• Title/Summary/Keyword: self therapy

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Evaluation of Therapeutic Effects of Cognitive-Behavioral Therapy in Patients with Panic Disorder using Serial $^{99m}Tc-ECD$ Brain Perfusion (공황장애 환자에서 $^{99m}Tc-ECD$ 뇌관류 SPECT를 이용한 인지행동치료 효과 평가)

  • Kim, Jung-Hee;Song, Ho-Chun;Yang, Jong-Chul;Lee, Byeong-Il;Heo, Young-Jun;Bom, Hee-Seung;Park, Tae-Jin;Min, Jung-Joon
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.6
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    • pp.302-308
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    • 2006
  • Purpose: Although several neuroanatomical models of panic disorder have been proposed, little is known regarding the neurological mechanisms underlying cognitive-behavioral therapy (CBT) in patients with panic disorder. This study was performed to identify the brain structures that show changes of regnioal cerebral blood flow (rCBF) after CBT in patients with panic disorder. Materials and Methods: Seven patients who were diagnosed as panic disorder by DSM-IV were treated with CBT for 8 weeks and twelve healthy volunteers joined in this study. Serial $^{99m}Tc-ECD$ brain perfusion SPECT images were acquisited and PDSS-SR (Self-Report version of Panic Disorder Severity Scale) and ACQ (Agoraphobic Cognitive Question) scores were measured just before and after CBT in all patients. Data were analyzed using SPM2. Results: Subjective symptoms were improved, and PDSS-SR and ACQ scores were significantly reduced ($14.9{\pm}3.9\;vs.\;7.0{\pm}1.8$, p<0.05; $30.3{\pm}8.5\;vs.\;21.6{\pm}3.4$, p<0.05, respectively) after CBT in panic patients. Before CBT, a significant increase of rCBF was found in the cingulate gylus, thalamus, midbrain, both medial frontal and temporal lobes of the panic patients compared to the normal volunteers. After CBT, we observed a significant rCBF decrease in the left parahippocamus, right insula and cingulate gyrus, both frontal and temporal lobes, and a significant rCBF increase in both the occipital lobes, left insula, both frontal and left parietal lobes. Conclusion: These data suggested that CBT is effective for panic disorder and diminish the activity of the brain areas associated with fear in panic disorder.

Clinical Course of Untreated Sarcoidosis (스테로이드 치료를 받지 않은 유육종증 환자의 임상경과)

  • Koh, Young-Min;Chung, Kyeong-Jae;Park, Sang-Joon;Kang, Kyeong-Woo;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.807-816
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    • 1999
  • Background: Sarcoidosis, uncommon in Korea, has variable clinical course, ranging from benign self-limited recovery to life-long disability regardless of corticosteroid therapy. The purpose of this study is to observe the clinical course of untreated sarcoidosis. Methods: Twenty four patients who were confirmed as sarcoidosis by tissue diagnosis were included. For average 12month follow-up periods, subjective symptoms, radiologic findings, and parameters of pulmonary function test(FVC, $FEV_1$, DLco) were evaluated every 3mooths compared between corticosteroid treated(n=5) and non-treated(n=19) patients. 'Deterioration' was defined if patients met more than one of followings (1) decrement in any parameters of pulmonary function test(2) worsening in the degree of dyspnea(3) increase in radiologic extents, and (4) newly developed extrapulmonary sarcoidosis. 'Stable' was defined as no significant interval changes in every parameters. 'Improvement' was defined as decrement of extension of the radiologic lesions without deterioration. Results: Among 19 untreated sarcoidosis patient, one deteriorated, 14 improved(13 of them showed complete resolution in radiology), and 4 were remained stable. On the other hand, five corticosteroid treated patients, uveitis was developed in one, 2 improved, and 2 remained stable. Conclusion : These findings suggest that patient with sarcoidosis, especially those without serious extrapulmonary disease, has stable clinical course and would not need corticosteroid therapy.

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Development and Utility Evaluation of Portable Respiration Training Device for Image-guided Stereotactic Body Radiation Therapy (SBRT) (영상유도 체부정위방사선 치료시 호흡동조를 위한 휴대형 호흡연습장치의 개발 및 유용성 평가)

  • Hwang, Seon Bung;Park, Mun Kyu;Park, Seung Woo;Cho, Yu Ra;Lee, Dong Han;Jung, Hai Jo;Ji, Young Hoon;Kwon, Soo-Il
    • Progress in Medical Physics
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    • v.25 no.4
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    • pp.264-270
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    • 2014
  • This study developed a portable respiratory training device to improve breathing stability, which is an important element in using the CyberKnife Synchrony respiratory tracking device, one of the typical Stereotactic Radiation Therapy (SRT) devices. It produced an interface for users to be able to select one of two displays, a graph type and a bar type, supported an auditory system that helps them expect next respiration by improving a sense of rhythm of their respiratory period, and provided comfortable respiratory inducement. By targeting 5 applicants and applying individual respiratory period detected through a self-developed program, it acquired signal data of 'guide respiration' that induces breathing through signal data gained from 'free respiration' and an auditory system, and evaluated the usability by comparing deviation average values of respiratory period and respiratory amplitude. It could be identified that respiratory period decreased $55.74{\pm}0.14%$ compared to free respiration, and respiratory amplitude decreased $28.12{\pm}0.10%$ compared to free respiration, which confirmed the consistency and stability of respiratory. SBRT, developed based on these results, using the portable respiratory training device, for liver cancer or lung cancer, is evaluated to be able to help reduce delayed treatment time due to respiratory instability and improve treatment accuracy, and if it could be applied to developing respiratory training applications targeting an android-based portable device in the future, even use convenience and economic efficiency are expected.

Comparison of Experimental and Radiation Therapy Planning (RTP) Dose Distributions on Air Cavity (공동(air cavity)의 존재 시 실험적 선량분포와 치료계획상의 선량분포 비교)

  • Kim, Yon-Lae;Suh, Tae-Suk;Ko, Shin-Gwan;Lee, Jeong-Woo
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.261-268
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    • 2010
  • This study is compared that the dose distribution by experimentation and radiation therapy planning (RTP) when the air cavity region was treated high energy photon. The dose measurements were performed with a 6 MV photon beam of linear accelerator. The polystyrene and self made acyl phantom were similar to tissue density of the human body. A parallel plate chamber was connected to an electrometer. The measurement setup was SCD (Source Chamber Distance) 100 cm and the distance of surface from air cavity was 3 cm. Absorbed dose of interface were measured by area and height. The percent depth dose were measured presence and absence of air cavity, depth according to a ratio of field size and air cavity size. The dose distribution on planning was expressed to do the inhomogeneity correction. As the area of air cavity was increased, the absorbed dose were gradually reduced. It was slightly increased, when the height of air cavity was changed from 0 cm to 0.5 cm. After the point, dose was decreased. In case of presence of air cavity, dose after distal air cavity interface was more great than absence of air cavity. The rebuild up by field size and area of air cavity occurred for field size, $4{\times}4\;cm^2$, $5{\times}5\;cm^2$ and $6{\times}6\;cm^2$, with fixed on area of air cavity, $5{\times}5\;cm^2$. But it didn't occur at $10{\times}10\;cm^2$ field size. On the contrary, the field size was fixed on $5{\times}5\;cm^2$, rebuild up occurred in area of air cavity, $4{\times}4\;cm^2$, $5{\times}5\;cm^2$. but, it did not occur for air cavity, $2{\times}2\;cm^2$, $3{\times}3\;cm^2$. All of the radiation therapy planning were not occurred rebuild up. It was required to pay attention to treat tumor in air cavity because the dose distribution of planning was different from the dose distribution of patient.

In vitro Anti-tumor Effect of an Engineered Vaccinia Virus in Multiple Cancer Cells and ABCG2 Expressing Drug Resistant Cancer Cells (재조합 백시니아 바이러스의 다양한 암세포 및 ABCG2 과발현 내성 암세포에 대한 항 종양 효과 연구)

  • Park, Ji Hye;Yun, Jisoo;Heo, Jeong;Hwang, Tae Ho;Kwon, Sang Mo
    • Journal of Life Science
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    • v.26 no.7
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    • pp.835-846
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    • 2016
  • Chemo-resistance is the biggest issue of effective cancer therapy. ABCG2 is highly correlated with multi-drug resistance, and represent a typical phenotype of multiple cancer stem-like cells. Accumulating evidence recently reported that oncolytic viruses represent a new strategy for multiple aggressive cancers and drug resistant cancers including cancer stem cell-like cells and ABCG2 expressing cells. In this study, we generated an evolutionally engineered vaccinia virus, SLJ-496, for drug-resistant cancer therapy. We first showed that SLJ-496 treatment enhanced tumor affinity using cytopathic effect assay, plaque assay, as well as cell viability assay. Next, we clearly demonstrated that in vitro SLJ-496 treatment represents significant cytotoxic effect in multiple cancers including colorectal cancer cells (HT-29, HCT-116, HCT-8), gastric cancer cells (AGS, NCI-N87, MKN-28), Hepatocellular carcinoma cells (SNU-449, SNU-423, SNU-475, HepG2), as well as mesothelioma cell (NCI-H226, NCI-H28, MSTO-221h). Highly ABCG2 expressing HT-29 cells represent cancer stem like phenotype including stem cell marker expression, and self-renewal bioactivities. Interestingly, we demonstrated that in vitro treatment of SLJ-496 showed significant cytotoxicity effect, as well as viral replication capacity in ABCG2 overexpressing cell. In addition, we also demonstrated the cytotoxic effect of SLJ-496 in Adriamycin-resistant cell lines, SNU-620 and ADR-300. Taken together, these findings provide us a pivotal clue that cancer therapy using SLJ-496 vaccinia virus might be new therapeutic strategy to overcome ABCG2 expressing cancer stem-like cell and multiple chemo-resistance cancer cells.

Predicting Healthy Lifestyle Patterns in Older Community Dwelling Adults: A Latent Profile Analysis (잠재프로파일 분석을 활용한 한국 노인 라이프스타일 유형화와 영향요인 분석)

  • Park, Kang-Hyun;Yang, Min Ah;Won, Kyung-A;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.10 no.2
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    • pp.75-93
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    • 2021
  • Objective : The aim of this study was to identify subgroups of older adults with respect to their lifestyle patterns and examine the characteristics of each subgroup in order to provide a basic evidence for improving the health and quality of life. Methods : This cross-sectional study was conducted in South Korea. Community-dwelling older adults (n=184) above the age of 65 years were surveyed from April 2019 to May 2019. This study used latent profile analysis to examine the subgroups. Chi-squared (χ2) and multinomial logistic regression measures were then used to analyze individual characteristics and influencing factors. Results : The pattern of physical activity which is one of the lifestyle domains in elderly was categorized into three types: 'passive exercise type (31.1%)', 'low intensity exercise type (54.5%)', and 'balanced exercise type(14.5%)'. Activity participation was divided into three patterns: 'inactive type (12%)', 'self-management type (61%)', and 'balanced activity participation type (27%)'. In terms of nutrition, there were only two groups: 'overall malnutrition type (13.5%)' and 'balanced nutrition type (86.5%)'. Furthermore, as a result of the multinomial logistic regression analysis to understand the effects of lifestyle types on the health and quality of life of the elderly, it was confirmed that the health and quality of life were higher in those following an active and balanced lifestyle. In addition, gender, education level and residential area were analyzed as predictive factors. Conclusion : The health and quality of life of the elderly can be improved when they have balanced lifestyle. Therefore, an empirical and policy intervention strategy should be developed and implemented to enhance the health and quality of life of the elderly.

A Study of Home Care Needs of Patients at Discharge and Effects of Home Care -Centered on Patients Discharged from a Rural General Hospilal- (퇴원환자의 가정간호요구와 가정간호사업의 효과 분석 - 일 종합병원을 중심으로)

  • Choi, Yun Soon;Kim, Dai Hyun;Storey, Margaret;Kim, Cho Ja;Kang, Kyu Sook
    • The Korean Nurse
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    • v.31 no.4
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    • pp.77-99
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    • 1992
  • The study was carried out at W. hospital, an affiliated hospital of Y university, involved a total of 163 patients who were discharged from the hospital between May 1990 und March 199J. Data collection was twice, just prior to discharge and a minimum of three months post discharge. Thirty patients who lived within a hour travel time of the hospital received home care during the three months post discharge. Nursing diagnoses and nursing interventions For these patients were analyzed in this study. The results of the study are summarized as follows : 1. Discharge needs for the subjects of the study were analyzed using Gordon's eleven Functional categories and it was found that 48.3% of the total sample had identified nursing needs. Of these, the needs most frequently identified were in the categories of sexuality, 79.3 %, health perception, 68.2 % self concept, 62.5 %, and sleep and rest 62.5 %. Looking ut j he nursing diagnosis that were made for the 30 patients receiving home care, the following diagnoses were the most frequently given; alteration in sexual pattern 79.3%, alterations in health maintenance, 72.6%, alteration in comfort, 68.0%, depression, 64.0%, noncompliance with diet therapy, 6.3.7%, alteration in self concept, 55.6%, and alteration in sleep pattern, 53%. 2. In looking at the effects of home nursing care as demonstrated by changes in the functional categories over the three month period, it was Found that of the 11 functional categories, the need level for health perception, nutrition, activity and self concept decreased slightly over the three month period. On the average sleep patterns improved, but restfulness was slightly less and bowel elimination patterns improved but satisfaction with urinary elimination was slightly less. On the other hand, role enactment, sexuality, stress management and spirituality decreased slightly. The only results that were statistically significant at the 0.05 level were improvement. in digestion and decrease in pain. No statistically significant changes were found in ability related to ADL, the total ADL Score at discharge was $19.78{\pm}8.234, and after 3 months $19.01{\pm}8.12$. Considering that a majority of the patients were over 60 years of age and that many had brain or spinal cord injuries, the fact that their ADL ability did nor deteriorate after discharge can be interpreted as related to a positive impact by the home health care nurses. Similarly there was a slight be not statistically significant decrease in the quality of life scores between the two lest times(l47.83 at discharge and 113.02 at the three month period). Again, when the chronic nature of thee problems facing these patients is considered this maintenance of quality of life can be interpreted as a positive impact by the home health care nurses. 3. One of the home care nursing activities was diagnosis. For this activity it was found that for nine functional health categories(sexuality and spirituality excepted) there were 20 nursing diagnoses. The most frequent were noncompliance, alteration in skin integrity both actual and potential, and impaired physical mobility in that order. 4. Delivery of home health care by the home health nurses included the following nursing activities; assessment, patient education, demonstration of care activities, counselling, direct care to the patient and referrals. Direct care included changing dressings, bladder irrigations, changing Foley catheters, measurement of residual urine, perineal care, position change, back care, oral hygiene, exercise and massage of motion exercises, cleansing enemas, tracheostomy suctioning and tracheostomy care, care of dentures, applications of heat and other similar nursing activities. In conclusion almost 50% of (he sample indicated a need for continued nursing care at the time of discharge and for the patients in the sample who received home care there was a slight decrease in nursing needs but while the patients had chronic and debilitation problems there was ill decrease in ADL abilities or in quality of life. Further study needs Lo be done La increase the reliability and validity of the tool that was used to measure home health care needs. It is also recommended that study by done using a randomized sampling with a control group to compare patients who receive home care with those who do not.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Insomnia in Patients with Chronic Renal Failure on Hemodialysis (혈액투석 중인 만성 신부전증 환자에서의 불면증에 대한 연구)

  • Kim, Gyung-Ryul;Yang, Chang-Kook;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.126-132
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    • 1999
  • Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

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A Perspective of Analytical Psychology on 'Yeondo', a Prayer for Souls in Purgatory of Korean Catholic Church (한국 천주교 '연도(煉禱)'의 분석심리학적 고찰)

  • Chun Ja Yeo
    • Sim-seong Yeon-gu
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    • v.31 no.1
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    • pp.1-40
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    • 2016
  • This thesis is a study on the symbolism of 'Yeondo', a prayer for the souls in purgatory of Korean Catholic Church as a 'psychic container' for the spiritual transformation in the psyche from a perspective of analytical psychology. Yeondo' could be the 'rites of passage' of the last judgement for the souls in purgatory which is in between the heaven and the hell. And both the bereaved and the dead go through the stages of separation, transition and incorporation which are the schema of the 'rites of passage'. In particular, they have a special sense of solidarity at the stage of transition, a middle state. The symbolic process of 'Yeondo' is a spiritual transformation of recovery of paradise which could access by the confusion of death, purification and the rebirth. A spiritual reborn process of death and rebirth takes place by contacting the collective unconscious. In 'Yeondo', the death is not the end of life but the beginning of the eternal life. The confusion and disintegration caused by death can be purified and start incorporating. The rites of a paradise recovery has the meaning of trying constantly for the recovery of a wholeness. Praying for the blessing of God and a help from saints in paradise for the sake of the dead means to require conscious cooperation for the Self-realization. Integrating and recognizing unconscious also means something beyond the conscious. The blessed souls in purgatory recovers the paradise experiencing specific purifying process heading towards Self. Going into the center, abyss of unconscious will be recognized as an absolute part of oneself. One becomes the inner man, the transformed personality who is reached by the path of self-knowledge, the kingdom of heaven within oneself and can have the transpersonal energy, which enables to access to God's world and union with God. All desire and the will become one with God. In the final analysis, praying for the blessing of God and a help from saints in paradise for the sake of the dead becomes the path for the more and more conscious expansion of the alive. Therefore, 'Yeondo' as an initiation is the individuation process of the alive and the dead to reflect on themselves.