Influence of Severity of Problem Drinking, Circadian Rhythm and Sleep Quality on Sleep Disorder in Alcohol Use Disorder Patients

PURPOSE: This study was done to identify the influence of severity of drinking problem, circadian rhythm and sleep quality in patients with alcohol use. METHODS: A descriptive study design was utilized. Data were collected using self-report questionnaires from 139 patients with alcohol use disorder who were admitted to a psychiatric hospital in D city, Korea. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Composite Scale of Morningness (CMS), Pittsburgh Sleep Quality Index (PSQI), and Korea sleep scale A. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple regressions using the SPSS 20.0 program. RESULTS: There was significant correlations among severity of problem drinking, circadian rhythm, sleep quality and sleep disorder. The significant factors influencing sleep disorder were severity of problem drinking(β=.12, p=.042), circadian rhythm(β=−.14, p=.039) and sleep quality(β=.63, p=<.001). This model explained 56% of variance in sleep disorder(F=57.34, p=<.001). CONCLUSION: The results of this study suggest that the development of sleep intervention programs for alcohol use disorder patients needs to consider severity of alcohol use, circadian rhythm and sleep quality, and sleep assessment and intervention are needed the early stage of the treatment and recovery process.

Carotid Intima-Media Thickness Measurement in Obese Children / 소아과

PURPOSE: The aim of the present study was to ascertain whether the increase of carotid intima- media thickeness (cIMT) as one of premature pathologic changes of atherosclerosis, was present in obese children compared to normal weight children. METHODS: The obese group consisted of 21 obese/overweight (body mass index (BMI) above 85 percentile of age, sex standards) children and the control group of 11 normal weight children. None of the children had any chronic illnesses or previous medication history. We investigated the age, sex, height, weight, and systolic/diastolic blood pressure. We measured cIMT by ultrasonogram. In 19 of the obese group, we tested the serum glucose level, liver transaminase level, and cholesterol level etc. RESULTS: The increase of cIMT in obese group did not achieved statistical significance (obese group vs. control group; 0.42 vs. 0.40 mm, P=0.0592). In addition, cIMT showed no significant correlation with any physical/laboratory variables including BMI (P=0.0585). CONCLUSION: To our knowledge, this is the first study to measure the cIMT in Korean children. Though the results approached statistical significance, we could not prove an increase of cIMT in obese children or an association between cIMT and BMI, due to the study's small sample size. In the future, larger and more extensive trials are needed.

Pulmonary Venous Flow Doppler Pattern in Infant Atrial Septal Defect Cases / 소아과

PURPOSE: Doppler findings of pulmonary venous flow in large atrial septal defect(ASD) has been known to show a contiguous form rather than showing a form with two peaks in a cardiac cycle. The aim of this study was to find out the affecting variables in flow pattern change. METHODS: The present study was conducted on 16 isolated secondum ASD infants with defect diameters greater than 3 mm(L group), 10 infants with a defect diameter less than 3 mm(S group) and 11 infants with no structural abnormal findings(N group), among infants who visited the Pediatric Department of Soonchunhyang University Hospital and underwent a echocardiographic examination from April 2001 through June 2003. The echocardiographic examination included the midflow ratio of the pulmonary vein, calculated by division(numerator:the minimum velocity between S & D velocities, denominator: the mean value of S & D velocities). RESULTS: The mean ages of these three groups(L group, S group and N group) were 0.35+/-0.34 years, 0.22+/-0.22 years and 0.45+/-0.27 years, respectively. The midflow ratios were 0.76+/-0.20, 0.54 +/-0.11, 0.53+/-0.11 in groups, and significant difference between L group and the other two groups (P=0.002). The only affecting variable to midflow ratio is the defect area. And there is a significant causal relationship between them(P=0.003). CONCLUSION: The fact that Doppler findings of the pulmonary venous flow in a large sized atrial septal defect show a contiguous form is thought to be due to the unique hemodynamic characteristics of the ASD. The results of this study showed that such altered pattern ascertained as the defect size became larger.

A Case Report of Non-surgical Removal of Fragmented Remnant of Umbilical Vein Catheter Using an Intravascular Snare / 대한주산의학회잡지

Umbilical catheters have been used in NICUs for drawing blood samples, measuring blood pressure, and administering fluid and medications for more than 50 years. When the patient does not need the umbilical catheter or complications associated with umbilical catheters have risen, the catheter must be removed. In this process, the catheter may snap or be cut off and the fragment may migrate to a near vessel or to the heart and cause infection, thrombosis, or arrythmia. We report a case where in the process of removing an umbilical vein catheter, the catheter was stuck to the dried umbilical cord and pulling at it caused the catheter to snap. An immediate roentgenogram showed the fragmented catheter had migrated to the left pulmonary artery. Using an intravascular snare with a femoral approach, we were able to collect the remaining catheter and remove it from the patient's body without any complications.