• 생물정신의학
• /
• 제27권2호
• /
• pp.42-57
• /
• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제33권3호
• /
• pp.73-81
• /
• 2022

Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.

• 지역사회간호학회지
• /
• 제12권3호
• /
• pp.755-772
• /
• 2001

The specific purpose of this study was as follows: 1) To identify the level of sexual awareness and demand for sex education of teenagers, their parents and teachers. 2) To investigate the attitude toward and acceptance of heterosexual friendships by teenagers, their parents and teachers. 3) To identify the experience and direction of sex education of parents and teachers. For this purpose, this study selected 341 male and female teenagers at three high schools located in a city, 119 parents with high school students and 243 elementary/middle/high school teachers. The structured questionnaire was distributed to each of them and returned by them. This study was conducted over the period between June 1. 2001 and Aug 31. 2001. A total of 720 questionnaires were distributed to them and 703 were returned. Data analysis was conducted to obtain percentage and frequency using the SAS program. As a result, the following findings were obtained: Parents and teachers showed a similar attitude about sexual awareness, but teenagers showed a different attitude. In terms of the level of feeling of and interest in 'sex', teenagers, parents and teachers were comfortable in accepting it. As for sexual curiosity in puberty, 84.8% of the parents and 95.5% of the teachers responded that it was natural, whereas only 14.7% of teenagers responded that it was natural. But As for the item that 'sex is natural as one of human needs', 3.6% of the teenagers, 16.8% of the parents and only 1.2% of the teachers responded that it was not. As for the item that 'A man has a stronger sexual impulse than a woman', 6.1% of the teenagers, 16.8% of the parents and 17.3% of the teachers responded that it was not. 64.2% of the teenagers and 90.2% of the teachers responded that it was impossible to overcome the sexual impulse, whereas only 8.4% of the parents responded that it was possible. As for the item of masturbation, 64.5% of the teenagers responded that it was possible for male students and not possible for female students. 67.2% of the parents and 91.1% of the teachers responded that it was possible regardless of sex. As for the item of an attitude toward virginal purity, both the parents and teachers showed that virginal purity was important for both man and woman, but teenagers showed a weak awareness of virginal purity. As for the item, 'It is possible to have sexual intercourse with a lover during adolescence', 20.2% of the teenagers, 79% of the parents and 87.7% of the teachers responded that it was impossible. As for the item 'It is necessary to keep premarital virginal purity for a happy married life', 21.1% of the teenagers, 74.8% of the parents and 55.1% of the teachers responded that it was necessary, which shows that teenagers had a different opinion than parents and teachers. In case of pregnancy in adolescence, most of the responding teenagers, parents and teachers chose abortion. As for the item 'female refusal on male sexual approach', respondents accepted female refusal as they did for orders of teachers, parents and adolescents. As for item 'An assaulter is entirely to blame for sexual assault', all of three groups responded in the affirmative.

• 한국임상수의학회지
• /
• 제29권6호
• /
• pp.483-487
• /
• 2012

심장에 발생하는 원발성 그리고 전이성 종양은 개에서는 흔치 않다. 우리는 본 연구에서 심장초음파적 진단을 이용하여 요크셔테리어 2마리에서 발생한 심장내 종괴를 확인하였다. 첫째 증례에서의 종괴는 상행 대동맥과 폐동맥 사이에 위치하고 있었으며, 중증도의 대동맥 역류와 좌심실의 확장을 유발하고 있었다. 이 증례의 환자등급은 ISACHC II 등급의 심부전으로 분류되었다. 환자에 대한 심장처방으로는 furosemide, enalapril, pimobendan 그리고 경구적인 화학요법으로는 lomustine가 처방되었다. 둘째 증례에서의 종괴는 좌심방의 2/3를 차지하고 있었으며, 좌심방의 확연한 확장과 심각한 이첨판 역류 (~5 m/s) 를 유발하고 있었으나, 환자의 심부전 등급은 ISACHC Ib 등급으로 심각한 울혈성 심부전은 나타나지 않았다. 종괴의 성상은 cardiac myxoma로 추정되었으나, 조직생검검사는 보호자의 거절로 인하여 수행되지 않았다. 환자에 대한 심장처방으로는 ramipril, clopidogrel 그리고 기관지 확장제는 aminophylline이 처방되었다. 본 증례의 두 환자들은 여전히 생존해 있으며, 정기적인 검진을 받고 있다.

• 한국간호교육학회지
• /
• 제9권2호
• /
• pp.264-275
• /
• 2003

The purpose of this study were to develop a smoking preventive education program for elementary students and evaluate it's effectiveness. This study was a quasi experimental study under the nonequivalent control group with pretest-posttest design. The subjects of this study were 62 who are attending elementary school(31 for each group), 2 different district elementary school. The subjects were matched by grade, similar in anti-smoking educational background of smoking, as well as their residence and income level of their families. The instruments used in this study was 18 criterion referenced test items modeled by Dick & Carey that were developed by researchers for evaluating the subjects' knowledge and attitude about smoking. A pretest was administered a week before treatment The program given to the experimental group is composed of the texts explaining the poisonous substances in tobacco, social and cultural harmfulness of smoking to the body and psychology, indirect smoking, smoking of pregnant women, motives of smoking, refusal skills of smoking; and for the subjects' understanding and the better results of study - pictures, role play, discussion, text through computer based multi-media, puzzle searching for hidden pictures, cross-word puzzle, and finally compensation. The data were collected for 50 days form mid- September to the end of October in the year of 2000, composed of formative evaluation, pre-test and summative evaluation via 2 sessions. Accordingly, the collected data were analysed by t-test, paired t-test, repeated measure ANOVA by the SAS program. This research summarize the findings as follows; 1. There was a significant difference in knowledge between the experimental group(after 1 wks t=10.4680, p=.0001; after 4 wks t= 9.310, p=.0001) and control group(after 1 wks t=0.0420, p= .9669; after 4 wks t= -0.378 p=.7079) in between the results of 1 and 4 week after education in summative evaluation (F=27.45, P=.0001). 2. There was non statistical significant difference in attitude between the experimental group (after 1 wks t=1.2292, p=0.2286 ; after 4 wks t=1.330, p=0.1935) and control group (after 1 wks t=0.1819, p=0.8569 ; after 4 wks t=0.2970, p=0.7685) in between the results of 1 and 4 week after education in summative evaluation(F=0.71, P=0.494). To sum up, the statistics of conclusive analysis evaluative for the children under school age of the 'knowledge acquisition' about smoking harmfulness. On the other hand, as there was already sound attitude about smoking, the evaluation of attitude was non significant difference between control group and experimental group, just there was partially significant difference.

• Radiation Oncology Journal
• /
• 제13권1호
• /
• pp.19-26
• /
• 1995

Purpose : Surgery is the treatment of choice for resectable non-small cell lung cancer. For patients who are medically unable to tolerate a surgical resection or who refuse surgery, radiation therapy is an acceptable alternative. A retrospective analysis of Patients with stage I non-samll cell lung cancer treated with curative radiation therapy was performed to determine the results of curative radiation therapy and patterns of failure, and to identify factors that may influence survival. Materials and Methods : From 1986 through 1993, 39 Patients with T2N0M0 non-small cell lung cancer were treated with curative radiation therapy at department of radiation oncology, Kyungpook national university hospital. All Patients were not candidates for surgical resection because of either Patient refusal (16 patients), poor pulmonary function (12 patients), old age (7 patients), Poor Performance (2 patients) or coexisting medical disease (2 patients). Median age of patients was 67 years. Histologic cell type was squamous cell carcinoma in 36, adenocarcinoma in 1, large cell carcinoma in 1 and mucoepidermoid carcinoma in 1. All patients were treated with megavoltage irradiation and radiation dose ranged from 5000cgy to 6150cGy with a median dose of 6000cGy. The median follow-up was 17 months with a range of 4 to 82 months, Survival was measured from the date therapy initiated. Results : The overall survival rate for entire Patients was $40.6\%$ at 2 years and $27.7\%$ at 3 years, with a median survival time of 21 months. The disease-free survival at 2 and 3 years was $51.7\%$ and $25.8\%$, respectively. Of evaluable 20 patients with complete response, 15 patients were considered to have failed. Of these, 13 patients showed local failure and 2 patients failed distantly. Response to treatment (p=0.0001), tumor size (p=0.0019) and age (p=0.0247) were favorably associated with overall survival. Only age was predictive for disease-free survival (p = 0.0452). Conclusion : Radiation therapy is an effective treatment for small (less than 3cm) tumors, and should be offered as an alternative to surgery in elderly or infirm patients. Since local failure is the prominent Patterns of relapse, potential methods to improve local control with radiation therapy are discussed.

• 한국산학기술학회논문지
• /
• 제17권12호
• /
• pp.71-80
• /
• 2016

본 연구의 목적은 우리나라 청소년들의 성 행태와 성 경험을 파악하고, 성 경험에 영향을 미치는 예측요인을 규명하여 향후 성 건강 개발을 위한 기초자료를 제공하고자 한다. 연구대상은 2012년 제8차 청소년 온라인건강행태조사에 참여한 중학교 1학년부터 고등학교 3학년까지의 중 고등학생 74,186명이며, 기술통계, $X^2-test$, 복합표본 로지스틱 회귀분석을 실시하였다. 본 연구결과 성관계를 경험한 학생은 중 고등학교 청소년 중 4.3%였으며, 이중 남학생은 5.9%, 여학생은 2.6%로 남학생들의 성경험이 높게 나타났다. 성 경험에 영향을 미치는 유의한 변수는 남학생이 학교급, 아버지 학력, 사회경제적 상태, 아르바이트경험, 학교 성교육경험, 거주형태가 유의한 변수로 확인되었고, 여학생은 학교급, 학교유형(공학여부), 사회경제적 상태, 아르바이트 경험, 학교성교육경험, 거주형태가 유의한 변수로 확인되었다. 본 연구결과에서 남녀모두에서 성 경험에 승산비가 가장 컸던 변수는 아르바이트 경험으로 나타났다. 따라서 어른들에 의한 물리적 성폭력에 대한 심층적인 연구가 더 필요할 것으로 보이며 거절기술이나 의사소통기술과 같은 프로그램이 필요할 것으로 사료된다. 또한 학교성교육을 받은 경험이 있는 남녀 청소년들이 학교 성교육을 받은 적이 없다고 응답한 학생에 비해 성관계 경험이 유의하게 적었던 만큼 학교에서의 성교육을 활성화하는 방안이 필요하다. 이러한 본 연구결과를 바탕으로 청소년 아르바이트경험이 중 어른이나 혹은 물리적 힘에 의한 성폭력을 경험한 적이 있는 지에 대한 지표를 청소년 건강행태온라인조사에 반영하는 방안을 고려해 볼 필요가 있으며, 거절기술이나 의사결정 기술 등 생활기술을 반영한 학교성교육을 강화하는 것이 필요하다.

• 경영정보학연구
• /
• 제25권4호
• /
• pp.291-314
• /
• 2023

데이터 경제의 확산과 함께 개인 데이터를 개인이 주도하는 생태계를 구현하기 위해 마이데이터의 개념이 등장했다. 마이데이터는 다양한 영역에서 개인이 주체적으로 정보를 관리 및 통제하고 이를 통해 기업은 혁신적인 서비스를 제공할 수 있을 것으로 기대되고 있다. 그 중에서도 금융 분야에서는 개인이 마이데이터를 2022년부터 도입하여 활발히 활용하고 있으며 금융기관뿐만 아니라 빅테크 및 핀테크 기업까지도 적극적으로 가세하여 빠른 확장세를 보일 것으로 예상된다. 금융분야에서 마이데이터 산업이 지속적으로 성장하기 위해서는 개인 사용자의 다양한 수용행동을 살펴볼 필요성이 있지만 기존 연구들은 주로 긍정적 수용행동에 초점을 두고 있다는 한계점을 가진다. 이에 본 연구는 혁신저항 및 수용저항에 초점을 두고 사용자의 개인특성과 혁신특성이 미치는 영향을 분석하였다. 분석 결과, 개인정보유출우려, 기술변화속도, 현상유지관성, 정보제공민감성, 기술스트레스가 마이데이터 서비스에 대한 불신과 혁신저항을 증가시킨다는 사실을 발견하였으며 이는 수용지연과 수용거부와 같은 수용행동으로 이어질 수 있음을 확인하였다. 본 연구 결과는 금융 마이데이터 서비스가 확산되고 있는 시장에서 사용자 행동에 관한 이론 및 실무적 통찰력을 제공한다.

• Journal of Hospice and Palliative Care
• /
• 제15권1호
• /
• pp.10-17
• /
• 2012

목적: 완화의료를 위해서는 완화의료 대상자에 대한 판단을 하고 완화의료를 직접 시행하거나 완화의료에 자문/의뢰하는 의료인의 역할이 중요하다. 이에 본 연구는 한국의 암환자를 주로 진료하는 의사들의 완화의료에 대한 인식과 완화의료 의뢰 시 장애요인에 대해 알아보았다. 방법: 2010년 5월부터 6월까지 암환자를 주로 진료하는 전문의 477명을 대상으로 무기명 자기 기입식 웹 설문 조사를 수행하였다. 결과: 총 128명(26.8%)이 응답하였고, 설문에 응답한 모든 의사들은 말기암환자에게 완화의료가 필요하다고 생각하는 것으로 조사되었다. 80% 이상의 응답자들이 '3차 의료기관 및 암센터는 완화의료 서비스를 제공해야 한다.', '진행 암환자는 항암 화학요법을 받는 중이더라도 완화의료를 받아야 한다.', '말기암환자의 치료에는 여러 과의 협력이 필요하다.'에 동의하였다. 완화의료 수행능력에 대해서는 58% 이상이 자신이 하고 있는 신체 증상 조절 및 정신증상 조절, 말기암환자 가족의 정서적 지지에 만족한다고 응답하였으나 전반적인 말기암환자 및 임종 환자 관리 서비스는 64%에서 '만족스럽지 않다'고 응답하였다. 응답자 중 34명(26.6%)은 '자신의 말기암환자를 완화의료팀으로 자문'하거나 '의뢰한 경험이 없는 것'으로 나타났고 완화의료 의뢰의 장애 요인으로 '환자나 보호자의 거부'가 61명(47.7%)으로 가장 많았으며 다음으로 '믿고 의뢰할 수 있는 완화의료팀이 없어서'라고 응답한 의사가 59명(46.1%)으로 많았다. 결론: 본 연구에서 대부분의 암환자를 주로 진료하는 의사들은 말기암환자의 완화의료 시행에 대해 긍정적 인식을 가지고 있지만 실제 말기암환자 진료에 있어 다학제 간 협력이나 임종관리까지 충분한 완화의료의 제공은 이뤄지지 않는 것으로 나타났다. 효율적이고 수준 높은 말기암환자의 관리를 위해서 보다 적극적인 완화 의료 자문이나 의뢰가 시행되어야 할 것으로 생각된다.

• 복식문화연구
• /
• 제8권3호
• /
• pp.387-410
• /
• 2000

The purpose of this study was to approach to the internal meanings included in the Happening and the culture of hippies, by analysing the basic mental conditions in the process of the Happening. And this study was composed of the concept and the development of Happening, the characteristics of the hippies that related in the midst of the happening's background, and the formativeness between these factors and hippies'fashion. Since the happening a genre of fine arts expression attended the New School for social research in New York in 1954, Allan Kaprow direct-influenced by John Cage used the word 'Hapening'first, practicing '18 Happenings in 6 parts'at the Rueben gallery in 1959. Kaprow's 18 Happenings was one of the earliest opportunities for a wider public to attend the live events that several artists had performed more privately for various friends. Despite the very different sensibilities and structures of artist's works, artists were all thrown together by the press under the general heading of 'Happening', following Kaprow's 18 Happenings. Being considered as the root of the Happening 'Expression of Sound'of John Cage was the discovery of the exisiting thing- the Happening. Most artists were to be deeply influenced by Cage's theories and attitudes-that is, his sympathy for Zen Buddihism and oriental philosophy-and by reports of the Black Mountain events. These events would directly reflect contemporary painting and stemmed from the Futurists, Dadaists and Surrealists. And Happening's development background was based on the culture of hippies. Swinging London had been under the sway of psychedelic drugs and utopian visions of 'hippie'wave sweeping in from Califonia. This wave, which affected solid middle-class youth first and formost, began in Haight Ashbury in San Francisco. Without dwelling on the hippie movement here, it is worth nothing that it resulted from the convergence of several undercurrents : consciousness-expending drugs, the anti-Vietnam war developments, the impact of English pop groups on American music and the rise of protest songs, and finally the beatnik tradition of non-conformism. Hippie culture and its pursuit of love, peace and psychedelia was the antitheses of 1960s main street fashion. The media gave everyone with long hair the label of 'hippie', but it was always a very loose collage of attitudes and styles. The rejection of sexual taboos was conveyed by the hippie's refusal to wear. Although the bold exposure of body raised controversies because it went against the existing moral values, it has a significant implications. Psychedelics brought mind-expansion and the possibillity that modern technology (light show, synthesized electronic sounds), new fabrics or colors, and LSD could be utilized to provide an escape route from the dreariness of modern life. During the 1960s, traditional costumes, many of which had never been seen outside their native regions, became sought after and adopted in the West, initially by the young, who wanted to demonstrate their solidarity with cultures uncontaminated by mass industry. The most ardent proponents of such folk costumes were the hippies. Hippies dress was sometimes decribed as 'anti-fashion', produced by a patchwork of ragged cast-offs and flamboyant accessories, of outmoded Western dress and time-honored ethnic garments all combined, modified and permutated into variety of personal statements. 'Flower Power'became a reality. From the results of this study, we can see the expanding trend of the influence and the concept of the sew art genre 'Happening'in the formativeness as well as the fine arts field.