• 성인간호학회지
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• 제23권1호
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• pp.60-71
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• 2011

Purpose: This study explored cardiovascular health (CVH), depressive symptoms, and well-being among community-based Korean women according to hwa-byung (HB) symptoms. Methods: This cross-sectional study measured HB symptoms, depressive symptoms, quality of life (QoL), and spiritual well-being (SWB) in addition to biophysical indicators of CVH. Results: Fourteen women of the HB group are more likely to live alone with lower income than 36 women in the comparison group. Compared to the comparison group, the HB group has larger mean waist circumference and higher prevalence of abdominal obesity along with more knee arthritis and back pain. Although women in the HB group appeared worse in other CVH than their counterparts, this was not statistically significant. It is noteworthy, that the HB group showed a higher probability of having a hard cardiovascular event (CVE) within 10 years than the comparison group. Women in the HB group reported more depressive symptoms, poor QoL, and low SWB as well as smoking and sleep difficulties. Conclusion: Despite the small sample size, significant relationships of HB symptoms to abdominal obesity, the probability of a hard CVE within 10 years, and psychosocial health were found. Strategies for effective community-based cardiovascular programs for Korean women may include HB screening and/or management.

• 대한간호학회지
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• 제37권3호
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• pp.313-323
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• 2007

Purpose: Health-related quality of life (HRQOL) in patients with cardiovascular disease in Korea has rarely been studied, mostly due to the lack of a psychometrically validated disease-specific instrument. The purpose of this study was to develop and validate a cardiovascular specific-HRQOL questionnaire (CD-QOL). Method: The CD-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. Patients were recruited from three-university hospitals. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, SF-36, and CES-D. The NYHA and KASI classifications were used to classify the functional performance of the patients. The data was analyzed using correlation, factor analysis, multidimensional scaling, multitrait/multi-item matrix, ANOVA, and Cronbach's alpha. Result: Preliminarily, thirty-nine items were generated. Factor analysisextracted a five-factor solution with a total of twenty-two items. One item was deleted based upon the MDS. The remaining items were moderately correlated with the subscales of the SF-36 and associated with depression measured with the CES-D. The mean scores of patients in NYHA and KASI class I were significantly higher than those in NYHA and KASI class II or/and III, which suggested patients with better functional performance were likely to have a better HRQOL. Cronbach's alphas of the total and subscales were all greater than 0.70. Conclusion: The CD-QOL is a easily applicable instrument with excellent psychometric properties of content, criterion, factorial, convergent, and known-groups validity, and internal consistency reliability in Korean patients with cardiovascular disease.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.523-528
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• 2006

목 적 : 선천성심질환 청소년의 우울정도와 극복력의 상관관계를 파악하고 우울과 관련된 변수를 확인하고자 하였다. 방 법 : 선천성심질환으로 수술을 받고 2개 대학병원 및 심장전문병원에 등록되어 추적관찰 중인 만 13-18세 청소년 231명을 대상으로 하였다. 연구 도구는 만성질환아를 대상으로 개발한 극복력 도구와 Beck의 우울척도를 8-18세에 맞게 변형시킨 Kovasc의 CDI를 사용하였다. 결 과 : 선천성심질환 청소년의 우울정도는 0-54점 가능 점수에서 평균 16.74점이었고, 극복력은 70-160점 가능 점수에서 115.84점이었다. 극복력에 따른 우울정도는 극복력과 우울은 유의한 역상관관계(r=-0.59, P<0.01)를 나타났다. 또한, 극복력의 하부 개념인 개인내적요인(r=-0.69, P<0.01), 대처양상(r=-0.39, P<0.05), 대인관계(r=-0.59, P<0.01)도 우울정도와 통계적으로 유의한 역상관관계를 보였다. 다중회귀분석 결과 선천성심질환 청소년의 우울과 관련된 유의한 변수는 부모의 양육태도(${\beta}=-0.48$, P<0.01) 및 극복력(${\beta}=-0.62$, P<0.01)으로 나타났다. 결 론 : 선천성심질환 청소년에서 청소년 자신의 극복력이 높을수록 부모가 긍정적인 양육태도를 가질수록 우울정도가 낮음을 알 수 있었다. 따라서 환자 자신의 극복력을 파악하고 증진할 수 시킬 수 있는 심층 연구와 선천성심질환 청소년과 같이 만성질환을 가진 자녀의 부모에게 양육태도의 중요성을 가질 수 있도록 돕는 중재개발이 필요하다.

• 동의신경정신과학회지
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• 제12권2호
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• pp.37-51
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• 2001

The clinical study was carried out the 43 patients with Depression who were treated in Department of Neuropsychiatry, College of Oriental Medicine, Dae Jeon University from 22 February 2000 to 14 November 2001. The results were summarized as follows. 1. The ratio of male and female was 10:33, 60's(32.6%) was frequent, no inducing factor(38.3%) was seen in a lot of cases and many patients came to our hospital by way of west-neuropsychiatry(56.8%). 2. The period of clinical history was frequent from 3 to 10 years(23.2%), the most frequent preceding disease was cardiovascular systemic disease(18.4%). 3. The main clinical symptoms were apprehension alpitation(13.4%), anorexia(9.8%), headache nuchal region stiffness(9.8%), general body weakness(6.5%), chest discomfort(6.5%), dizziness(5.7%), febris(5.3%) and constipation(5.3%). 4. The patient's tongue aspect had pink tongue and empty fur(32.6%) and pulse type had thin and deficient pulse(39.5%). The prescription drugs were Chunggansoyo-san(30.0%), purging liver and alleviating depression to regulate qi, and Guibiondam-tang(15.8%) eliminating phlegm, cooling pericardium and warming gallbladder. 5. The curve was within normal range at Psychoneural system(81.4%), and Visceral system(90.1%). 6. The regulation was Normal(48.1%), RL(27.9%), RR(20.2%) at Psychoneural system and Normal(45.9%), RL(28.5%), RR(20.3%) at Visceral system. 7. Activity and Reactivity had much lower response at 1th, 2th, 3th, 4th, 7th SANGHAN, Polalization had much higher response at 1th, 4th, SANGHAN and much lower response at 2th, 3th, 7th SANGHAN.

• The Korean Journal of Pain
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• 제11권1호
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• pp.91-95
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• 1998

Background: Quality of postoperative care may be improved by management of postoperative pain. Epidural anesthesia and analgesia have several advantages over general anesthesia and parenteral analgesics in managing the postoperative pain. We retrospectively reviewed records of obstetrical patients who underwent the cesarean sections under epidural anesthesia to evaluate perioperative analgesic use, side effects, and complications. Methods: All patients received epidural anesthesia consisting of 0.25% bupivacaine, 2% lidocaine and 100 ${\mu}g$ fentanyl, followed by epidural analgesia with 0.1% bupivacaine and 12.5 ${\mu}g$/ml fentanyl at rate of 2 ml/hr for 48 hours. Patients' records were reviewed for: medications administered for pain relief, incidence of nausea and vomiting and pruritus, and presence of respiratory or cardiovascular depression. Results: Over 18 months, 1,054 patients' records were reviewed. Average age was 27.8 years (18~43 years). 768 patients (72.9%) received no additional drugs for the pain relief. Intramuscular analgesics, ketoprofens, were one time administered to 247 patients (23.4%), 39 patients (3.7%) received two more dosages. The time of administration was $8.3{\pm}4.3$ hours postoperatively. Antiemetics, for example, low-dose droperidol, were administerd one time for 160 patients (15.2%), 5 patients (0.5%) received two or more administrations. The medication was administered $5.1{\pm}4.2$ hours postoperatively. Drugs for relief of pruritus, low-dose naloxone, were administered one time for 108 patients (10.2%), 10 patients (0.9%) received 2 or more dosages. The time of administration was $6.3{\pm}4.2$ hours postoperatively. None of the patients experienced cardiovascular nor respiratory (<8 breath/min) depression. Conclusions: Postoperative continuous epidural analgesia in combination with bupivacaine and fentanyl is an effective method of providing postoperative analgesia with low incidence of side effects.

• 한국보건간호학회지
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• 제10권1호
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• pp.80-94
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• 1996

This study was to investigated the complaints of physical and mental health problem of professors and officials in H University of Seoul and collected during the period from April 25 to May 31. 1995. The complaints of physical and mental health problem were measured by Cornell Medical Index. The results of this study are as follows: 1. Among the items of physical health problem. respondents showed the highest rate of complaints related to fatigability. and among the items of mental health problem. respondents showed the highest rate of complaints related to inadequacy. 2. Females showed significantly higher rates of complaints related to the musculoskeletal system(p<0.001), fatigability(p<.001). habits(p<.01), inadequacy(p<.05). and tension(p<.001) compared with those of males. Twenties showed significantly higher rates of complaints related to the digestive system(p<.01) compared with those of other age groups. Singles showed significantly higher rates of complaints related to the digestive system(p<.05). inadequacy(p<.01) and depression(p<.001) compared with those of marries. Officals showed significantly higher rates of complaints related to the cardiovascular system(p<.01). digestive system(p<.05), musculoskeletal system(p<.05), and tension(p<. 05) compared with those of professors. Resondents who have irregular eating habits showed significantly higher rates of complaints related to the digestive system(p<.01), musculoskeletal system(p<.05). habits(p<.05). and depression(p<.001) compared with those of respondents who have regular eating habits. Respondents who usually sleep below 6 hours a day showed significantly higher rates of complaints related to the cardiovascular system(p<.01). digestive system(p<.05). musculoskeletal system(p<.01). fatigability(p<.05). habits(p<.01). and tension(p<.05) compared with those of respondents who sleep above 6 hours.

• 대한안전경영과학회지
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• 제15권2호
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• pp.1-7
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• 2013

Based on a literature review regarding shift work, it is recognized that it has an adverse effect on workers' health. Especially, the night shift rather than the day shift imposes severe disorders on workers, which are indicated to dyssomnia, maladaptation to social life, and health problems such as gastroenteric trouble, cardiovascular diseases and depression. As the shift work can be explainable by using workers' labor ability necessarily to maintain company business consistently, it does not consider biorhythm, active mass and health condition of workers Actually duration of shit work would deprive workers of fundamental life rights by causing physical and mental effects. As a result of reviewing previous case studies related to effect of work pattern (day shift and night shift) on workers' health, an incidence of physical diseases like dyssomnia, gastroenteric trouble, cardiovascular diseases and premature delivery was higher in shift workers than normal workers. Additionally the incidence of mental disorders such as busy brain, social isolation, depression and work stress was also higher in shift workers than normal workers. These adverse physical and mental problems were intensified to night shift workers compared to day shift workers. Considering current various reports and study results, it is recommended that the shift work, especially the night work pattern, should not apply to contemporary work situation for sustaining workers' health condition constantly.

• 수면정신생리
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• 제11권2호
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• pp.100-105
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• 2004

목 적：본 연구의 목적은 주요우울장애환자를 대상으로 Heart Rate Variability(HRV) 검사를 이용하여 비침습적으로 자율신경계의 기능, 심혈관조절체계 및 항상성을 측정하여 정상대조군과 비교해보고 생리학적, 임상적 의미를 고찰해보는 것이다. 방 법：DSM-Ⅳ의 진단기준에 의하여 주요우울장애로 진단받은 환자 30명과 정상대조군 30명을 대상으로 하였다. 검사는 SA-2000E 기기를 사용하여 HRV parameter를 측정한 후 시(time) 영역과 주파수(frequency)영역별로 분석하였다. 결 과：Heart rate(HR)는 환자군에서 유의하게 증가된 소견을 나타내었으며 the standard deviation of the NN interval(SDNN), the root square of successive differences(RMSSD)도 환자군에서 유의하게 낮은 소견을 보였다. Total power(TP) band, very low frequency(VLF：$0.003{\sim}0.04\;Hz$) band, low frequency(LF：$0.04{\sim}0.15\;Hz$) band, high frequency(HF：$0.15{\sim}0.4\;Hz$) band는 환자군에서 유의하게 낮은 수치를 보였고, LF/HF의 비는 유의한 차이를 나타내지 않았다. 결 론：우울증 환자는 심박수의 증가와 HRV의 감소를 보였으며, 교감 신경과 미주 신경의 불균형이 높은 심혈관계 사망률과 부분적으로 연관이 있는 것 같다. 우울증 환자들은 심장에서 자율신경기능의 이상을 나타내며 이렇게 교감/부교감 신경활성 조절능력이 저하되어 균형이 깨짐으로써 높은 심혈관계 사망률을 보인다고 할 수 있다.

• 정신신체의학
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• 제15권1호
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• pp.51-55
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• 2007

연구목적 : 비만과 우울증은 모두 심각한 공공 의료 문제이고 특히 주된 심혈관계 질환 위험인자이다. 비만과 우울증 상에 관한 해외 연구는, 일정한 결론은 아니나, 여러 연구에서 연관성 존재를 보고하고 있고 특히 일부 연구는 여성에서 그 연관 정도가 큼을 보고 한 바 있다. 본 연구는 한국 여성에서 있어 비만, 특히 복부비만과 우울증상의 연관성을 분석하고자 한다. 방법: 여성 연구 대상자 4,609명을 대상으로 Beck 우울 척도 및 체계측을 시행한 결과를 이용 우울증상과 비만과의 연관성을 분석하였다. 비만도는 체질량지수로 정하였으며 체질량지수 $25kg/m^2$ 이상을 비만으로 하였고 복부비만은 허리둘레 85cm 이상으로 정의하였다. 임상적으로 우울증을 의심할 수 있는 Beck 우울척도 분할점은 16점으로 하였다. 결과: 정상 체중군에 비해 비만 여성군에서 우울 여성의 비율이 유의미하게 높았고(27.6% VS. 23.2%, p<0.01), 복부 비만 여성에서도 우울 여성군의 비율이 통계적으로 유의하게 높았고(26.9% VS. 22.7%, p<0.01), 비만 여성군 중 우울 여성에서 복부 비만 가진 비율이 통계적으로 유의미하게 높았다(93.2% VS. 86.9%, p<0.01). 결론 : 본 연구의 결과는 한국 여성에서 비만, 특히 복부비만과 우울증간 연관성이 존재함을 보였고 향후 전향적 연구를 통한 비만과 우울증간 상호 역할에 대한 적극적 이해가 필요함을 시사한다.

• 대한약리학회지
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• 제19권1호
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• pp.61-69
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• 1983

Hypothermia is an essential preparatory procedure for cardiac surgery, which lows the metabolic rate and myocardial oxygen demand. However, hypothermia itself is a stress enough to change the tonus of sympathoadrenal system, especially the cardiovascular responses to the catecholamines. It is reported that the positive chronotropic and inotropic response of catecholamines is exaggerated during hypothermia because of decreased norepinephrine uptake at the junctional cleft or decreased catecholamine metabolism. On the other hand, there are evidences of diminished catecholamines responses in low temperature ana further, interconversion of adrenergic receptors is also suggested. Present investigation was planned to observe the cardiovascular changes and its responses to catecholamines during surface hypothermia in cat. Healthy mongrel cats, weighing $2{\sim}3\;kg$, anesthetized with secobarbital(30 mg/kg), were permitted to hypothermia by external cooling technic. Esophageal temperature, ECG (lead II), heart rate, left ventricular pressure with dP/dt, carotid artery pressure and left ventricular contractile force were monitored with Polygragh (Model 7, Grass), and the respiration was maintained with artificial respirator (V 5 KG, Narco). Followings are summarized results. 1) Surface cooling caused progressive decrease of body temperature and reached $l8.8{\pm}0.8^{\circ}C$ and $16.9{\pm}0.6^{\circ}C$ in 120 and 150 min respectively, after immersion into ice water, and ventricular fibrillation was developed at $20.4{\pm}0.65^{\circ}C$. 2) Heart rate, blood pressure and myocardial contractility were decreased after initial increase as the body temperature falls. 3) Systolic and diastolicdd P/dt of left ventricular pressure were decreased and that the decrement of diastolic dP/dt was more marked. 4) On ECG, ST depression, Twave inversion and prolongation of PR interval were prominent in hypothermia, and moreover, the prolongation of PR interval was marked just prior to the development of ventricular fibrillation. 5) The cardiovascular responses to catecholamines, especially to isoproterenol, were suppressed under hypothermia.