• 수면정신생리
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• 제29권2호
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• pp.40-44
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• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• Journal of Korean Biological Nursing Science
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• 제16권4호
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• pp.309-317
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• 2014

Purpose: The purpose of this study was to understand sleep circadian rhythm and sleep quality between normal-weight and obese group according to Body Mass Index to develop education and nursing intervention programs for the obese. Methods: This study involved 186 subjects who visited at S hospital obesity clinic, K province. They were divided into 2 groups: normal-weight group 91 and obese group 95. Data were collected from October 18th to November 12th in 2013. Data were analyzed with frequency, percentage, ${\chi}^2$-test, Mann-Whitney U test, ANCOVA, t-test and ANOVA with using SPSS version 20.0. Results: The results showed that morning type 1.1%, middle type 91.2% and evening type 7.7% of sleep circadian rhythm in normal-weight group and middle type 92.6% and evening type 7.4% of sleep circadian rhythm in obese group. There were statistically significant results on sleep quality with covariance sex and stress, sleep duration, habitual sleep efficiency and sleep disturbance between normal-weight and obese group. There were statistically significant results on sleep quality, sleep duration, habitual sleep efficiency and sleep disturbance in middle type of sleep circadian rhythm between normal-weight and obese group. Conclusion: Therefore, it is necessary to consider subject's sleep pattern to develop education and nursing intervention programs for the obese.

• 한국임상수의학회지
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• 제27권4호
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• pp.440-444
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• 2010

5.2 kg의 7살령 중성화 된 수컷 시추가 심각한 신경증상(paddling, 무의식, 실명, 발작)으로 내원하였다. 내원 당시 ECG 상에 심실 유래의 심박동 약 140회의 가속성 심실 고유박동(AVIR)이 지속적으로 나타났다. 이 환축은 자기공명영상법(MRI)과 뇌척수액검사(CSF)를 통해 파종성 육아종성 뇌수막염(GME)로 잠정 진단 내려졌다. 신경증상은 스테로이드제와 항경련제, 이뇨제, 항생제, 20% 만니톨 정맥 주사 등으로 호전 되었으며 부정맥은(AIVR) mexiletin으로 통제되었다. 신경학적인 문제에 대한 응급 처치 후 증상의 호전에도 불구하고 항부정맥제 처치 없이는 심장의 리듬이 불안정 했기 때문에 항부정맥 처치는 신경증상이 완전히 소실 될 때까지 유지되었다.

• Childhood Kidney Diseases
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• 제16권1호
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• pp.1-8
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• 2012

야간 다뇨는 야뇨증의 중요한 원인 중 하나로 거론된다. 소변 양을 조절하는 항이뇨호르몬의 일중 변동의 부적절한 조절, 고칼슘뇨증, 용질 이뇨가 야간 다뇨의 원인으로 생각되며, 이러한 기전들로 야간의 소변량이 많은 환자에서 방광용적이 상대적으로 작고 잠에서 깨어나기 어려운 경우 야뇨증이 발생한다. 야뇨증 환자에서 이러한 요인들을 평가하여 개개인에게 적절한 치료를 도입하여야 할 것이다.

• Clinical and Experimental Pediatrics
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• 제53권6호
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• pp.680-687
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• 2010

Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

• 수면정신생리
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• 제20권1호
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• pp.10-14
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• 2013

Sleep disturbances are commonly encountered problems in cancer patients. Sleep has a role in maintenance of immunity, metabolism, and quality of life but little has been known about the prevalence, risk factors, and effects on prognosis of sleep disturbances in patients with cancer. Also little attention has been made on proper assessment and management of sleep disorders in these patients. Recently, there have been some reports that sleep disorders are related with development of many cancers such as breast, colorectal, prostate, and endometrial cancers. An intermittent hypoxia and a disruption of circadian rhythm are considered as one of the possible mechanisms of cancer developments. More aggressive evaluation and meticulous management of sleep disturbances in cancer patients are essential to improve quality of life as well as prognosis.

• 대한간호학회지
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• 제40권1호
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• pp.43-51
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• 2010

Purpose: The purpose of this study was to investigate sleep habits, sleep disturbance, and circadian types, and to identify factors influencing sleep disturbance in nursing students. Methods: Participants were 140 senior nursing students. The data were collected from May 19 to 27, 2008 using self-report questionnaires. Results: 1) Evening type delayed sleep-wake schedules were more frequent than for morning type, especially during weekend and evening shift duty. 2) In total sleep time, there were no significant statistical differences between morning type and evening type during weekdays, weekend, day or evening shift duty. 3) On weekdays and day shift duty, the mean score for sleep disturbance was significantly higher in the evening type compared to the morning type. 4) Sleep disturbance in weekday and day shift duty was influenced by circadian types, eating habits, and gender. Conclusion: The circadian types are a very important factor for determining the sleep quantity and quality in nursing students.

• Journal of Chest Surgery
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• 제23권1호
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• pp.192-200
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• 1990

The results of conventional operative resection of diffuse subaortic stenosis[tunnel subaortic stenosis] have been less than satisfactory. We have performed modified Konno operation to enlarge the outflow tract of both ventricle with a patch in three patients with diffuse tunnel subaortic stenosis in the department of Thoracic and Cardiovascular Surgery, Seoul National University Children`s Hospital. Preoperative left ventricular aortic pressure gradients were 135 mmHg, 50 mmHg, 80 mmHg respectively in these patients. After right ventriculotomy, the septotomy was done and extended beyond the limit of the stenosis and fibrous and/or muscular tissue was removed from each edge of septal incision. After adequate widening of the tunnel subaortic stenosis with various patches, right ventricle was closed primarily or with prosthetic patches successfully. One patient who was diagnosed as complete atrioventricular septal defect had complete AV block preoperatively and was implanted permanent pacemaker, and others who were sinus rhythm preoperatively have no serious postoperative rhythm disturbance. One patient developed mild postoperative aortic insufficiency and one who had preoperative aortic insufficiency has still same grade of aortic insufficiency after operation. All had good postoperative hemodynamics without any postoperative residual pressure gradient.

• 한국임상수의학회지
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• 제24권2호
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• pp.218-224
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• 2007

소동물 임상에서 디지털 심전도기가 일반 아날로그 방식의 심전도기를 빠르게 대체하고 있다. 이러한 디지털 심전도기는 일반 아날로그 방식의 심전도기에 비해서 심전도 자료의 저장 능력, 이동성 및 넓은 임상적 적용 범위를 갖는 장점이 있다. 본 연구에서는 소동물 임상에 있어서 이러한 디지털 심전도기의 유용성을 연구하였고, 실제 심장전도계 장애가 있는 4마리의 개를 진단하고 치료하였다.

• Journal of Korean Biological Nursing Science
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• 제23권3호
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• pp.227-236
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• 2021

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW_shift) and free days (SDF_shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL_shift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW_D was shortest (4.68 hr) and SDF_E was longest (8.93 hr) in the EG. SJL_D was longest in the EG (3.77 hr), and SJL_N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.