• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.1-8
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• 2018

Objectives : This study aimed to investigate the psychosocial characteristics of functional gastrointestinal disorder (FGID) in patients with psychiatric disorders. Methods : This study was conducted with 144 outpatients visiting the psychiatric clinic at a university hospital. FGIDs were screened according to the Rome III questionnaire-Korean version. Demographic factors were investigated, and psychosocial factors were evaluated using the Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, and State-Trait Anger Expression Inventory. Chisquared test and student's t-test were used as statistical analysis methods. Results : There were differences in education level between two groups divided according to FGID status (${\chi}^2=10.139$, p=0.017). Comparing the psychiatric disorder by FGID group, irritable bowel syndrome (IBS) group showed significant differences (${\chi}^2=11.408$, p=0.022). According to FGID status, IBS group showed significant differences for anxiety (t=-3.106, p=0.002), depressive symptom (t=-2.105, p=0.037), somatic symptom (t=-3.565, p<0.001), trait anger (t=-3.683, p<0.001), anger-in (t=-2.463, p=0.015), and anger-out (t=-2.355, p=0.020). Functional dyspepsia group showed significant differences for anxiety (t=-4.893, p<0.001), depressive symptom (t=-3.459, p<0.001), somatic symptom (t=-7.906, p<0.001), trait-anger (t=-4.148, p<0.001), state-anger (t=-2.181, p=0.031), anger-in (t=-2.684, p=0.008), and anger-out (t=-3.005, p=0.003). Nonerosive reflux disease group showed significant differences for anxiety (t=-4.286, p<0.001), depressive symptom (t=-3.402, p<0.001), somatic symptom (t=-7.162, p<0.001), trait anger (t=-2.994, p=0.003), state anger (t=-2.259, p=0.025), anger-in (t=-2.772, p=0.006), and anger-out (t=-2.958, p=0.004). Conclusions : Patients with psychiatric disorders had a high prevalence of FGID, and various psychosocial factors contributed to such differences. Therefore, the psychiatric approach can offer better understandings and treatments to patients with FGID.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.178-184
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• 2004

Objectives : This study was conducted to investigate the association of the COMT polymorphism with the TD in Korean sample of families with TD probands. The relationship between risk alleles and specific clinical features (tic severity, comorbidity, drug response) was also explored. Method : Patients were recruited from the Tic Disorder clinic at the Child & Adolescent Psychiatric Division of Seoul National University Hospital and assessed through 2 stage evaluation. Firstly, all the patients and parents received semistructured interview using Korean version of K-SADS-PL. Secondly all the patients received clinical interview and tic severity assessment with Korean version of YGTSS. The subjects in control group were recruited from the health promotion center in out hospital and were evaluated by SCL-90 and SCID-IV. Through these process, total of 42 children and adolescents with TD, their 84 parents and 86 control subjects were finally recruited. Genotyping for The Val158Met polymorphism of the COMT gene was done by standardized method. After collection of genetic data of all the patients, parents and control subjects, case-control comparison and tranmission dysequilibrium test was executed by SPSS version 11. Result : From the case-control comparison, the frequency of L-allele and LL genotype was significantly higher in TD group. However, no differences were found from the TDT. No significant differences were found in in family history of tic, ADHD, OCD, drug response and comorbid conditions among the three different genotypes in patients with TD. Conclusion : Though this study results should be interpreted cautiously due to small sample size and negative finding in TDT test, this study is the first report that there is positive association between the functional polymorphism of COMT gene the TD.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.77-84
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• 2019

Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.107-112
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• 2001

Introduction: Narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and cataplexy, is known to be closely associated with the human leukocyte antigen (HLA) DQB1*0602. Several studies have suggested that HLA-DQB1*0602 is strongly linked with narcolepsy-cataplexy. However, no studies have yet been made on whether HLA DQB1*0602 is associated with Korean patients with narcolepsy. This study was designed to investigate the frequency of HLA-DQB1*0602 of Korean patients with narcolepsy. Methods: Twenty patients were selected (mean age: $28.2{\pm}3.0$, 11 men and 9 women). The patients were confirmed to have narcolepsy by the overnight polysomnography and multiple sleep latency test (MSLT) in addition to their clinical history and symptoms at St. Vincent's Hospital and Korea University Hospital Sleep Disorders Clinic. Any subjects co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep were excluded. Clinical data was collected through a semi-structured interview for narcoleptic patients. All patients and 21 control did HLA typing for the presence of DQB1*0602. Results Obtained were as Follows: 1) Mean sleep latency was 2.4 (${\pm}2.0$ minutes) and mean frequency of sleep-onset REM period was 3.0 (${\pm}1.6$) by MSLT. 2) Characteristic symptoms of narcolepsy investigated were as follows: excessive daytime sleepiness (100%), cataplexy (100%), sleep paralysis (60%), hypnagogic hallucination (70%) and disrupted nocturnal sleep (75%). 3) Strong emotional expression such as laughing (80%) and joking (70%) triggered cataplexy which affects the knee and leg region (80%) and jaw region (30%). 4) HLA-DR2 was found in 90% of patients and 35% in controls. The frequency of HLA-DQB1*0602 in patients and controls was 90%, and 24%, respectively. Conclusions: These results, which exhibit high HLA-DQB1*0602 expression in Korean patients with narcolepsy, suggest that HLADQB1*0602 could be a strong genetic marker in narcolepsy.

• 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 Radiology
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• v.22 no.12
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• pp.2094-2123
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• 2021

Incidental thyroid nodules are commonly detected on ultrasonography (US). This has contributed to the rapidly rising incidence of low-risk papillary thyroid carcinoma over the last 20 years. The appropriate diagnosis and management of these patients is based on the risk factors related to the patients as well as the thyroid nodules. The Korean Society of Thyroid Radiology (KSThR) published consensus recommendations for US-based management of thyroid nodules in 2011 and revised them in 2016. These guidelines have been used as the standard guidelines in Korea. However, recent advances in the diagnosis and management of thyroid nodules have necessitated the revision of the original recommendations. The task force of the KSThR has revised the Korean Thyroid Imaging Reporting and Data System and recommendations for US lexicon, biopsy criteria, US criteria of extrathyroidal extension, optimal thyroid computed tomography protocol, and US follow-up of thyroid nodules before and after biopsy. The biopsy criteria were revised to reduce unnecessary biopsies for benign nodules while maintaining an appropriate sensitivity for the detection of malignant tumors in small (1-2 cm) thyroid nodules. The goal of these recommendations is to provide the optimal scientific evidence and expert opinion consensus regarding US-based diagnosis and management of thyroid nodules.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.153-163
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• 2001

This study was attempted to investigate the discriminant validity of Korean version of Eating Attitude Test-26(KEAT-26) and to provide the sensitivity, specificity and efficiency according to cutting score, which may be useful to determine the optimal cutoff point on various purposes. The KEAT-26 was administered to 108 female patients with eating disorders, 179 female participants in body slimming center, 120 female athletic college students, 227 female college students, and 183 healthy normal women. Validity was tested by ANOVA and ROC curve analysis. The results revealed that the total score of the KEAT-26 showed a statistically significance between groups and that the score of the KEAT-26 of eating disorders group was significantly higher than that of the other groups in post hoc test. In comparison of the 4 subfactor score of the KEAT-26 between groups, significant differences in main effect within groups were found in all subfactors except factor IV. ROC curve analysis showed 80% of efficiency to discriminate eating disorders group from normal control group using cutoff score on maximum discriminant efficiency and 69% of efficiency to discriminate eating disorders group from high risk groups for eating disorders. Each cutoff score on maximum in efficiency was as follows ; 25 between eating disorders group and participants in body slimming center, 19 between eating disorders group and healthy normal woman, 23 between eating disorders group and athletic college students, 21 between eating disorders group and college students. Using 22(T score 65) of the KEAT-26 as the cutoff score, sensitivity was 54%, specificity was 84%, and overall efficiency was 80%. These results indicate that the KEAT-26 has a good discriminant validity in Korean population and also suggest that the KEAT-26 may be useful assessment tool to screen the disordered eating problems on clinical and epidemiological purposes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.11 no.1
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• pp.60-69
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• 2000

Objective：This study was carried out to evaluate the reliability and validity of the Korean form of the Children's Yale-Brown Obsessive Compulsive Scale(CY-BOCS). Method：Forty-two children with obsessive-compulsive disorder(OCD)(31 boys and 11 girls, aged 7 to 18 years) were assessed with CY-BOCS. Interrater agreement was assessed by two raters in subsample(n=20). discriminant and convergent validity were assessed by comparing CY-BOCS scores to Clinical Global Impression-OCD(CGI-OCD), Leyton Obsessional Inventory-Child Version (LOI-CV), State-Trait Anxiety Inventory for Children(STAI-C), and Child Depression Inventory(CDI). Results：Internal consistency was high, measuring 0.86 for the 10 items and total score. The intraclass correlations for the CY-BOCS total, obsession, and compulsion scores were 0.94, 0.94, 0.84, suggesting excellent interrater agreement for subscale and total scores. The CY-BOCS total score showed highest correlation with CGI-OCD(r=0.88), and significant correlation with LOI-CV(r=0.51), Trait Anxiety score(r=0.43), and CDI scores(r=0.49), but it was not correlated with State-Anxiety score(r=0.25). Conclusion：The results of this study indicate that the Korean form of CY-BOCS is a reliable and valid scale for rating obsessive-compulsive symptom severity.

• The Journal of Korean Medical History
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• v.18 no.2
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• pp.197-227
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• 2005

Heojun was the top scientist on Medicine in the 16th and 17th centuries and wrote the Dongeubogam describing the top-level medical theory and technology. So far, his outlook on nature has been disregarded even though his medicine is still effective. Through this study, I would like to know if his outlook on nature as well as his medicine is still effective. The conclusions are as follows: 1. According to his output, the origin of the universe started from the spinning of One Gi(一氣) which is quite different from Hawking's theory. Hawking assumed that the origin of the universe started from the Big-bang and will end to the Big-crunch. However, the current report on the origin of a star is quite similar to Heojun's theory and we acknowledge that his view on the origin of the universe is still effective. 2. According to his output, the universe repeats expanding and contracting forever while Hawking assumed it will come to the end, the Big-crunch, based on the expanding universe theory. Some scientists assists that Hawking's assumption should have some contradictions. Now, we acknowledge that Heojun's universal cycling theory which corresponds with modern physical theories is still effective, which would lead to a new environmental movement. 3. His view on the structure of the universe is quite different from the output of the current science, which results from his thought that the nature should be reviewed from the point of human's view. His view on the structure will be able to be updated based on the output of the current science. 4. The universe analogy started from the East Asian area as well as the Greek and Roman area in the ancient. The idea has disappeared since the scientific revolution era in the West while the idea has been deepened and abundant in the East and has become one of the major philosophical bases. Heojun emphasized its importance from the beginning of his book. 5. The nation analogy has been popular all times and places. According to his output, governing a country is like controlling one's body. 6. According to Needham's output, the universe analogy and the nation analogy were based on the ancient developed alchemy. And Harper assumed that Taiosm was based on the macrobiotic hygiene which was developed by the ancient developed alchemists. We acknowledge that xian(仙) cult, macrobiotic hygiene, medicine, alchemy and the ancient philosophy started from our ancients. Heojun's output restored our ancient tradition by combining the macrobiotic hygiene and philosophy with medicine. 7. Roughly predicting yearly weather would be unacceptable by the current scientist but Heojun's yearly weather forecast is still used in the clinic and seems effective to prepare from any epidemic disease. 8. 'Day and Night' and Four seasons are the most important factors to the macrobiotic hygiene according to the Dongeubogam. The new environmental movements should be based on the most important factors, otherwise the human beings as well as the environment would fail to survive. 9. Wind, Coldness, Heat, Humidity, Dryness and Fire represents weather. The six weather factors represent one of six phases of a year which is decided by the areal factors. Heojun preferred the six factors generated in the body itself to them from the outside. He thought a human being was a universe and the six factors generated in the body responded to the factors of the outside. 10. According to his output, Heat and Humidity are the most important factors which make a human being ill. 11. Life span, disease, food, and dwelling are dependent upon the geographical feature, according to Heojun's output. In addition, one's appearance and his five viscera and the six entrails depend on the food as well as the geographical feature. 12. Heath is related with the environment and they effects upon each other. If one is weak, he will be deeply effected by the nature. On the other hand, if one is strong, he will effect on the nature. That's why people live together. 13. According to Heojun's work, the society is an important factor comprising the environment. During a peaceful era, the society becomes stable and human beings are stable as well while they will be on fire during a chaotic era. 14. Medicine deals with human beings who live in the nature, so any medical book cannot be excellent unless it has any description on the nature. Heojun's outlook on the nature turned out to be logical and suitable even from the point of the current view and it is still effective as if his clinical knowledge and technology are still effective. Something unsuitable may be substituted with the output of the current science.