OBJECTIVES: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. METHODS: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. RESULTS: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. CONCLUSION: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.
Anxiety ; Cognitive Therapy ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Outpatients ; Primary Health Care ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study was done to examine how laughter therapy impacts serotonin levels, QOL and depression in middle-aged women and to perform a path analysis for verification of the effects. METHODS: A quasi-experimental study employing a nonequivalent control group and pre-post design was conducted. Participants were 64 middle-aged women (control=14 and experimental=50 in 3 groups according to level of depression). The intervention was conducted five times a week for a period of 2 weeks and the data analysis was conducted using repeated measures ANOVA, ANCOVA and LISREL. RESULTS: Results showed that pre serotonin and QOL in women with severe depression were the lowest. Serotonin in the experimental groups increased after the 10th intervention (p=.006) and the rise was the highest in the group with severe depression (p=.001). Depression in all groups decreased after the 5th intervention (p=.022) and the biggest decline was observed in group with severe depression (p=.007). QOL of the moderate and severe groups increased after the 10th intervention (p=.049), and the increase rate was highest in group with severe depression (p<.006). Path analysis revealed that laughter therapy did not directly affect depression, but its effect was indirectly meditated through serotonin variation (p<.001). CONCLUSION: Results indicate that serotonin activation through laughter therapy can help middle-aged women by lessening depression and providing important grounds for depression control.
Adult ; Depression/pathology/*therapy ; Female ; Humans ; *Laughter Therapy ; Middle Aged ; *Quality of Life ; Serotonin/*blood ; Severity of Illness Index ; Surveys and Questionnaires

BACKGROUND/OBJECTIVES: This study explores the parental characteristics that affect the eating behaviors of preschool children. The nutrition quotient for preschool children (NQ-P) tool was applied to measure the eating behaviors of preschool children, and the relationship between parents’ health beliefs and children’s eating behaviors was investigated by applying the health belief model.MATERIALS/METHODS: In August 2018, a self-administered online survey was conducted on a sample of parents of children aged 3 to 5 years living in the Seoul and Gyeonggi area. A total of 248 respondents were analyzed via descriptive statistics, one-way ANOVA, Tukey’s multiple comparison test, Pearson correlation analysis, and multiple regression analysis. RESULTS: The eating behaviors of preschool children significantly differed based on parents’ education level and monthly income (P < 0.01). Among the factors of the health belief model, “perceived benefit” had the highest score at 4.37 points. The multiple regression analysis confirmed that parents’ “self-efficacy” raised the NQ-P scores (β = 0.175, P< 0.05), balance scores (β = 0.204, P < 0.01), and environment scores of preschool children (β = 0.149,P < 0.05). The study results showed that if parents are educated on healthy eating habits and their level of self-efficacy for healthy eating practices increases, the formation of correct eating behaviors for preschool children is more likely. CONCLUSION This study provides preliminary data to develop an education program for parents to understand proper eating behaviors for their children and may help form healthy eating habits and encourage the healthy growth of preschool children.

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea.
Airway Resistance ; Asthma ; Child* ; Diagnosis ; Functional Residual Capacity ; Histamine ; Humans ; Infant ; Korea ; Lung* ; Mechanics ; Methacholine Chloride ; Oscillometry ; Patient Compliance ; Plethysmography ; Respiratory Function Tests ; Spirometry

PURPOSE: This study examines the difference of optimism, self-esteem and depression to verify an effect of laughter therapy program for menopausal women. METHODS: A quasi-experimental nonequivalent control group pre / post-test design was used. The participants (n=57) were 28 in the experimental group and 29 in the control group. The data were collected in December of 2011. The experimental group participated in laughter therapy for 30 min per session, five times a week for the period of 2 weeks. The questionnaires were used to measure pre / post-test optimism, self-esteem, and depression of menopausal women. RESULTS: The results showed that laughter therapy was effective in increasing optimism (p=.020) and self-esteem (p<.001). And the depression of menopausal women decreased (p=.003). CONCLUSION: The result of the study indicates that laughter therapy for menopausal women may be an effective nursing intervention to improve optimism, self-esteem and depression of menopausal women.
Depression ; Female ; Humans ; Laughter ; Laughter Therapy ; Menopause ; Surveys and Questionnaires

We present a case of erosive adenomatosis of the nipple in a 22-year-old woman. The clinical features of erosive adenomatosis of the nipple are similar to Paget's disease in that it has erythematous erosions with oozing and fissured crusts on one nipple. However, histologic findings are characteristic, consisting of dilated tubular structures that are lined by a peripheral layer of cuboidal cells and a luminal layer of columnar cells showing secretary properties into the lumen. The clinical course is benign, so simple mastectomy is enough for treatment.
Female ; Humans ; Mastectomy, Simple ; Nipples* ; Phenobarbital ; Young Adult

The common split-gilled mushroom, Schizophyllum commune is found throughout the world on woody plants. This study was initiated to evaluate conditions for favorable vegetative growth and to determine molecular phylogenetic relationship in twelve different strains of S. commune. A suitable temperature for mycelial growth was obtained at 30degrees C. This mushroom grew well in acidic conditions and pH 5 was the most favorable. Hamada, glucose peptone, Hennerberg, potato dextrose agar and yeast malt extract were favorable media for growing mycelia, while Lilly and glucose tryptone were unfavorable. Dextrin was the best and lactose was the less effective carbon source. The most suitable nitrogen sources were calcium nitrate, glycine, and potassium nitrate, whereas ammonium phosphate and histidine were the least effective for the mycelial growth of S. commune. The genetic diversity of each strain was investigated in order to identify them. The internal transcribed spacer (ITS) regions of rDNA were amplified using PCR. The size of the ITS1 and ITS2 regions of rDNA from the different strains varied from 129 to 143 bp and 241 to 243 bp, respectively. The sequence of ITS1 was more variable than that of ITS2, while the 5.8S sequences were identical. A phylogenetic tree of the ITS region sequences indicated that the selected strains were classified into three clusters. The reciprocal homologies of the ITS region sequences ranged from 99 to 100%. The strains were also analyzed by random amplification of polymorphic DNA (RAPD) with 20 arbitrary primers. Twelve primers efficiently amplified the genomic DNA. The number of amplified bands varied depending on the primers used or the strains tested. The average number of polymorphic bands observed per primer was 4.5. The size of polymorphic fragments was obtained in the range of 0.2 to 2.3 kb. These results indicate that the RAPD technique is well suited for detecting the genetic diversity in the S. commune strains tested.
Agar ; Agaricales ; Calcium ; Calcium Compounds ; Carbon ; DNA ; DNA, Ribosomal ; Genetic Variation ; Glucose ; Glycine ; Histidine ; Hydrogen-Ion Concentration ; Lactose ; Nitrates ; Nitrogen ; Peptones ; Phosphates ; Polymerase Chain Reaction ; Potassium ; Potassium Compounds ; Quaternary Ammonium Compounds ; Random Amplified Polymorphic DNA Technique ; Schizophyllum ; Solanum tuberosum ; Sprains and Strains ; Yeasts

This study investigated the intake of alcoholic and non-alcoholic beverages in college students. Five hundred and eighty seven students age 19-30 (432 male and 155 female) responded to the beverage consumption survey. Of the students 19.9% were freshman, 42.2% sophomore, 23% junior, and 15% seniors. Results are summarized as follows : 1) Beer and soju were the most commonly consumed alcoholic beverages by the college students. The amount of beverage normally consumed was 3 cans of beer or 1 bottle of soju. 2) There was no age related change in amount of alcoholic beverage consumed, but preference for liquor rather than beer increased with age. 3) Foods most commonly consumed prior to drinking were cooked rice and milk. 4) Following the drinking of alcoholic beverages the most commonly consumed food or beverage was cold water for both males and females. The next most commonly foods were cooked rice, instant noodles, and cola for males ; and cooked rice, milk, and fruit for females. 5) Cola and pear juice were the preferred non-alcoholic beverages for college students. Also popular among students were date juice for males and orange juice for females. Milk and non-cola carbonated beverages were not commonly consumed. This study provides information for the identification of possible alcoholic beverage related public health risks among college students.
Alcoholic Beverages ; Alcoholics* ; Beer ; Beverages* ; Carbonated Beverages ; Citrus sinensis ; Cola ; Drinking ; Female ; Fruit ; Humans ; Jeollanam-do* ; Male ; Milk ; Public Health ; Pyrus ; Water

PURPOSE: The goal of our study was to identify the incidence and clinical, neurophysiological and neuroradiological variables with predictive value for posttraumatic seizure(PTS). METHODS: The medical records of 625 children with head traumas under 15-year-old who were admitted to the Wonju Christian Hospital, from January, 1993 to January, 2002 were retrospectively reviewed. Among them, 472 patients were included in this study. The PTS patients were divided into early PTS, in whom seizure occurred within one week after head trauma and late PTS, in whom seizure occurred beyond the first week after head trauma. The injuries were classified into mild(Glasgow Coma Scale, GCS 13 to 15 or no brain CT abnormality and a brief hospital stay), moderate(GCS, 9 to 12, or a GCS above 12 and longer than 48-hour hospital stay, or brain CT abnormalites) and severe(GCS, below 9). The variables such as age, sex, duration of unconsciousness, GCS, brain CT scan finding, initial neurologic finding and anticonvulsant therapy were analyzed for risk factors of PTS. RESULTS: Early PTS was developed in 41(8.7%) patients, 35(77.8%) patients among them had a seizure within 24 hours after head trauma. Late PTS was developed in 17(3.6%) patients. The frequency and duration of PTS were not correlated with the latency of PTS. And there was correlation between the frequency and duration of PTS. The 82.9% of early PTS and the 76.5% of late PTS were generalized tonic-clonic seizure. There was a significant difference in the incidence of PTS by severity of head trauma. The incidence of PTS after mild head trauma(5.8%) was lower than after severe head trauma(29.9%). The risk factors of early PTS were unilateral hemorrhage, neurologic finding(hemiparesis and coma), GCS(under 12 score), and diffuse contusion. And the late PTS were the same as early PTS, except for diffuse contusion, and age factor(under 2 years was also significant). CONCLUSION: The incidence and risk factors of PTS were correlated with severity of head trauma.
Adolescent ; Brain ; Child* ; Coma ; Contusions ; Craniocerebral Trauma ; Gangwon-do ; Head ; Hemorrhage ; Humans ; Incidence* ; Length of Stay ; Medical Records ; Neurologic Manifestations ; Retrospective Studies ; Risk Factors* ; Seizures* ; Tomography, X-Ray Computed ; Unconsciousness

PURPOSE: Kawasaki disease (KD) shows a variety of clinical signs of multi-system involvement, including clinical diagnostic criteria. It is unknown that the severity of the clinical signs is associated with the risk of coronary artery lesions (CALs). We wanted to evaluate clinical characteristics and the risk of CALs in the patient groups who had severe skin lesions or those with arthritis. METHODS: We retrospectively reviewed the medical records of 220 KD patients who were treated with intravenous immunoglobulin (IVIG). We compared clinical and laboratory data between the group with severe skin lesions (n=52) and those with mild or no skin lesions (n=168), and between the group with arthritis (n=6) and those without arthritis (n=214). RESULTS: The mean age of total patients was 2.23±1.87 years of age, and the male-to-female ratio was 1.5:1 (138/82). Among 220 patients, 52 patients had CALs (23.6%), and 29 patients (13.2%) showed incomplete KD. The patients with CALs had a higher mean age, longer total fever duration, and higher rate of IVIG non-responsiveness. The patient group with severe skin lesions showed a higher mean age (P<0.001), more prolonged fever duration (P=0.041), higher frequency of CALs (P=0.033), higher WBC, neutrophil, and neutrophil-to-lymphocyte ratio levels, compared to the patient group without severe skin lesions. The patients with arthritis had a tendency of further treatment with methylprednisolone or infliximab. CONCLUSIONS: The frequency of CALs was higher in patient group with severe skin lesions. Our results suggest that the intensity of clinical signs of KD such as skin rash, cervical lymphadenopathy and possibly arthritis may be associated the risk of CALs.
Arthritis* ; Coronary Vessels* ; Exanthema ; Fever ; Humans ; Immunoglobulins ; Immunoglobulins, Intravenous ; Infliximab ; Lymphatic Diseases ; Medical Records ; Methylprednisolone ; Mucocutaneous Lymph Node Syndrome* ; Neutrophils ; Retrospective Studies ; Skin*