• The Journal of Korean Medicine
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• v.42 no.3
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• pp.72-85
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• 2021

Objectives: The objective of this study was to investigate the correlation of the scores on the State-Trait Anxiety Inventory-I (STAI-I), State-Trait Anxiety Inventory-II (STAI-II), Beck's Depression Inventory (BDI), and Core Seven Emotions Inventory-short form (CSEI-s) scales with pain improvement. Methods: We retrospectively investigated the medical records of 66 traffic accident inpatients who satisfy the selection criteria. They had received Korean medical treatment including acupuncture, electroacupuncture, pharmacopuncture, herbal medicine, and Chuna during hospitalization. STAI-II, BDI, and CSEI-s scores on hospital day 1, and STAI-I and numerical rating scale(NRS) scores on hospital day 1, 4, 7, and 10 were used for analysis. Pain improvement was evaluated by difference in NRS scores between hospital day 1 and hospital day 4, 7, 10. Results: The STAI-I, BDI, and CSEI-s scores showed significant correlations with pain or pain improvement. Conclusions: This study may be used in the research on psychological state and pain management of traffic accident patients and for patient education. Large-scale, well-designed studies need to be conducted in future to strengthen the results in this regard.

• Journal of Korean Academy of Nursing
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• v.53 no.4
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• pp.371-384
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• 2023

Purpose: With an increase in the aging population, the number of patients with degenerative spinal diseases undergoing surgery has risen, as has the incidence of postoperative delirium. This study aimed to investigate the risk factors affecting postoperative delirium in older adults who had undergone spine surgery and to identify the associated biomarkers. Methods: This study is a prospective study. Data of 100 patients aged ≥ 70 years who underwent spinal surgery were analyzed. Demographic data, medical history, clinical characteristics, cognitive function, depression symptoms, functional status, frailty, and nutritional status were investigated to identify the risk factors for delirium. The Confusion Assessment Method, Delirium Rating Scale-R-98, and Nursing Delirium Scale were also used for diagnosing delirium. To discover the biomarkers, urine extracellular vesicles (EVs) were analyzed for tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), neurofilament light, and glial fibrillary acidic protein using digital immunoassay technology. Results: Nine patients were excluded, and data obtained from the remaining 91 were analyzed. Among them, 18 (19.8%) developed delirium. Differences were observed between participants with and without delirium in the contexts of a history of mental disorder and use of benzodiazepines (p = .005 and p = .026, respectively). Tau and UCH-L1-concentrations of urine EVs-were comparatively higher in participants with severe delirium than that in participants without delirium (p = .002 and p = .001, respectively). Conclusion: These findings can assist clinicians in accurately identifying the risk factors before surgery, classifying high-risk patients, and predicting and detecting delirium in older patients. Moreover, urine EV analysis revealed that postoperative delirium following spinal surgery is most likely associated with brain damage.

• Sleep Medicine and Psychophysiology
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• v.7 no.2
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• pp.88-95
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• 2000

Objectives: The object of this experiment was to evaluate the effect of sleep deprivation on mood states of normal adults using a subjective scale and an objective scale, minimizing the effect of other factors other than that of sleep deprivation. Methods: Seventy volunteers were first participated in this sleep deprivation schedule, and 36 of them completed this experiment. The subjects and the control group members were all in their early 20's (mean $age=20.8{\pm}1.35$ vs $20.6{\pm}1.10$) and in good health. A log was checked by these subjects from a week before the laboratory study started. Drugs, alcohol and beverages containing any caffeine had been prohibited for a week before and during sleep deprivation periods. The study was performed only in summer to control other factors like sunlight, temperature and moisture. Before this experiment, the subjects had slept adequately for a week at least. On day 1 of the experiment the subjects got up at 6 a.m. and stayed in a sleep laboratory without sunlight or external noises. They could only go about their daily routines. They were forbidden to have a nap and be drowsy. GVA (Global Vigor and Affect) and MADRS (Montgomery-Asberg Depression Rating Scale) were checked 11 times. The data was analysed focusing on the changing mood states. Results: The mood during sleep deprivation became worse as the sleep deprivation time progressed. Especially 20 hours ($GA=59.25{\pm}8.06$, $MADRS=3.43{\pm}1.25$) and 40 hours ($GA=38.83{\pm}9.22$, $MADRS=6.08{\pm}1.46$) after sleep deprivation, there were significant changes compared to the control group ($MADRS=6.08{\pm}1.46$ vs $1.07{\pm}1.18$, p<0.001). Conclusions: While controlling factors other than sleep deprivation might have had some influence on mood changes, significant mood changes during sleep deprivation were observed. The mood states became worse as the sleep deprivation progressed.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.121-129
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• 2014

Objectives : This study was to assess the prevalence and its correlates of restless legs syndrome(RLS) in outpatients with bipolar disorder. Methods : A total of 100 clinical stabilized bipolar outpatients were examined. The presence of RLS and its severity were assessed using the International Restless Legs Sydrome Study Group(IRLSSG) diagnostic criteria. Beck's Depression Inventory(BDI), Spielberg's State Anxiety Inventory(STAI-X-1), Pittsburgh Sleep Quality Index(PSQI), Korean version Drug Attitude Inventory(KDAI-10), Subjective Well-Beings under Neuroleptic Treatment Scale-Short Form(SWN-K) and Barnes Akathisia Rating Scale(BARS) were used to evaluate the depressive symptomatology, level of anxiety, subjective quality of sleep, subjective feeling of well-being, drug attitude, presence of akathisia, respectively. Results : Of the 100 bipolar outpatients, 7(7%) were met to full criteria of IRLSSG and 36(36%) have at least one of the 4 IRLSSG criterion. Because of relatively small sample size, non-parametric analysis were done to compare the characteristics among 3 groups(full-RLS, 1 ${\geq}$positive RLS-symptom and Non-RLS). There were no significant differences in sex, age, and other sociodemographic and clinical data among 3 groups. BDI, STAI-X-1 and PSQI are tended to be impaired in RLS and 1 ${\geq}$positive RLS-symptom groups. Conclusions : This is the first preliminary study for studying the prevalence and its correlates of RLS in bipolar disorder. The results shows that relatively small proportion of RLS was present in bipolar disorder patients when compared to patients with schizophrenia. Same tendencies shown in schizophrenic patients were found that bipolar patients with RLS had more depressive symptoms, state anxiety and poor subjective sleep quality. Further systematic studies may be needed to find the characteristics of RLS in bipolar patients.

• Sleep Medicine and Psychophysiology
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• v.22 no.2
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• pp.57-63
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• 2015

Background and Objectives: Internet addiction is an increasing problem in Korea. The previous studies in this area have targeted adolescents and young adults. This study was conducted to examine the risk of internet addiction in Korean adults and the effect of internet addiction on circadian rhythm. Materials and Methods: For this study, 508 subjects were chosen through population proportional sampling to represent the adult population in Korea, 325 of whom were included based on the Alcohol Use Disorder Identification Test-Korea (Audit-K), Zung's Self-Rating Depression Scale (SDS), drug use in the past year, and suicide attempts. In these subjects, sociodemographic factors including age, gender, and residential area were analyzed, and Young's Internet Addiction Scale (IAS), Morningness-Eveningness Questionnaire (MEQ), and an online survey examining sleep onset time on weekdays and weekends, wake-up time, and caffeinated drink intake were executed. Results: Of the 325 subjects, 136 (41.8%) belonged to a high-risk internet addiction group ($IAS{\geq}40$), and 189 (58.2%) belonged to a normal group (IAS < 40). There was a high proportion of male subjects (p = 0.03) in the high-risk group compared to the normal group. There was a high proportion of younger subjects (p = 0.055) in the high-risk group compared to the normal group, but this difference was not statistically significant. Compared to the normal group, there was a high proportion of the evening type ($MEQ{\leq}41$) in the high-risk group (p = 0.024), who also showed a high proportion of caffeinated drink intake (p < 0.001). Also, the high-risk group was found to go to bed and wake up late, but there was no statistically significant difference with the normal group. Conclusion: This study showed that many adults have a high-risk of internet addiction, and there was a significant correlation between internet addiction and sleep in adult, as has been found in adolescents and early adults. In the future, a longitudinal study will be needed to verify the causal relationship between internet addiction and morningness-eveningness.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.60-68
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• 2019

Objectives : The association between thyroid-related hormones and cognitive function has been controversial. The purpose of this study is to compare the levels of thyroid-related hormones in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI). Furthermore, we investigated the relationship between thyroid-related hormones and cognitive function. Methods : From January 2011 to December 2018, we retrospectively reviewed 105 patients who were diagnosed with AD and MCI by visiting a dementia clinic at Ilsan Paik Hospital. Thyroid-related hormones [triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)] was measured using chemiluminescent immunoassay. An independent sample t-test was performed to analyze the mean value of thyroid-related hormones in patients of AD and MCI. To investigate whether thyroid-related hormones correlate significantly with Global deterioration scale (GDS), Clinical dementia rating (CDR) and scores of each The Korean version of the consortium to establish a registry for Alzheimer's disease items, we conducted a partial correlation analysis with geriatric depression scale-Korean version (GDS-K) scores as covariates. Results : There was no significant difference in the mean serum T3, T4 and TSH levels between patients of the AD and the MCI, but the Construction Praxis Test (CPT) showed a significant positive correlation with the serum TSH concentration (p-value=0.004). Conclusions : In our study, the positive correlation between serum TSH level and the CPT associated with executive function was found to be helpful in understanding the association between thyroid-related hormones and the pathophysiology of dementia. Prospective studies in regard of the pathophysiology of thyroid-related hormones on cognitive function will be necessary in the future.

• Korean Journal of Acupuncture
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• v.40 no.1
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• pp.1-12
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• 2023

Objectives : This study aims to provide information regarding the status and quality of mobile applications (MAs) using self-acupressure by performing a systematic review. Methods : We conducted comprehensive searching on five international databases and two app markets from inception to July 31, 2022 to identify MAs using self-acupressure. We analyzed the characteristics of each MA regarding the name of the MA, registered app markets, target symptoms, developers, the year and country of development, cost, target age, media function, and expertise. We assessed the quality of each MA using Mobile Application Rating Scale (MARS). Results : We identified a total of 30 MAs using self-acupressure (25 MAs from the app market and 6 MAs from clinical studies, with 1 MA in common). 17 out of 24 MAs from the app market provided self-acupressure regimens for various symptoms and the others provided regimens for specific symptoms such as memory, anxiety, depression, asthma, allergy, low back pain, and headache. 14 developers were reported. 23 MAs were developed after 2013. The largest number of MAs were developed in the United States. The target age group of 12 MAs was above the age of 3, and that of 11 MAs was above the age of 12. 14 MAs provided multimedia functions such as videos. 13 MAs provided information of expertise. From clinical studies, only 3 out of 6 MAs were accessible through the app market. 4 MAs were developed by the researchers of the study. In terms of MARS, the score of MAs from the app market was higher than that of MAs from clinical studies in both objective and subjective evaluation areas. Conclusions : This study summarizes the characteristics of MAs using self-acupressure. More MAs using self-acupressure should be developed and further clinical research for MA on each symptom and disease is warranted for the diversification of MA fields using self-acupressure.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.2
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• pp.82-93
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• 2010

Objectives : The purpose of this study was to explore attitude and belief about menopause and severity of menopausal symptoms according to menopausal status. This study conducted a cross-sectional assessment of the effects of depressive symptoms and the severity of trait anxiety on the severity of menopausal symptoms. Methods : Participants were all outpatients at the psychiatric outpatient clinic of Korea University Guro Hospital. All participants, aged 40 to 64, had depressive or anxiety disorders and were divided into the premenopause, perimenopause, premenopause, and postmenopause groups. Menopause Rating Scale(MRS) was used to measure the severity of menopausal symptoms. The attitude toward menopause was examined by a self-report questionnaire regarding menopause. Beck Depression Inventory(BDI) and State-Trait Anxiety Inventory(STAI) were used to assess depressive symptoms and anxiety. Results : The severity of menopausal symptoms was not different among the groups according to menopausal status. There was a significant correlation between a negative attitude toward menopause and the severity of menopausal symptoms. Patients with moderate to severe depressive symptoms and trait anxiety had more severe menopausal symptoms. Conclusion : Negative attitude toward menopause, depressive symptoms, and anxiety had a significantly negative impact on the severity of menopausal symptoms. The results of this study suggest that treatment to relieve depressive symptoms and anxiety and intervention to reduce negative attitude toward menopause are required. Further studies with larger sample size are needed to evaluate potentially effects of depressive symptoms and anxiety on severity of menopausal symptoms in middle-aged female psychiatric patients.

• Korean Journal of Acupuncture
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• v.37 no.1
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• pp.54-62
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• 2020

Objectives : Acute low back pain syndrome causes pain and poor quality of life. There are various studies of SBV (Sweet bee venom) pharmacopuncture, but few have identified the therapeutic effects for patients unable to walk due to acute back pain. This case series report three cases of acute low back pain syndrome treated with SBV pharmacopuncture combined with Korean Medicine (KM) treatments. Methods : Three acute low back pain syndrome patients with no other acute abnormalities in the imaging were treated by KM treatments including SBV pharmacopuncture, acupuncture, cupping, herbal medicine and physical therapy. The improvement of symptoms was evaluated using Numerical rating scale (NRS), Oswestry disability Index (ODI), EuroQol-5 dimension index (EQ-5D) and EuroQol-visual analogue scale (EQ-VAS). Results : Patients who were unable to walk due to acute back pain were able to walk. There were significant improvements of NRS, ODI, EQ-5D and EQ-VAS after treatment. The patients experienced an average 90% decrease in low back pain after inpatient KM treatment for about 8 days. NRS decreased by an average of 78.9%, ODI decreased by an average of 49.4%, and EQ-VAS increased by an average of 92.6%. In the case 1, EQ-5D decreased in all categories, but in the case 2, it decreased in all categories except for pain/discomfort and anxiety/depression, but in the case 3, it decreased in all categories except anxiety/depression. There was no serious side effect after treatment of SBV pharmacopuncture. Conclusions : KM treatments including SBV pharmacopuncture may be effective for acute low back pain syndrome patients. However, randomized controlled trials are needed in the future to confirm the clinical effects of these interventions.

• Korean Journal of Biological Psychiatry
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• v.10 no.1
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• pp.70-79
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• 2003

Object : Currently, the alteration of cytokine system has been known to play an important role in regard to depressive symptom. We focused on the relationship between immunological parameters and clinical improvement in major depressive disorder. Method : Data were collected on 26 patients with major depressive disorder using a 8-week prospective follow-up design. After 8-week treatment period with fluoxetine, patients were classified into a response group and a non-response group according to their psychopathological outcome as evaluated by Hamilton Depression Rating Scale. The differences of the immunological parameters between pre-treatment phase and post-treatment phase were compared among patients. The difference of those was also compared within each phase among them. The relationship between socio-demographic variables, depression, cytokine, mononuclear cells was examined by correlation analysis. Multiple regression analyses were performed to explore the predictors of clinical improvement of major depressive disorder. Result : Pre-treatment levels of IL-$1{\beta}$ in the response group were significantly higher than those in the non-response group. Pre-treatment levels of IL-$1{\beta}$ of all patients and in the response group were positively correlated with pre-treatment monocyte counts. Patients with subsequent remission showed significantly lower IL-6 values at baseline than those with non-response. Post-treatment values of IL-6 did not differ significantly among the patients. The correlation test showed more frequent relations among cytokines and mononuclear cells in the response group than in the non-responder group. Especially, serum level of IL-6 in pre-treatment phase was only significantly correlated with HAMD score after 8-week treatement phase, while other cytokines and mononuclear cells were not. Pretreatment level of IL-6 was of paramount importance in predicting clinical improvement of depressive symptom. Conclusion : The immune system of major depressive disorder patients might dichotomize the patients into subsequent responders and non-responders. Immune system might be of great influence on the clinical improvement of major depressive disorder. The mode of interaction between depression and cellular immune function and the mediators responsible for the cytokine production need to be studied further.