frequency via operative findings. The diagnostic value of MRI was also evaluated based on the concordance between the operative findings and the MRI findings. Methods: This study was performed in retrospective by using medical record of the patients who underwent operations with TTS from August 2003 to May 2010. Physical examination, nerve conduction study, and MRI were conducted on patients who visited department of neurology or orthopedic surgery due to pain and sensory abnormality of their ankle and foot. Results: 34 patients underwent the operation. Ganglion accounted for the largest portion of the operative findings. In addition, varicose veins, intrinsic foot muscle hypertrophy, tenosynovitis, and fascia thickening were mainly observed. Of the 34 patients, 33 patients underwent pre-operative MRI, of whom 18 patients showed MRI findings consistent with the operative findings. Conclusions: Space-occupying lesions accounted for the majority of the causative factors in TTS patients who underwent the surgical treatment. In this study, the MRI appeared useful for identifying causes of TTS.
Nitric oxide (NO) is a small molecule (mol. wt. 30 Da) and oxidative free radical. It is uncharged and can therefore diffuse freely within and between cells across membrane. Such characteristics make it a biologically important messenger in physiologic processes such as neurotransmission and the control of vascular tone. NO is also highly toxic and is known to acts as a mediator of cytotoxicity during host defense. NO is synthesized by nitric oxide synthase (NOS) through L-arginine/nitric oxide pathway which is a dioxygenation process. NO synthesis involves several participants, three co-substrates, five electrons, five co-factors and two prosthetic groups. Under normal condition, low levels of NO are synthesized by type I and III NOS for a short period of time and mediates many physiologic processes. Under condition of oxidant stress, high levels of NO are synthesized by type II NOS and inhibits a variety of metabolic processes and can also cause direct damage to DNA. Such interaction result in cytostasis, energy depletion and ultimately cell death. NO has the potential to interact with a variety of intercellular targets producing diverse array of metabolic effects. It is known that NO is involved in hemodynamic regulation, neurogenic inflammation, re-innervation, management of dentin hypersensitivity on teeth. Under basal condition of pulpal blood flow, NO provides constant vasodilator tone acting against sympathetic vasoconstriction. Substance P, a well known vasodilator, was reported to be mediated partly by NO, while calcitonin-gene related peptide has provided no evidence of its relation with NO. This review describes the roles of NO in dental pulp in addition to the known general roles of it.
Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.
Recently, the number of the elderly has increased according to the improvement of socioeconomic status and the efficient medical care system. In spite of the development of medicine, the elderly suffers from the various health problems caused by weakness of musculoskeletal system, cardiopulmonary function and immunologic dysfunction. Regular rhythmic exercise program is known to be one of the effective tools to enhance the health condition in the elderly. However, there has been few studies to evaluate the comprehensive effects of rhythmic movement program on the elderly. This study was focused to evaluate the indices of cardiopulmonary function, life satisfaction, calcium, phosphorous, osteocalcin and deoxypyridinoline which are the essential factors of health problems in the elderly women. Twenty six subjects, aged between 68 and 72, who can do the ordinary activities and do not have cardiovascular dysfunction and mental disorder, participated in this study. They were divided into two groups: 13 in the experimental group and 13 in the control group. The experimental group participated in the rhythmic movement program at the welfare center located in G-city. The program were consisted of three sessions a week during 10 weeks. Each session had three parts: warming up(10 minutes), main exercise(40 minutes), finishing(10 minutes). Heart rate, blood pressure and peripheral arterial oxygen saturation were measured for the evaluation of cardiopulmonary function. Serum calcium, phosphorous, osteocalcin and urine deoxypyridinoline were measured as the indices of bony metabolism. Data were analyzed with mean, standard deviation, $x^2$-test, t-test, paired t-test using SPSS PC+ program. The results of this study were as follows. 1) Heart rate of the experimental group showed significant decrease following the rhythmic movement program. Peripheral arterial oxygen saturation of the experimental group showed significant increase following the program. 2) The degree of life satisfaction of the experimental group showed significant increase following the program. 3) Calcium showed significant decrease following the program but remained within normal range. There was no significant difference of phosphorous between two groups. 4) Osteocalcin, the index of bone formation, showed no significant change following the program, but significant increase in the experimental group comparing with the control group. 5) Deoxypyridinoline, the index of bone resorption, in urine of the experimental group showed significant decrease following the program. In conclusion, the rhythmic exercise program in the elderly showed the improvement of physiologic function and favorable effects on life satisfaction and bony metabolism. According to the above results, the regular rhythmic movement program can be strongly recommended for the improvement of health in the elderly women.
The purpose of this study was to explore convergence on the theory of unpleasant symptom, and factors affecting quality of life of liver cirrhosis patients. A total of 198 liver cirrhosis patients were recruited symptom experiences, physiologic factors, psychological factors, situational factors, and quality of life. Data were collected from March, to May, 2014 and analyzed using one-way ANOVA, Pearson correlations, multiple regressions analysis with PASW (SPSS) 21.0. Variables such as duration of liver cirrhosis(${\beta}=.19$, p<.001), symptom experiences(${\beta}=.19$, p=.032), physical(${\beta}=.15$, p=.008), psychological(${\beta}=.39$, p<.001) and situational factors(${\beta}=.32$, p<.001) explained 51.8% of variance in quality of life(F=15.57, p<.001). The symptom experiences, physiological, psychological and situational factors should be considered for caring liver cirrhosis patients. Symptoms of postmyocardial infarction (post-MI) patients at risk for progression to heart.
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