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Correlations between Neurologic and Psychiatric Symptoms in Acute Stroke Patients (급성기 뇌졸중 환자에서 신경 및 정신 증상간 상호관계)

  • Kang, Hee-Ju;Bae, Kyung-Yeol;Kim, Sung-Wan;Kim, Jae-Min;Shin, Il-Seon;Park, Man-Seok;Cho, Ki-Hyun;Yoon, Jin-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.20 no.2
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    • pp.98-104
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    • 2012
  • Objectives : This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. Methods : For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale(NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). Results : At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. Conclusions : More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.

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Comparisons of Subjective and Actigraphic Measurements of Sleep between Shift-working and Daytime Psychiatric Nurses (정신과 교대근무와 주간근무 간호사에서 수면의 주관적 및 활동기록기 평가의 비교)

  • Kwak, Jun;Yoon, Bo-Hyun;Jeon, Bong-Hee;Sea, Young-Hwa;Song, Jye-heon;Park, Su-hee;Kim, Kyung-Min;Jung, Ha-ran;Jeong, Yu-Ran;Park, Jinhyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.2
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    • pp.166-175
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    • 2017
  • Objectives: Shiftwork is known to be one of the common causes of sleep and health problems and finally causes the decreased quality of life. The purpose of this study was to investigate the sleep patterns of shift-working and daytime psychiatric nurses using actigraphy and compare it with subjective assessment for sleep. Methods : Twenty-three shift-working and 25 daytime nurses were enrolled. They rated their sleep quality using Pittsburgh Sleep Quality Index(PSQI) and other self-rating scales were measured for psychosocial aspects. Actigraphy was applied to the subjects for a total of 7 days to measure the sleep parameters. They also wrote sleep diaries during the period of wearing actigraphy. Sleep-related parameters of actigraphy, global score and components of PSQI, and the results of other self-rating scales were compared between shift-working and daytime nurses. Results : Although the global score of PSQI did not show significant difference, the PSQI components showed significant differences between two groups: the shift-working nurses showed lower sleep quality, more sleep disturbance and hypnotic medication use, and worsened daytime dysfunction than daytime nurses. The shift-working nurses showed significantly shorter total time in bed and total sleep time, lower sleep efficiency, and longer average awakening time than those of daytime nurses in actigraphy. Conclusions : The results showed that shift-working nurses experienced more sleep disturbances in both subjective and objective aspects of sleep than daytime nurses. This study also suggests that actigraphy may be useful to measure the objective aspects of sleep that are difficult to assess with subjective questionnaires alone.

Adolescent obesity and the elevation of aminotransferase levels (청소년 비만과 혈청 아미노 전이 효소 증가)

  • Kim, Su Yeon;Lee, Ho Jun;Park, Tae Su;Kim, Soo Geun;Shin, Hye Jung
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1037-1041
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    • 2006
  • Purpose : The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). Methods : We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was $15.7{\pm}0.7$ years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. Results : The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : $32.1{\pm}34.3U/L$, overweight : $19.6{\pm}13.6U/L$, control : $12.7{\pm}6.7U/L$, P<0.001). The average AST level was also different according to group(obese : $27.8{\pm}16.5U/L$, overweight : $22.8{\pm}8.6U/L$, control : $20.8{\pm}8.5U/L$, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). Conclusion : The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase levels.

The prevalences of asthma and allergic diseases in Korean children (한국 소아알레르기 질환의 유병률)

  • Hong, Soo-Jong;Ahn, Kang-Mo;Lee, Soo-Young;Kim, Kyu-Earn
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.343-350
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    • 2008
  • Asthma and allergic diseases are one of the most common disorders in children. Due to its increased prevalence, as well as the increased morbidity and mortality from these diseases, asthma and allergic diseases have come to be recognized as a major worldwide public health issue. In addition, socioeconomic burden of asthma and allergic diseases has increased in Korea also. The International Study of Asthma and Allergies in Childhood (ISAAC) investigated the worldwide prevalence of asthma and other allergic diseases using simple standardized methods because of the comparison of asthma and allergic diseases between the countries. In Korea, several epidemiologic studies have been conducted to determine the prevalence of asthma in children. Although these studies showed increased prevalence of asthma among Korean children (from 3.4% in 1964 to 10.1% in 1989), these findings were based on data from small numbers of subjects. The first Nationwide Study of Asthma and Allergies in Korean Children, which utilized the Korean version of ISAAC written and video questionnaire, was conducted in 1995 and the second Nationwide Study of Asthma and Allergies in Korean Children was conducted in 2000, directed by the Korean Academy of Pediatric Allergy and Respiratory Diseases. We report here the prevalence of asthma and other allergic diseases in Korean children and adolescents, and show the changes that occurred over this 5 year period. We also describe the risk factors for development of these diseases in Korean children. We developed Korean versions of the ISAAC written (WQ) and video (AVQ) questionnaires for allergic diseases. In 1995, the enrolled population consisted of 25,117 children selected from 34 elementary school and 14,946 children selected from 34 middle school across the nation, the response rate was 94.8%. In 2000, 27,831 children selected from 34 elementary school and 15,214 children selected from 34 middle school, and the response rate was 96.4%. From these studies, we can confirm that increase of the prevalences of asthma, allergic rhinitis, and atopic dermatitis in Korea, except the prevalence of food allergy. Especially, the video questionnaire showed increases in the lifetime and 12 month prevalence rates of wheeze at rest, exercise-induced wheeze, nocturnal wheeze, nocturnal cough, and severe wheeze over this period of time in middle school children. In addition, the increase of prevalences of symptoms, diagnosis and treatment of atopic dermatitis was noted significantly. Risk factor analysis showed that body mass index (BMI), passive smoking and living with a dog or cat were associated with higher risk of wheeze. Also the occurrence of fever during infancy and the frequent use of antibiotics were associated with the risk of wheeze. In conclusion, during the 5 year period from 1995 to 2000, the prevalences of asthma, allergic rhinitis, and atopic dermatitis has increased in Korean children. BMI, passive smoking, living with a dog or cat, the fever episodes in infancy, and the frequent use of antibiotics in infancy are important risk factors to development of asthma and atopic dermatitis. In the near future, the birth cohort study will be needed to investigate the causes of this increase and the natural course of allergic diseases, then we develop the methods to control asthma and allergic diseases.

Accuracy of the 24-hour diet recall method to determine energy intake in elderly women compared with the doubly labeled water method (에너지 섭취 조사를 위한 24시간 회상법의 정확도 평가: 여자노인을 대상으로 이중표식수법을 이용하여)

  • Park, Kye-Wol;Go, Na-Young;Jeon, Ji-Hye;Ndahimana, Didace;Ishikawa-Takata, Kazuko;Park, Jonghoon;Kim, Eun-Kyung
    • Journal of Nutrition and Health
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    • v.53 no.5
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    • pp.476-487
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    • 2020
  • Purpose: This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. Methods: The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/㎡. The total energy expenditure (TEEDLW) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. Results: TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by -533.9 ± 228.0 kcal/day (-25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW, showed that the agreement between them was negatively skewed, ranging from -980.8 kcal/day to -86.9 kcal/day. Conclusion: This study showed that the energy intake of elderly women was underreported. Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

Energy expenditure of physical activity in Korean adults and assessment of accelerometer accuracy by gender (성인의 13가지 신체활동의 에너지 소비량 및 가속도계 정확성의 남녀비교)

  • Choi, Yeon-jung;Ju, Mun-jeong;Park, Jung-hye;Park, Jong-hoon;Kim, Eun-kyung
    • Journal of Nutrition and Health
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    • v.50 no.6
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    • pp.552-564
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    • 2017
  • Purpose: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system ($K4b^2$) and to assess the accuracy of the accelerometer (Actigraph $GT3X^+$) by gender in Korean adults. Methods: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the $K4b^2$ portable indirect calorimeter and predicted by the $GT3X^+$ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. Results: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and $K4b^2$ was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. Conclusion: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.

Differences in serum ferritin and vitamin D levels of Korean women with obesity and severe obesity (비만과 고도비만 한국 여성의 혈청 페리틴과 비타민 D 수준의 비교)

  • Kang, Nan Hui;Park, Ji Sook;Lee, Hongchan;Yim, Jung-Eun
    • Journal of Nutrition and Health
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    • v.53 no.4
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    • pp.381-389
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    • 2020
  • Purpose: This study examined the relationships among serum ferritin, vitamin D, folate, iron, and vitamin B12 as indicators of obesity. The results provide the basic data for the prevention and treatment of obese and severely obese people. Methods: This study selected 44 people from 18 years of age or older to 59 years. This study used the indicators of the body mass index (BMI) to analyze obesity as the obesity group (BMI of 25.0-29.9 kg/㎡) and as the severe obesity group (BMI ≥ 30.0 kg/㎡). Of the 44 subjects, 23 and 21 subjects were in the obesity and severe obesity groups, respectively. Their height, weight, body fat, skeletal muscle mass measured using bioimpedance analysis, and measured serum nutrients and biochemical parameters. Results: The obesity group showed a significantly lower age, body weight, BMI and body composition, body fat mass, and body fat percentage, and the height was significantly lower in the severe obesity group. The results of the biochemical parameters of the subjects showed that the levels of aspartate transaminase, alanine transaminase, hemoglobin A1c, total cholesterol, and triglyceride were within the normal range, and there was no significant difference between the 2 groups. The levels of folate, vitamin B12, 25-hydroxyvitamin D3, iron, and ferritin were almost normal, and there was no significant difference between the 2 groups. Conclusion: This study revealed an association with the serum nutrients and obesity, but there was no difference between the obesity group and severe obesity group. Observations of the nutrient levels in not only the blood in obesity and severe obesity but also in red blood cells and tissues will be necessary.

Human Risk Assessment of Polybrominated Diphenyl Ethers by Breast Milk Feeding of Infants (영유아의 모유 섭취에 따른 폴리브롬화디페닐에테르의 위해성 평가)

  • We, Sung-Ug;Cho, Bong-Hui;Cho, Yu-Jin;Yoon, Cho-Hee;Choi, Shi-Nai;Min, Byung-Yun
    • Journal of Korean Society of Environmental Engineers
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    • v.34 no.2
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    • pp.109-118
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    • 2012
  • This study achieves results from 22 maternity breast milk samples in total to demonstrate exposure level and risk assessment of PBDEs in Seoul area. PBDEs were detected in all the breast milk samples of the present study, indicating that general population in these Seoul area are widely exposed to these chemicals. Residue levels of total PBDEs (sum PBDEs from tri- to hepta-BDE) ranged of 0.84~13.1 ng/g lipid with an arithmetic mean and median of 3.56 ng/g lipid and 2.6 ng/g lipid, respectively. Global comparison shows that the levels of total PBDEs were relatively similar to those of China, Taiwan and European country (Sweden), and somewhat higher than those in some Asian (Vietnam, Philippines, and Indonesia). In the present study, however, the levels of total PBDEs in human milk are still one to two orders of magnitude lower than those in North America. Contribution rate of each congener appeared to be predominant with BDE-47, followed by BDE-153, BDE-100, BDE-99, BDE-154 and BDE-183. The sum of BDE-47 and BDE-153 accounted for more than 65% of total PBDEs in most samples. From the result of the human risk assessment of infants for total PBDEs and BDE-47 by breast milk feeding, we could find out that the average daily doses and hazard index (95th percentile) were 16.5 ng/kg bw/day and $1.2{\times}10^{-1}$ each other when nursing for 6 months after infants born. However, it was concluded that the infant health hardly had adverse seriously effects under this research condition.

Effects of Liquid Culture of Coriolus Versicolor on Lipid Metabolism and Enzyme Activities in Rats Fed High Fat Diet (운지버섯 균사체 배양액이 고지방 식이를 급여한 흰쥐의 지질대사 및 효소활성에 미치는 영향)

  • 문상필;고진복
    • Journal of Nutrition and Health
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    • v.37 no.2
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    • pp.88-94
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    • 2004
  • The effects of liquid culture of Coriolus versicolor on weight gain, food intakes, food efficiency ratios, serum and hepatic lipid concentrations, serum protein levels and serum enzyme activities, were studied in growing male rats. Sprague-Dawley rats were given four different types of diets for a succeeding period of 5 weeks, respectively: a normal diet group (7% corn oil), a high fat diet group (7% corn oil+15% lard), a 20% or 30% C. versicolor diet groups (high fat diet+20% or 30% C. versicolor in water) according to the levels of C. versicolor supplementation. The body weight gains of the rats fed the 30% C. versicolor diets were lower than those in the rats fed high fat diet. The epididymal fat pad weight of the rats fed high fat diet and 20% or 30% C. versicolor diets were significantly higher than that of the rats fed normal diet. The concentrations of triglyceride in the serum and the liver of the rats fed the 30% C. versicolor diets were more significantly decreased compared to rats on the high fat diet. The concentrations of total cholesterol in the serum and the liver of rats fed the high fat diet, 20% and 30% C. versicolor diets were similar to those of rats fed the normal diet. The HDL-cholesterol concentration and the HDL-cholesterol/total-cholesterol ratio of the rats fed 20% and 30% C. versicolor diets were significantly lower than those of the rats fed high fat diet. But the antherogenic index of the rats fed 20% or 30% C. versicolor diets were significantly higher than those of the rats fed high fat diet. There were no differences in the activities of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and alkaline phosphatase in the serum among the experimental groups. These results showed that the 30% C. versicolor diet feeding decreased the triglyceride in serum and liver of the rats.

The Effect of Grape Seed Oil, Perilla Oil, or Corn Oil-Containing Diet on Lipid Patterns in Rats and Fatty-Acid Composition in Their Liver Tissues (포도씨유, 들깨유 및 옥수수유의 급여가 흰쥐의 체내 지질패턴 및 간조직의 지방산 조성에 미치는 영향)

  • Kang Myung-Hwa;Park Won-Jong;Lee Ji-Hyun;Chung Hae-Kyung
    • Journal of Nutrition and Health
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    • v.38 no.1
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    • pp.3-10
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    • 2005
  • The study analyzed the lipid patterns and fatty acid compositions of serum and liver tissues in groups of Sparague-Dawley rats. Some of the groups were fed with an basal diet, which contained com oil (C), grape seed oil (GSO), or perilla oil (P), and the others were fed with a high fat diet, which had cholesterol (1%) and lard (10%) mixed with corn oil (CHF), grape seed oil (GSHF), or perilla oil (PHF). The amount of dietary intake was higher for the basal diet groups than the high fat diet groups. And diet efficiency was significantly low in the group of rats fed with the basal diet mixed with perilla oil. From the analysis of the serum lipid patterns, a significant decrease in total lipid concentration was observed in the group of rats fed on the basal diet mixed with perilla oil and the high fat diet group. The levels of triglyceride and phospholipid were significantly low in the basal diet group when perilla oil or grape seed oil was involved. The ordinary diet groups showed significantly higher in HDL-C than the high fat diet groups. There was no significant difference among the basal diet groups, whether the diet was mixed with grape seed oil, perilla oil, or com oil. However, a significant increase in HDL-C was observed in the group of rats fed with the high fat diet containing perilla oil. For LDL-C, there was a significant difference between the high fat diet groups and the basal diet groups. LDL-C was especially low in the group of rats fed with the high fat diet to which perilla oil was added, and the grape seed-added high fat diet group showed a decreasing tendency in LDL-C. The content of total fat, total cholesterol, and triglyceride was the lowest in the group of rats fed with the perilla oil-containing basal diet, and this group was followed in order by the grape seed oil-containing diet group and com oil-containing diet group. In the analysis of the fatty-acid composition in liver tissue, the high fat diet groups showed an increase in saturated fatty acids and polyunsaturated fatty acids, but a decrease in mono unsaturated fatty acids when compared to the basal diet groups. The composition ratio of fatty acids varied according to which type of oil the diet contains. Our finding suggest that grape seed oil was an apparent diet effect on the fatty-acid composition.