PURPOSE: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. RESULTS: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. CONCLUSION: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.
Antidepressive Agents ; Antihypertensive Agents ; Calcium ; Caregivers ; Creatinine ; Depression ; Dialysis ; Erythropoietin ; Fatigue ; Hematocrit ; Hemoglobins ; Humans ; Insurance ; Marital Status ; Potassium ; Surveys and Questionnaires ; Renal Dialysis ; Sleep Wake Disorders ; Sodium

This study was designed to evaluated the effects of opioid receptor agonists on the spontaneous alternation behaviour in an animal model of obsessive-compulsive disorder in rats. According to the theory that dopamine is related to the biological etiology of obsessive-compulsive disorder, the effect of the nalbuphine(opioid kappa agonist) and the tramadol(opioid mu agonist), which act as manipulating agents on the inhibition or stimulation of dopamine release, in the spontaneous alternation behaviour were evaluated. 24 hours prior to the experiment, rats were food-deprived. These rats were put into the T-maze, in which white and black goal boxes were baited with small amounts of chocolate milk. Each rat was given 2 set of 7 trials during which it was placed in the start box and allowed to choose the one of the goal boxes for each time. After identifying the stable baseline of spontaneous alternation behaviour, nonselective 5-HT agonist 5-MeODMT(1.25mg/kg/IP) disrupted spontaneous alternation. Rats were stratified into fluoxetine(10mg/kg/IP), nalbuphine(10mg/kg/IP), tramadol(46.4mg/kg/IP), and saline(0.5cc/IP) injection group with experimental drug treatment for 21 days. The effects on the 5-M?DMT(1.25mg/kg/IP) induced disruption of spontaneous alternation behaviour were checked at the next day of discontinuation of drug treatment. The results were as follows : 1) At the day after 21 days of the drug treatment, the nalbuphine treated group and the fluoxetine treated group showed significant difference from the tramadol treated group and the saline treated group in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. 2) Within each drug treatment group, the fluoxetine treated group showed significant difference between before and after the treatment of fluoxetine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. And also, the nalbuphine treated group showed significant difference between before and after the treatment of nalbuphine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. There was no difference between the baseline and after the treatment of nalbuphine in the 5-MeODMT(1.25mg/kg/IP) induced suppression of spontaneous alternation behaviour. We indentified that the opioid kappa agonist that act as dopamine release inhibitor affect the spontaneous alternation behaviour which is an animal model of obsessive-compulsive disorder in rat.
Animals ; Cacao ; Dopamine ; Fluoxetine ; Milk ; Models, Animal ; Nalbuphine ; Obsessive-Compulsive Disorder ; Rats* ; Receptors, Opioid ; Serotonin Receptor Agonists ; Tramadol

PURPOSE: Quality of life in patients with cancer may be influenced by various kinds of variables, such as personal, environmental, and medical factors. The purpose of this study was to identity the influencing factors on the quality of life in patients with cancer. MATERIALS AND METHODS: One hundred and forty seven patients, who were taking medical therapy or following up after surgery for cervix cancer, participated in the present study. Quality of life, medical variables (cancer stage, types of treatment, follow-up status, and symptom distress), and psychosocial variables (mood disturbance, orientation to life, and social support) were measured. The obtained data were computed using multiple regression analyses. RESULTS: The medical-and-psychosocial variables explained 63.3% of the total variance in the quality of life (R2=0.633, F=16.969, p=.000). Cancer stage, symptom distress, mood disturbance, social support (family), and optimistic orientation to life were significant factors influencing on the quality of life in patients with cervix cancer. CONCLUSION: An integrative care program which includes medical - and - psychosocial characteristics of patients is essential to improve quality of life in patients with cervix cancer.
Cervix Uteri* ; Female ; Follow-Up Studies ; Humans ; Quality of Life* ; Uterine Cervical Neoplasms*

OBJETIVE: To investigate the efficacy of high infusion frequency of liquid nitrogen on pregnancy in human embryo after freezing and thawing. MATERIALS AND METHODS:: 150 infertile patients underwent 162 consecutive thawing-ET cycles. In the high infusion frequency group (Group A), 47 patients (50 cycles) underwent cryopreservation with high infusion frequency of liquid nitrogen. In the low infusion frequency group (Group B), 103 patients (112 cycles) underwent cryopreservation with low infusion frequency of liquid nitrogen. We analyzed the clinical characteristics, fertilization rates, development of embryo, good quality embryo ratio, implantation rates, and pregnancy rates between these two groups. RESULTS: There was no difference between the groups with regard to clinical characteristics (mean age, infertility duration, infertility factors, hormone profile), mean number of oocyte retrieval, fertilization rates, and mean embryo number of transfers. The survival rates in group A was 64.9% (228 of 350 embryos), and among the 228 embryos 190 embryos (83.3%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 65 (34.2%), 29 (15.3%), 35 (18.4%), and 37 (19.5%) of grades 1, 2, 3, and above 4, respectively. The survival rates in group B was 63.8% (482 of 755 embryos), and among the 482 embryos 465 embryos (96.5%) which progressed to the two- to eight-cell stage. After thawing, the embryo numbers were 106 (22.8%), 94 (20.2%), 89 (19.1%), and 112 (24.1%) of grades 1, 2, 3, and above 4, respectively. There was no difference in embryo quality change after the freezing-thawing procedure between the groups. Implantation rates (31.1% vs. 34.3%) were not significant. However hCG positive rates in group A (40%) were higher than group B, but not statistically significant. Clinical pregnancy rate (26% vs. 25.9%), on going pregnancy rates (>20 weeks) were not significant (26% vs. 25%). CONCLUSION: We compared embryo quality change, survival rates, and pregnancy rates between high infusion frequency group and low infusion frequency group and the results were similar between the two groups. Therefore, high infusion frequency of liquid nitrogen for cryopreservation is a worthy method to preserve in human embryos.
Cryopreservation ; Embryonic Development* ; Embryonic Structures* ; Female ; Fertilization ; Freezing* ; Humans* ; Infertility ; Nitrogen* ; Oocyte Retrieval ; Pregnancy ; Pregnancy Rate* ; Pregnancy* ; Survival Rate

BACKGROUND: The prevalence of depression has been steadily increasing. This study aim to identify associations between smoking, drinking and depression in Korean adults. METHODS: The study subjects were 17,871 adults aged 19 or over who participated in the 5th Korea National Health and Nutrition Examination Survey (2010-2012). We performed multiple logistic regression to identify whether smoking and drinking were independently significant variables to depression after adjusting for the confounding variables. RESULTS: The proportion of having any depressive episodes was a total of 13.4% with 9.1% of male and 16.6% of female, respectively. Among all of smoking behaviors, higher cigarette consumption was only associated with depression in men. However, for women ever-smoking (adjusted odds ratio [aOR]=1.63, 95% confidence interval [CI]=1.38-1.92), ex-smoking (aOR=1.38, 95% CI=1.10-1.54), current smoking (aOR=1.89, 95% CI=1.53-2.94) and younger initiation of smoking (aOR=2.34, 95% CI=1.73-3.16) had significantly higher odds for depression. Moreover, and higher cigarette consumption (20 or more per day) showed significantly higher odds ratios for depression both in men (aOR=1.21, 95% CI=1.01-1.54) and women (aOR=2.41, 95% CI=1.32-4.41). For alcoholic drinking behaviors, frequent binge drinking (1 per week: aOR=1.46, 95% CI=1.16-1.85, most everyday: aOR=1.79, 95% CI=1.14-2.80) was an independent risk factor for depressive symptoms in female. CONCLUSIONS: Smoking and drinking behaviors were independently associated with depression especially in female. Smoking and drinking management may benefit depression control as well as health promotion.
Adult* ; Alcohol Drinking ; Alcoholics ; Binge Drinking ; Confounding Factors (Epidemiology) ; Depression* ; Drinking Behavior ; Drinking* ; Female ; Health Promotion ; Humans ; Korea* ; Logistic Models ; Male ; Nutrition Surveys* ; Odds Ratio ; Prevalence ; Risk Factors ; Smoke* ; Smoking* ; Tobacco Products

BACKGROUND: Lumbar stabilization exercise was used to improve spinal mobilization and stabilization. This research was conducted to investigate the effects of lumbar stabilization exercise programs on shoulder pain and range of motion among a group of elderly individuals. METHODS: The study subjects were 28 elderly patients from C hospital, Gochang, Jeollabukdo. They were randomly divided into 3 groups: lumbar stability exercise group, passive upper arm exercise group, and conservative therapy group. The therapies were conducted for 4 weeks. Shoulder pain and range of motion were measured both before and after therapies. The homogeneity of study subjects was analyzed using the chi-square and Kruskal-Wallis tests. For the pre-/post-status comparison, the Wilcoxon's signed-ranks tests and Kruskal-Wallis tests were conducted. RESULTS: General characteristics including age, sex, and disease history of the 3 groups were comparable. After 4 weeks of exercise, shoulder pain was significantly reduced in the lumbar stability exercise group (6.4+/-2.9 vs. 3.6+/-3.1, P=.026) and range of motion was significantly increased in the same group. More specifically, right flexion (121.1+/-12.0degrees vs. 137.9+/-11.9degrees, P=.008), right abduction (96.6+/-21.8degrees vs. 129.7+/-50.7degrees, P=.008), and left abduction (92.0+/-21.8degrees vs. 110.3+/-21.2degrees, P=.038) increased significantly. CONCLUSIONS: Shoulder pain and range of motion improved significantly in the lumbar stability exercise group. Further study is needed to look into the longer effects of this exercise program using more subjects.
Aged ; Arm ; Humans ; Range of Motion, Articular* ; Shoulder Pain ; Shoulder*

PURPOSE: The previous studies on H1 antihistamine overdose have generally been limited to cases of acute doxylamine succinate (DS) poisoning, yet there have been some studies on diphenhydramine (DPH) overdosing. But many clinicians consider the two drugs to be very similar and to have similar ingredients. The purpose of this study was to clarify the toxicologic characteristics and clinical outcomes between DS and DPH poisoning/overdose. METHODS: We reviewed the medical and intensive care records of the patients with acute DS or DPH poisoning and who admitted to our emergency department from January 2008 and April 2010. We collected patient information regarding the features of the poisoning and the clinical and demographic characteristics. The patients were assessed for the clinical outcomes, the GCS, the PSS (Poisoning Severity Score) and the SOFA (Sequential Organ Failure Assessment). RESULTS: Fifty seven patients (45 cases of DS poisoning and 12 cases of DPH poisoning) were enrolled. Compared with the DS group, the DPH group had higher incidences of intubation, serious mental change, QTc prolongation and ECG conduction abnormality (p=0.041, <0.001, 0.014 and 0.044, respectively). The DPH group had a higher PSS and a longer ICU stay. The peak CPK time and the CPK normalization time were longer for the patients with rhabdomyolysis due to DS poisoning. CONCLUSION: Two common H1 antihistamines, doxylamine and diphenhydramine, are in the same ethanolaminestructural class, but the toxico-clinical outcomes are different according to many aspects. Therefore, clinicians could take a careful approach for the differential diagnosis and management between DS and DPH poisoning.
Diagnosis, Differential ; Diphenhydramine ; Doxylamine ; Electrocardiography ; Emergencies ; Histamine Antagonists ; Humans ; Incidence ; Critical Care ; Intubation ; Rhabdomyolysis ; Succinic Acid

The purpose of this study was to identify the association between health-related behaviors including smoking, alcohol intake, and the practice of a low-salt diet using data from a Community Health Survey conducted in 2008. The study subjects were 129,151 persons (19 years and older) without cardiovascular diseases or diabetes mellitus diagnosis history. An index for evaluating low salinity was created by summing three low salinity-related questions (range: 0~3), and a low-salt diet was defined if the index of low salinity was 3. We examined the levels of smoking and alcohol intake according to the index of low salinity, and conducted multiple logistic regression analysis to examine the odds ratios of low-salt diet practice in relation to smoking and drinking behavior, adjusting for general characteristics. The smoking and drinking status significantly improved as the level of low salinity index increase. Adjusting for general characteristics, those with smoking, alcohol intake, or a combined habit of the two behaviors had significantly lower odds ratios for practice of a low-salt diet. In conclusion, smoking and drinking behavior were negatively associated with the practice of a low-salt diet. Based on these findings, it may be necessary to have comprehensive nutritional education programs that consider the multiple effects of smoking, drinking, and a low-salt diet.
Cardiovascular Diseases ; Diabetes Mellitus ; Diet, Sodium-Restricted ; Drinking ; Drinking Behavior ; Health Surveys ; Humans ; Logistic Models ; Odds Ratio ; Salinity ; Smoke ; Smoking

OBJECTIVES: Several previous studies have found that healthy behaviors substantially reduce non-communicable disease incidence and mortality. The present study was performed to estimate the prevalence of four modifiable healthy behaviors and a healthy lifestyle among Korean adults according to socio-demographic and regional factors. METHODS: We analyzed data from 199 400 Korean adults aged 19 years and older who participated in the 2010 Korean Community Health Survey. We defined a healthy lifestyle as a combination of four modifiable healthy behaviors: non-smoking, moderate alcohol consumption, regular walking, and a healthy weight. We calculated the prevalence rates and odds ratios of each healthy behavior and healthy lifestyle according to socio-demographic and regional characteristics. RESULTS: The prevalence rates were as follows: non-smoking, 75.0% (53.7% in men, 96.6% in women); moderate alcohol consumption, 88.2% (79.7% in men, 96.9% in women); regular walking, 45.0% (46.2% in men, 43.8% in women); healthy weight, 77.4% (71.3% in men, 73.6% in women); and a healthy lifestyle, 25.5% (16.4% in men, 34.6% in women). The characteristics associated with a low prevalence of healthy lifestyle were male gender, younger age (19 to 44 years of age), low educational attainment, married, living in a rural area, living in the Chungcheong, Youngnam, or Gwangwon-Jeju region, and poorer self-rated health. CONCLUSIONS: Further research should be implemented to explore the explainable factors of disparities for socio-demographic and regional characteristics to engage in the healthy lifestyle among adults.
Adult ; Age Factors ; Aged ; Alcohol Drinking ; Asian Continental Ancestry Group ; Body Weight ; Demography ; Female ; *Health Surveys ; Humans ; *Life Style ; Male ; Marital Status ; Middle Aged ; Republic of Korea ; Rural Population ; Sex Factors ; Smoking ; Social Class ; Young Adult

PURPOSE: The aim of this study was to evaluate the surgical outcomes of abdominal total gastrectomy, without mediastinal lymph node dissection for type II and III gastroesophageal junction (GEJ) cancers. MATERIALS AND METHODS: We retrospectively reviewed surgical outcomes in 67 consecutive patients with type II and III GEJ cancers that were treated by the surgical resection between 2004 and 2008. RESULTS: Thirty (45%) patients had type II and 37 (55%) had type III tumor. Among the 65 (97%) patients with curative surgery, 21 (31%) patients underwent the extended total gastrectomy with trans-hiatal distal esophageal resection, and in 44 (66%) patients, abdominal total gastrectomy alone was done. Palliative gastrectomy was performed in two patients due to the accompanying peritoneal metastasis. The postoperative morbidity and mortality rates were 21.4% and 1.5%, respectively. After a median follow up of 36 months, the overall 3-years was 68%, without any differences between the Siewert types or the operative approaches (transhiatal approach vs. abdominal approach alone). On the univariate analysis, the T stage, N stage and R0 resection were found to be associated with the survival, and multivariate analysis revealed that the N stage was a poor independent prognostic factor for survival. CONCLUSIONS: Type II and III GEJ cancers may successfully be treated with the abdominal total gastrectomy, without mediastinal lymph node dissection in the Korean population.
Esophagogastric Junction ; Follow-Up Studies ; Gastrectomy ; Humans ; Korea ; Lymph Node Excision ; Multivariate Analysis ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms