• Title, Summary, Keyword: Eating Disorder

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Deep Sedation for Palate Alginate Impression Procedure in a Post-Fontan Procedure Patient with Mental Retardation (Fontan 수술을 받은 정신지체 소아에서 인상채득을 위해 시행한 깊은 진정)

  • Lee, Jung-Man;Seo, Kwang-Suk;Kim, Hyun-Jeong;Shin, Soon-Young;Shin, Teo-Jeon
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.1
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    • pp.45-50
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    • 2012
  • The Fontan operation is a heart operation used to treat complex congenital heart defects like tricuspid atresia, hypoplastic left heart syndrome, pulmonary atresia and single ventricle. A single ventricle is dedicated to pumping oxygenated blood to the systemic circulation and the entire systemic venous return reaches the pulmonary arterial system without the direct influence of a pumping chamber. In the patient with Fontan operation, it is important to achieve adequate pulmonary blood flow and cardiac output in anesthetic management. In this case, a 10-year-old boy (19.6 kg, 114 cm) with cleft palate, cerebral palsy and severe mental retardation, who underwent a Fontan operation when he was 4 years old, was presented for deep sedation. Because he was suffering from eating disorder with cleft palate, the orthodontist and the plastic surgeon planned to insert intraoral orthodontic device before cleft palate repair. But it was impossible to open his mouth for alginate impression procedure. After careful pre-anesthesia evaluation we planned to administer deep sedation with propofol infusion. After Intravenous catheter insertion, we started propofol intravenous infusion with the formula of a loading dose of 1.0 mg/kg followed by an infusion rate of 6.0 mg/kg/hr with syringe pump. His blood pressure was remained around 80/40 mmHg after loss of consciousness, but he could not maintain his airway patent. So we lowered the infusion rate to 3.0 mg/kg/hr, immediately. The oxygen saturation was maintained above 95% with nasal oxygen supply, and blood pressure was maintained around 100-80/60-40 mmHg. After the sedation of 110 minutes with propofol (the infusion rate to 3.0-5.0 mg/kg/hr), he fully regained consciousness, and was discharged without complication after 1 hour observation. In case of post-Fontan patient, intravenous deep sedation with propofol was safe and effective method of behavioral management during dental treatment.

The Effect of Some Dental Clinic Workers' Working Environment and Health Habit Upon Their Musculoskeletal Disorder Subjective Symptom (일부 치과종사자들의 근무환경과 건강습관이 근골격계 자각증상에 미치는 영향)

  • Kim, Chang-Hee;Nam, Soo-Hyoun;Lee, Ji-Youn
    • Journal of dental hygiene science
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    • v.9 no.5
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    • pp.531-538
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    • 2009
  • This study examined the musculoskeletal symptom experience rate of some dental clinic workers and the factors influencing musculoskeletal symptoms according to their working environment and health habit. To that end, between March 9 and March 28, 2009, 200 workers at dental clinics in Chungcheong-do were surveyed using the self-administered questionnaire method. The data were analyzed using the SPSS WIN 12.0 program. The following conclusion was reached. 1. One-year musculoskeletal symptom experience rates of the subjects were categorized according to pans of the body: shoulders - 60.5%, lower limbs (legs, knees, and feet) - 57.0%, the lumbar region (back and waist) - 56.0%, the neck - 51.0% and the upper limbs (arms, wrists, and fingers) - 32.0%. 2. In general characteristics, a statistically significant difference was found according to gender, age, education, position, and oral health state. In working environments, a statistically significant difference was found according to work experience, the average daily number of patients handled, the average daily working hours, the posture for diagnosis, and satisfaction over work. In health habit, a statistically significant difference was found according to regular exercise, regular examination, and regular eating habit. 3. Factors influencing musculoskeletal symptoms were examined. As a result, influencing the musculoskeletal symptom experience were satisfaction over work among working environment characteristics, and regular exercise among health habit characteristics.

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Development of a Korean Version of the Levels of Emotional Awareness Scale(LEAS-K) (한국판 감정자각 수준 척도의 개발)

  • Lee, Jung-Jae;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.60-68
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    • 2003
  • Objectives: The purpose of this study was to develop a Korean version of the Levels of Emotional Awareness Scale(LEAS-K) and to examine its validity and reliability. Methods: LEAS-K was developed from translating original LEAS into Korean. The subjects were 476 Korean medical students(322 males and 154 females). The internal consistency was evaluated with the Cronbach's alpha coefficients and 40 protocols were independently scored by two raters to confirm interrater reliability. Additionally, a Korean version of 20-item Toronto Alexithymia Scale(TAS-20K), Korean versions of the Openness to Experience Inventory(OE), the Marlowe-Crowne Scale (MCS), the Bendig short form of the Taylor Manifest Anxiety Scale(TMAS) and the Emotional Expressivity Scale(EES) were rated to evaluate concurrent validity. Results: The internal consistency measured by Cronbach's alpha was 0.81 and interrater reliability was high{r(40)=0.99}. Correlation coefficients for concurrent validity were nonsignificant with TMAS and EES. LEAS-K correlated significantly with TAS-20K{r(476)=-0.10, p<0.05}, OE {r(476)=0.10, p<0.05} and MCS {r(476)=0.10, p<0.05}. Conclusion: LEAS-K was demonstrated to have high reliability and validity.

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Reliability and Validity of Korean Version of the SWAL-QOL (한국판 SWAL-QOL의 신뢰도와 타당도)

  • Kim, Se-Yun;Cha, Yu-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2981-2988
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    • 2014
  • The Purpose of the this study was to identify reliability and validity of the Korean version of the Swallowing Quality of Life questionnaire(KSWAL-QOL). The study was performed in 71 patients diagnosed dysphagia by videofluoroscopy and 80 healthy swallowers. The reliability was good with a Cronbach's ${\alpha}$ and intraclass correlation coefficient of .86~.96 and .80~.93, respectively. The Pearson product moment correlation coefficients between KSWAL-QOL scales ranged from .17~.74 which was showed significant correlation. Healty swallowers scored higher than dysphagic patients on all scales and statistically significant differences were observed across all the scales between healthy swallowers and dysphagic patients(p<.01). Tube feeders scored lower than non-tube feeders on all scales and statistically significant differences were observed in all the scales except sleep(p<.05). There are significant difference between diet steps in all scales except eating desire, communication, fear and people on diet fourth step feeding had the highest scores on the all scales(p<.05). Because KSWAL-QOL seems to be a reliable and valid tool, it is considered to be appropriate as a tool to measure quality of life of patient with swallowing disorder.

A Study on Dietary Behavior and Health Condition of Employees at Department Stores (백화점 종사자의 식행동과 건강상태에 관한 조사)

  • Kim, Hye-Kyung;Kim, Jin-Hee;Park, Young-Sook
    • Korean Journal of Community Nutrition
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    • v.13 no.3
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    • pp.374-385
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    • 2008
  • A study has been performed to provide the basic information about the current dietary habits, health related behaviors, and body indices and to bring forward the importance of this information to the people's attention based upon the relation between employee's life patterns and health conditions in their daily lives. Three hundred and five department store workers were examined from August 2006 to September 2006. With the average BMI values $23.9{\pm}2.2$ for males and $20.0{\pm}1.9$ for females, both gender groups were in normal, but 62.2% of the males were overweight and 15.4% of the females were under-weight. Regarding dietary and health related factors on how they perceive themselves, as normal were 204 (66.9%) the most and bad and very bad were respectively 43 (14.1%) and 5 (1.6%). Half of the subjects (43.2%) perceived sleeping hours to be insufficient, and 64.4% of them need to exercise regularly. As problems related to eating habits, they reported irregular meal times, overeating, preference of hot and spicy food, skipping meal, unbalanced meals. Regarding weight control they have attempted were the most (73.0%), after weight reduction, 51.2% of the subjects had side effects, such as gastrointestinal troubles, anemia, dizziness, sense of fatigue, constipation, physiological disorder, and diarrhea, etc. In the food habit score, it was shown that overall average score of the subjects was $62.63{\pm}9.86$ which is lower than other studies. Female ($62.76{\pm}10.15$) had better score than male ($61.67{\pm}8.06$). While the item with the highest point was eat all three meals of the day, that was the lowest point, exercise every day. The food habit score of the younger group had lower than older group, and also they preferred sweet foods to other group. The results suggest that nutrition education for workers at specific working fields needs to be more focused on the improvement of dietary habits and health status of workers.

Study on Effective Utilization Strategies of the Home Health Care Program in the Community Care Service of Welfare Policy (재가 복지 봉사 사업의 가정 간호 사업연계 필요 조사)

  • Kim, Sung-Sil
    • Journal of Korean Academy of Community Health Nursing
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    • v.7 no.2
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    • pp.183-202
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    • 1996
  • This study was designed out to develop a home health care service for nurses working in community care services. This study investigates actual conditions at welfare institutions related to health needs the demands of clients, and the state of home health care services we hope that this study will improve upon the current service system. In Korea home health care services are still developing and only new becoming a part of the health care supply system. The data was collected by recording the client home nursing assessments modified to the situation of UTMB home health agency. In this study 107 clients were selected for home care who needed care for physical and mental deficits. The study lasted from March to November of 1995 at one of the welfare service institutions in Chunchon city. The results show that those who most frequently needed care services were over 50 years old with a health deficit of 80.3%, followed by sex as women who needed care at 59.8%. 50.5% of the clients had very little education. 99.1% of the clients live with their family, and a medical diagnostic analysis reveals that 73.9% of the 5 year period of illnesses were the following : 38.8% - muscular -skeleton system disorder, 24.4% - hypertension and stroke, 25.7% sole disease of arthritis. For behavioral conditions 43.3% of the patients were without care services, 56.6% of the patients were taking treatment that 73.5% of those were taking medication. The most main complaint of patients were 22.4% of pain in the extremities, next were 16.8% of a limitation of body activities, 15.0% was lumbo-sacralgia. According to the investigator who was a senior student nurse, the following suggestions were made: 32.7% for curative medical services, 29.9% for physical exercise, 19.6% for emotional support. Consultation nursing services consisted of 67.2% for physical therapy, 11.2% for the maintaining healing, 9.4% for counseling. The patients at home, required assistance most frequently for muscular-skeleton problems under the category of physical systems (33.3%). But, on the other hand, 49.5% of the patients required care givers at home, 28.2% had a knowledge deficit, 21.0% had malnutrition, 18.4% had bad impaired communication. The character of health problems were devided into chronic disease(67.0%), accidents(I3.1%), and general disease(15.9%). 86% of the disabled client had an impairment of the physical system. Eating (86.9%) , Toileting(77.6%), and personal care showed much the same of ADL condition, the level and range of achievement of mobility, the most frequently self performed was 81.3% only in a room size area, and 40.2% were completely dependent when going out. Although there were a large number of home care services in th community at these welfare institutions, many clients needed a variety of curative services. As policy changes have gathered momentum, responsibility for the development of a more suitable program was demanded by the clients from the community.

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Effects of Ondamtang, Samulansintang and Shihosogansan Water Extract on the Obesity and Stress (온담탕(溫膽湯)과 사물안신탕(四物安神湯) 및 시호소간산(柴胡疏肝散)이 비만(肥滿)과 스트레스에 미치는 영향(影響))

  • Lee Sang-Yong;Ryu Hui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.3 no.1
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    • pp.25-45
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    • 1992
  • Many phychiatrists have reported that the change of serotonin concentration would cause mental disorder and affect the pathological conditions such as schizophrenia, depression and eating behabior. The end product of serotonin metabolism was excreted as 5-HIAA in urine. Serum lipids, according to the report, were concerned with obesity, said it was. This study aims to observe the changes of plasma serotonin, urinary 5-HIAA and serum lipids, making use of Fat Cell Mass rate of 27 normal persons and 42 psychosomatic patients. For this, I also observed the change of serotonin, 5-HIAA and lipids of the psychosomatic patients by the use of 3 kinds of herbs as treatment medication on the basis of physical symptoms and the results were obtained as follows; 1. Urinary 5-HIAA is correlated with the body water rate(r=0.381), while reversely correlated with the Fat Cell Mass rate(r=-0.330). 2. Compared the control group with the patients group for the serum lipids value, they showed the significant results ; $146.4{\pm}5.71$ mg/dl and $166.9{\pm}6.56$ mg/dl in the total cholestrol value over- weights, $471.2{\pm}42.99$ mg/dl in the total lipid value, and $158.1{\pm}6.50$ mg/dl and $181.1{\pm}6.30$ mg/dl in the phospholipid of the obesity, respectively. 3. With comparison of each group to other group to the others for Fat Cell Mass rate, the total cholesterol showed the significant differences when the Fat Cell Mass rate was 20% or more, HDL-cholesterol value when 30% or more, and triglyceride when 30% or more, respectively. 4. there was significant variations in the relations between Fat Cell Mass rate and body water, which body mass index was increased as the body water was decreased. 5. Fat Cell Mass rate was correlated with Cholesterol(r = 0.420), triglyceride (r = 0.443), and $\beta$-lipoprotein(r = 0.450) of serum lipids, while reversely correlated with HDL -Cholesterol(r = -0.354) and urinary 5- HIAA had the correlation coefficient of -0.330. 6. What related with body water rate urinary 5-HIAA (r = 0.381) and $\beta$-lipoprotein(r = -0.405). 7. there were significant changes in the total cholesterol value and HDL-Cholesterol Value of serum lipids after dose of Ondamtang, significant increase in the 5-HIAA value after dose of Samulansintang, and significant devrease in the Trigylceride value of serum lipids after dose of Shihosogansan. As a result, it was seen that there was direct correlations among the Fat Cell Mass, urinary 5-HIAA, and serum lipids and stress from the mental conditions was not correlated directly to Serotonin, 5-HIAA, and serum lipids. I would like to conclude, therefore, that the detailed study should be performed on the function of serotonin of hypothalamus.

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Parental Survey for Children with Feeding Problems (섭취 문제가 있는 영유아 아동에 대한 부모설문조사)

  • Kim, Hye-Jin;Chung, Kyong-Mee;Park, Mi-Jung;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.179-186
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    • 2008
  • Purpose: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. Methods: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. Results: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. Conclusion: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.

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Clinical Findings and Gene Analysis of 3-Methylcrotonyl-CoA Carboxylase Deficiency (3-methylcrotonyl-CoA carboxylase 결핍증의 임상 양상과 유전자 분석)

  • Lee, Seung Eun;Ahn, Hee Jae;Lee, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.1
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    • pp.1-8
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    • 2015
  • Purpose: 3-methylcrotonyl CoA carboxylase deficiency (3MCCD) is leucine metabolic disorder caused by mutation in MCCC1 or MCCC2 gene. Clinical manifestations are variable, ranging from fatal neonatal onset to asymptomatic individuals. There is no retrospective study of Korean patients undergoing long-term treatment for 3MCCD. We reported this study to find out clinical symptoms and gene analysis of 3MCCD patients. Methods: This study was based on data of patients diagnosed with 3MCCD in Soonchunhyang university hospital between April 2009 and September 2013. We report clinical, enzymatic and mutation data of 3MCCD patients found by newborn screening. Results: In tandem mass spectrometry, 3-OH-isovalerylcarnitine (C5OH) of all patients increased. And all 7 patients were elevated 3-methylcrotonylglycine (3MCG) and 3-hydroxyisovaleric acid (3HIVA) in urine. MCCC mutation was identified in 2 patients and MCCC2 was mutated in 5 patients. We found mutation occurred in 8 different parts of nucleotide and such mutation caused 7 different types of changes in amino acid. All patients are on medication of L-carnitine and L-glycine. 4 patients are taking biotin. And 4 patients are eating leucine free formula. After starting treatment, there were no significant changes of urine 3MCG and 3HIVA levels. Conclusions: According to our data, MCCC2 gene mutation was more common than MCCC1 gene mutation. But the level of 3HIVA or 3MCG in urine has no correlation with phenotype. All patients has no symptoms and are shown normal development.

Comparison of Reliability and Validity of Three Korean Versions of the 20-Item Toronto Alexithymia Scale (TAS-20의 한국판 3종간의 신뢰도 및 타당도 비교)

  • Chung, Un-Sun;Rim, Hyo-Deog;Lee, Yang-Hyun;Kim, Sang-Heon
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.77-88
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    • 2003
  • Objectives: The purpose of this study was to compare reliability and validity of three Korean versions of the 20-item Toronto Alexithymia scale and to confirm the most reliable and validated Korean translation of the 20-item Toronto Alexithymia Scale for both clinical and research purpose in Korea. The first one was a Korean version of the 20-Item Toronto Alexithymia Scale developed by Lee YH et al in 1996 which was designated as TAS-20K(1996) in this study. This scale had a problem with one item due to the cultural difference regarding the word 'analyzing' between western culture and Korean culture. The second one was the revised version of TAS-20K(1996) on that point by Lee YH et al in 1996 without validation which was designated as TAS-20K(2003) in this study. The third one was a 23-item Korean version developed by Sin HG and Won HT in 1997, which was somewhat different from the 20-item Toronto Alexithymia Scale(TAS-20) in the number of total item, the content of some items and the scoring method. This scale was designated as S-TAS here. Methods: 408 medical students were tested with one scale composed of all the different items randomly arranged from the three versions. We evaluated goodness-of-fit and Cronbach $\alpha$ coefficients of three scales for reliability. We used confirmatory factor analysis to compare validity. Results: TAS-20K(2003) showed that it had better internal consistency than TAS-20K(1996), which implied that the cultural difference should be considered in the Korean translation. Both TAS-20K(2003) and S-TAS replicated three-factor structures and had adequacy of fit, good internal consistency and acceptable validity. However, S-TAS had one item with poor item-factor correlation and didn't show high correlation between item 2 and factor 1 as before in 1997. Conclusion: Although S-TAS had added 3 items and changed the content of two items, it didn't show better reliability and validity than TAS-20K(2003). Therefore it is proposed to use TAS-20K (2003) as the Korean version of the 20-item Toronto Alexithymia Scale(TAS-20K) for international communication of results of Alexithymia research. It has good internal consistency and validity and maintains original items, the same construct and scoring method as the 20-item Toronto Alexithymia Scale.

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