• 제목/요약/키워드: Sleep loss

검색결과 110건 처리시간 0.025초

Midazolan과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험 -증례 보고- (Treatment of Intractable Hiccup with Midazolam and Baclofen -A case report-)

  • 양내윤;문동언;박철주;권오경;박종민;심재용;최종호
    • The Korean Journal of Pain
    • /
    • 제10권2호
    • /
    • pp.246-249
    • /
    • 1997
  • Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

  • PDF

아토피피부염 환자(患者)의 사상체질별(四象體質別) 신상특징(腎床特徵)에 관한 연구(硏究) (A Study on the Clinical Characteristics of Atopic Dermatitis According to Sasang Constitutions)

  • 임진희;이의주;고병희
    • 사상체질의학회지
    • /
    • 제20권1호
    • /
    • pp.67-88
    • /
    • 2008
  • 1. Objectives The aim of this study was to find out clinical characteristics of atopic dermatitis according to Sasang Constitutions and to help on Sasang Constitutional management and treatment of atopic dermatitis 2. Methods 108patients with atopic dermatitis were involved in the study. The patients had visited C Oriental Clinic from January 2007 to September 2007 and had taken oriental herbal medicine for over one month. They were divided into four groups by Sasang Constitutions and were evaluated the clinical features of atopic dermatitis according to Sasang Constitutions. 3. Results and Conclusions The clinical characteristics for 108 patients with atopic dermatitis was surveyed 1. Soyangin with atopic dermatitis had significantly more Allergic conjunctivitis than other Constitutions, and Taeumin with atopic dermatitis had significantly less Allergic conjunctivitis than other Constitutions. 2. Soyangin with atopic dermatitis had significantly more 'Sleep loss' than other Constitutions. 3. Emotion was significantly more aggravating factor of atopic dermatitis in Soyangin than in other Constitutions. 4. Soeumin with atopic dermatitis had significantly more 'Orbital darkening' than other Constitution. 5. 'Tuna' was significantly more aggravating factor of atopic dermatitis in Soeumin than in other Constitution. The treatment progress for 57 patients with atopic dermatitis was surveyed 6. Soyangin with atopic dermatitis had significantly more improvement than other Constitution and Soeumin with atopic dermatitis had significantly less improvement than other Constitution in Sasang Constitutional Medicine treatment.

  • PDF

COVID-19: "영양 아젠다" (Nutrition agenda during the era of the COVID-19 pandemic)

  • 이명숙
    • Journal of Nutrition and Health
    • /
    • 제54권1호
    • /
    • pp.1-9
    • /
    • 2021
  • This review describes the risk factors of the nutrition crisis in coronavirus disease 2019 (COVID-19) infections and suggests precision nutrition against long-term psychological and physiological stress. The mandatory quarantine and the social distancing are associated with an interruption of the lifestyle routine, resulting in psychological (i.e., boredom) and physiological stress. The stress with multiple causes and forms induces over-compensation of energy-dense food, such as sugary comfort food, and is defined as "food craving" because carbohydrates positively affect the psychological stability with serotonin secretion. The consumption of foods that promote an immune response against viral infections (vitamins & minerals; Cu, folate, Fe, Se, Zn, and Vit A, B6, B12, C, and D), reduce inflammatory cytokines (w-3 fatty acids, Vit D, fibers, and Mg), contain antioxidants (beta-carotene, Vit E, C, Se, and phenolics), and sleep-inducing proteins (serotonin, melatonin, and milk products) is essential. In addition, a reduced Vit D deficiency in winter due to less time spent outdoors under quarantine has been reported to be associated with viral infections. The case fatality rate of COVID-19 was significantly dependent on age, sex, race, and underlying health condition. To prevent malnutrition and cachexia in elderly people, weight loss and muscle wasting should be monitored and controlled. Inadequate protein intake, sedentary lifestyle, and inflammation are significant risk factors for sarcopenia. Moreover, relatively high intakes of fat or carbohydrate compared to low protein intake result in abdominal obesity, which is defined as "sarcopenic obesity." Keeping the food-safety guidelines of COVID-19, this study recommends the consumption of fresh and healthy foods and avoiding sugar, fat, salt, alcohol, and commercially frozen foods.

세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구 (A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE)

  • 왕매련
    • 대한간호
    • /
    • 제31권2호
    • /
    • pp.51-69
    • /
    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

  • PDF

경남소재 일개조선소 근로자의 건강이상소견과 아르곤 용접과의 관련성 (Association between Subjective Distress Symptoms and Argon Welding among Shipyard Workers in Gyeongnam Province)

  • 최우호;진성미;권덕헌;김장락;강윤식;정백근;박기수;황영실;홍대용
    • 한국산업보건학회지
    • /
    • 제24권4호
    • /
    • pp.547-555
    • /
    • 2014
  • Objective: This study was conducted to investigate the association between subjective distress symptoms and argon welding among workers in Gyeongnam Province shipyard. Method: 31 argon and 29 non-argon welding workers were selected as study subjects in order to measure concentrations of personal dust, welding fumes and other hazardous materials such as ZnO, Pb, Cr, FeO, MnO, Cu, Ni, $TiO_2$, MgO, NO, $NO_2$, $O_3$, $O_2$, $CO_2$, CO and Ar. An interviewer-administered questionnaire survey was also performed on the same subjects. The items queried were as follows: age, height, weight, working duration, welding time, welding rod amounts used, drinking, smoking, and rate of subjective distress symptoms including headache and other symptoms such as fever, vomiting and nausea, metal fume fever, dizziness, tingling sensations, difficulty in breathing, memory loss, sleep disorders, emotional disturbance, hearing loss, hand tremors, visual impairment, neural abnormality, allergic reaction, runny nose and stuffiness, rhinitis, and suffocation. Statistical analysis was performed using SPSS software, version 18. Data are expressed as the mean ${\pm}SD$. An ${\chi}^2$-test and a normality test using a Shapiro wilk test were performed for the above variables. Logistic regression analysis was also conducted to identify the factors that affect the total score for subjective distress symptoms. Result: An association was shown between welding type (argon or non-argon welding) and the total score for subjective distress symptoms. Among the rate of complaining of subjective distress symptoms, vomiting and nausea, difficulty breathing, and allergic reactions were all significantly higher in the argon welding group. Only the concentration of dust and welding fumes was shown to be distributed normally after natural log transformation. According to logistic regression analysis, the correlations of working duration and welding type (argon or non-argon) between the total score of subjective distress symptoms were found to be statistically significant (p=0.041, p=0.049, respectively). Conclusion: Our results suggest that argon welding could cause subjective distress symptoms in shipyard workers.

관절염을 앓고 있는 노인 여성 피로 경험의 근거 이론적 접근 (A ground theory approach on fatigue of the female elderly with osteoarthritis)

  • 권영은;정명실
    • 근관절건강학회지
    • /
    • 제3권1호
    • /
    • pp.50-62
    • /
    • 1996
  • The purpose of this study was to identify and construct a substantive theory about the experience of fatigue among the female elderly with osteoarthritis. The interviewees were 6 female elderly with osteoarthritis. Of them 3 were admitted General hospital, the remaining 3 didn't admitted hospital. The data were collected through in-depth interviews by the investigators from May 20th, 1995 to June 19th, 1995. The collected data were coded into concepts and categories according to Strauss & Corbin's grounded method. The data thus collected were analyzed immediatly after interviews and fed into next round of interviews until the data collection reaches the saturation point where no additional concepts emerge. The 35 concepts were from analyzing the grounded data. The results of this study were as follows : 'change of the health condition','change of the life pattern', 'physiologic change', 'change of the coping pattern', 'performance of homework', 'activity daily living', 'tireness', 'ache', 'change of general apperance', 'sleep disturbance', 'powerlessness'. 'Physiologic unbalance', 'change of the family dynamics', 'physical imbalance', 'loss of the control', aviodance', 'conversion', 'leaving', 'indifference', 'hesitation', 'the pursue of information and trial', 'the western therapy', 'heat therapy', 'the oriental therapy','exercise', 'weight control', 'support', 'solution', 'being as before', 'adding more'. Six categories emerged from the analysis of ground data. They were as follows : 'stimuli', 'fatigue', 'passive coping', 'active coping', 'disolution', 'remains'. 13 hypothesis were derived from the integration of categories as follows : 1. The stronger the stimulus as perceived by the subjects, the more the fatigue will exrerience. 2. The more severe the fatigue, the more severe the tireness. 3. The more severe the fatigue, the more the hardness. 4. The more severe the fatigue, the more the variability of appear will experience. 5. The more severe the fatigue, the more the pain will experience. 6. The more severe the fatigue, the more the insomnia will experience. 7. The more severe the fatigue, the more the powerless will experience. 8 The more severe the fatigue, the more the psychological unbalance will experience. 9. The more severe the fatigue, the more variability of the family dynamics will experience. 10. The more severe the fatigue, the more the physical unbalance will experience. 11. The more severe the fatigue, the more loss of control will experience. 12. The subjects who experienced the fatigue will be to show passive coping and active coping mechanism.

  • PDF

Identification of an effective and safe bolus dose and lockout time for patient-controlled sedation (PCS) using dexmedetomidine in dental treatments: a randomized clinical trial

  • Seung-Hyun Rhee;Young-Seok Kweon;Dong-Ok Won;Seong-Whan Lee;Kwang-Suk Seo
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • 제24권1호
    • /
    • pp.19-35
    • /
    • 2024
  • Background: This study investigated a safe and effective bolus dose and lockout time for patient-controlled sedation (PCS) with dexmedetomidine for dental treatments. The depth of sedation, vital signs, and patient satisfaction were investigated to demonstrate safety. Methods: Thirty patients requiring dental scaling were enrolled and randomly divided into three groups based on bolus doses and lockout times: group 1 (low dose group, bolus dose 0.05 ㎍/kg, 1-minute lockout time), group 2 (middle dose group, 0.1 ㎍/kg, 1-minute), and group 3 (high dose group, 0.2 ㎍/kg, 3-minute) (n = 10 each). ECG, pulse, oxygen saturation, blood pressure, end-tidal CO2, respiratory rate, and bispectral index scores (BIS) were measured and recorded. The study was conducted in two stages: the first involved sedation without dental treatment and the second included sedation with dental scaling. Patients were instructed to press the drug demand button every 10 s, and the process of falling asleep and waking up was repeated 1-5 times. In the second stage, during dental scaling, patients were instructed to press the drug demand button. Loss of responsiveness (LOR) was defined as failure to respond to auditory stimuli six times, determining sleep onset. Patient and dentist satisfaction were assessed before and after experimentation. Results: Thirty patients (22 males) participated in the study. Scaling was performed in 29 patients after excluding one who experienced dizziness during the first stage. The average number of drug administrations until first LOR was significantly lower in group 3 (2.8 times) than groups 1 and 2 (8.0 and 6.5 times, respectively). The time taken to reach the LOR showed no difference between groups. During the second stage, the average time required to reach the LOR during scaling was 583.4 seconds. The effect site concentrations (Ce) was significantly lower in group 1 than groups 2 and 3. In the participant survey on PCS, 8/10 in group 3 reported partial memory loss, whereas 17/20 in groups 1 and 2 recalled the procedure fully or partially. Conclusion: PCS with dexmedetomidine can provide a rapid onset of sedation, safe vital sign management, and minimal side effects, thus facilitating smooth dental sedation.

일 지역 성인의 구강건강실태에 관한 조사연구 (A study on the status of the Dental Health of Adults)

  • 정영숙
    • 보건교육건강증진학회지
    • /
    • 제17권1호
    • /
    • pp.95-113
    • /
    • 2000
  • The purpose of this study is to investigate the state of the dental health of adults, used self-reporting qestionnaire as objects of 923 residents living in nine districts at random among the sites of eleven town located in a County. The level of knowledge on dental health of adults in a County was 65.6 points out of 100 points, comparatively low. Accodingly, it is necessary for entire adults to have a dental health-related education and get high standard of knowledge. Especially, educational approach should be performed for groups of 40-49 years old, 50-59 years old, above 60 years old, male, no educational background, having only elementary and middle school education, not having any jobs, engaging in agriculture, doing business on their own and so on. When planning the contents of health education, one actually has to include the habit of amalgam, the factor in influencing on dental health as well as show an example such as how to brush teeth, checking point of proper brushing, how to grip toothbrush. The attitude score related to dental heath was 71.2 points out of 100 points, relatively low. Consequently, the change of attitude related the dental health among entire adults is necessary, particularily, the strategical approach is essential to change dental health connected to attitude positively for groups of male, having high school education background, office workers and the civil service. Besides, among dental health related symtoms, more that 30-40% of objects showed negative attitude toward as the following cases; in case that plaque or food debris are attached to the teeth (40.8%), upper and lower teeth do not fit together(40.3%), you cannot sleep well because of toothache(31.0%), more than one tooth fall out(31.0%), you have loosing teeth(30.6%), the approach should be conducted to form attitude that dental care is necessry. The state of dental health through dental health related symtoms was 33.3 points out of 100 points, which was fairly satisfactory. However, dental treatment for the state of dental health should be executed in case of comparison of the dental health state according to general characteristics, the group who are above 60 years old, have elementary school education background, engage in aggriculture who are not good in dental health state as opposed to other groups. Furthermore, there should be dental care needs according to dental health related symtoms, particularly, more than 60-70% of objects have experienced symtoms that plaque or food debris attached to the teeth, tartar is on the teeth so dental treatment should be peformed for a large number of adults. In addition, for the people who have indications that there was a cavity, more than one tooth loss, chilled teeth, toothache when chewing, loose teeth, upper and lower teeth do not fit together, you cannnt sleep well due to the toothach, etc, there should be care through dental treatment. The actual conditions of the hygine of the mouth was relatively good and the difference of the actual state of dental health care in terms of general characteristics showed in only gender; female was more careful in dental health. Comparing the state of oral health synthetically, when they have symtoms, only 34.8% of objects go to a dentist, 60.7% are using passive or negative care such as gargling, tolerating or ignoring. There was many symtoms to care through dental therapy such as plaque or food debris get in between the teeth, tartar on the teeth, teeth are very cold, more than one tooth fallout, loose teeth, there is wrong amalgam, and so on, among symtoms to care passively or negatively. Therefore the education for proper treatment program should be performed. As a result of dental health-related knowlege, attitude, health state, verification of correlation between the actual condition of care, the higher the dental heath-related knowldege becomes, the more positive the dental health-related attitude is, and the state of dental health, that is, the standard of the symtom of dental health diminishes. the care for dental health executed through more active method and the more positive dental health-related attitude is, the more active means they performed. Consequently, the high level of dental health-related knowledge should be necessary, the more positive the dental health-related attitude was, the more active method they adopted, therefore, the program is needed to form attitude related to the dental health positively. As the knowledge on dental health is increasing, the attitude is also positive, after all, the plan to increase the standard of knowledge on dental health should be contrived through education program related to dental health.

  • PDF

중국 거주 조선인의 불안과 우울에 관한 실태 (Anxiety and Depression of The Korean Residents in China)

  • 사공정규;정성덕;김창수;김철구;김봉진
    • Journal of Yeungnam Medical Science
    • /
    • 제9권2호
    • /
    • pp.275-287
    • /
    • 1992
  • 중국연변자치구에 있는 연길시에 거주하는 주민중, 조선족472명과 한족479명을 대상으로 1991년 1월에서 1991년 3월까지 통합불안우울척도를 사용하여 평가한 결과는 다음과 같다. 불안, 우울성적의 총평균점은 조선족이 $29.70{\pm}7.03$이었고 한족은 $29.45{\pm}9.01$로 유의한 차이가 없었고, 항목별성적에서 조선족이 높게 평가한 불안-우울척도의 상위 항목들은 피로, 소화불량 및 식욕감소, 수명장애, 악몽, 건강염려등이며 조선족이 낮게 평가한 하위수준의 항목은 졸도감, 두려움, 자살의도, 절망감, 이상감각 등이며 한족이 높게 평가한 상위 항목은 피로, 악몽, 불안감, 불만족, 정신붕괴, 건강염려등이었으며 한족이 평가한 하위수준의 항목은 두려움, 졸도감, 이상감각, 체중저하, 자살의도 등이었고, 두그룹비교에서 조선족이 한족에 비해 높게 평가한 항목은 소화불량 및 식욕감소(p<0.01), 수면장애(p<0.01), 건강염려, 감소된 성욕(각각p<0.05) 등의 항목이며 한족이 높게 평가한 항목은 안면 홍조p<0.01), 불안감, 불만족, 자살의도(각각p<0.05) 등의 항목이었다. 통합 불안, 우울척도의 총점이 50점이상인 고득점자는 조선족이 12명(2.54%) 한족이 21명(4.38%)였다. 사회정신의학적 요인 평가에서 양궁 모두 여성 20세미만의 경우(각각p<0.01),와 가정분위기에 불만인 경우(각각p<0.01), 정신과적 입원 경험이 있는 경우(조선족p<0.01, 한족p<0.05)와 과거, 현재, 미래에 대한 자아관의 태도가 비관적인 경우(각각p<0.01) 유의하게 높은 성적을 보였으며 종교의 요소에 대해서는 유의한 차이가 없었다. 결혼 여부에 대해서는 조선족에서는 이혼 및 별거의 경우 높았고, 한족에서는 미혼인 경우 높았으며(각각p<0.01), 교육에 대해서 조선족은 무학의 경우 높았고, 한족은 대졸의 경우 높았으며(각각p<0.01), 성장지에 대해서는 조선족의 경우 성장지별간에 유의한 차이점은 없었으나, 한족의 경우 대도시에서(p<0.01) 유의하게 높은 성적을 보였다. 현재 거주지에 대해서 조선족은 기숙사의경우 높았고, 한족은 자취의 경우 높았으며(각각p<0.01), 잡비에 대해서 조선족은 $1미만에서 높았고, 한족은 $7-10의 경우 높았다(각각p<0.01).

  • PDF

항암제 투여 환자의 우울 양상 (The Characteristics of Depression in Cancer Patients on Chemotherapy)

  • 주열;서완석;김진성;이종범;정성덕;송신호;배대석;이경희;현명수
    • 정신신체의학
    • /
    • 제10권2호
    • /
    • pp.154-165
    • /
    • 2002
  • 목적: 입원 치료 중인 항암제 투여 환자의 우울 양상을 알아보기 위해 본 연구를 시행하였다. 방법: 2001년 11월부터 12월까지 영남대학교 의과대학 부속병원 종양내과에 입원한 대상으로 Beck's depression inventory(이하 BDI), Zung's depression scale (이하 ZDS), Hamilton depression scale(이하 HDS)을 시행하였고 정신과적 면담을 통해 축 I 질환을 진단하였다. 결과: 대상군에서 각 우울 척도의 평균 접수는 BDI 18.27${\pm}$7.73, ZDS 36.51${\pm}$10.82, HDS 15.14${\pm}$6.60으로 나타났다. 성별, 결혼상태, 종교에 따른 우울척도의 차이는 나타나지 않았다. 대상은 위암 13명, 폐암 11명, 혈액종양 10명, 기타 종양 3명(자궁암 2명, 두경부암 1 명)이었다. 고용량의 항암치료를 받는 기타 종양군의 HDS, ZDS 점수가 다른 종양군에 비해 높았다. 8명(21.6%)은 주요우울장애로, 11명(29.7%)은 적응장애로 진단되었다. 주요우울장애군에서 ZDS의 우울감, 일의 어려움, 불안, 정신활동성 지체 항목의 점수가 다른 진단군에 비해 높았다. 장애군에서 ZDS의 변비, 피로, 식욕 감소, 공허감, 수면장애, 불만족, 체중감소 항목, HDS의 건강염려증, 초조, 피로, 성욕 감소 문항의 점수가 높았다. 결론: 항암제 투여 중인 입원 환자에 있어서 적응장애와 주요우울장애와 같은 정신과적 질환이 동반될 수 있다. 정신의학적 접근이 암환자의 삶의 질을 증가시키고 치료 순응도 측면에 있어서도 중요하다. 항암제 치료중인 환자의 우울 장애 진단시 우울 증상과 혼동될 수 있는 다양한 선체 증상을 감별하기 위하여 암의 부위, 임상 경과, 치료 방법, 항암제의 부작용에 대한 고려가 선행되어야 할 것으로 생각된다.

  • PDF