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Differences in Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Issues versus General Psychiatric Outpatients (군 복무 적합성 평가를 위해 정신건강의학과에 내원한 환자군과 일반 외래 환자군의 인지적 및 심리적 특성의 차이)

  • Shim, Seungyun;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.143-154
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    • 2020
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients with military service suitability issues compared to the general psychiatric outpatients. Methods : 108 patients who visited psychiatric clinic center due to military service suitability issues and 80 general psychiatric patients were recruited from the Department of Psychiatry of university hospital. ANCOVA and chi-equare test were used to examine differences between two groups. Furthermore, we utilized paired t-test to compare the scrore within military group depending on when they performed the psychological assessment. Results : There were no significant differences between military group and general outpatient group in WAIS-IV scores. However, military group scored remarkably higher than control group on validity scales, F-r and Fp-r whereas they scored lower on validity scale, K-r. Furthermore, military group showed significantly higher on BDI and MMPI-2-RF, EID, RCd, RC2, RC3, COG, HLP, SFD, NFC, STW, SAVE, SHY, DSF, NEGE-r, INTR-r. As a result of comparison within the military group following the periods of assessment, military group did not show the significant differences on the overall scales of MMPI-2-RF. Conclusions : The present study showed that military group tends to report their psychological distress more exaggeratedly. In addition, they had significantly elevated not only emotional distress such as depression and anxiety but interpersonal problem. The implications and limitations were discussed along with some suggestions for the future studies.

Multi-Institute, Single Group, Prospective Observational Study to Evaluate the Efficacy of Mucomyst® in Relieving Symptoms of Globus Pharyngeus Refractory to Proton Pump Inhibitor (양성자펌프억제제에 반응하지 않는 인두이물감 환자에서 "뮤코미스트Mucomyst®" 객담제거 및 상기도 염증치료를 통한 증상개선효과 평가 다기관, 단일군, 전향적 관찰 연구)

  • Park, Hannah;Park, Il-Seok;Lee, Sang Hyuk;Lee, Seung-Won;Lee, Sang Joon;Lee, Byung-Joo;Cheon, Yong-Il;Park, Jun-Ook;Oh, Kyoung Ho;Shin, Yoo Seob
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.20-25
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    • 2022
  • Background and Objectives Globus pharyngeus is one of the most common symptoms of patients visiting otorhinolaryngology out-patient clinic, and usually long-lasting, difficult to treat, and frequently recurrent. Mucomyst®, N-acetyl cysteine is an inhalation agent mainly used for mucolysis and reducing inflammation in airway via antioxidative effect. The purpose of this study was to evaluate the efficacy of inhaled Mucomyst® treatment in patients with globus pharyngeus refractory to proton pump inhibitor (PPI). Materials and Method We prospectively evaluated the efficacy of Mucomyst® in relieving symptoms of globus pharyngeus refractory to PPI in nine medical centers. Three hundred and three patients enrolled and finally 229 patients finished the inhaled Mucomyst® therapy for 8 weeks. We analyzed the change of Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Visual Analogue Scale (VAS) for globus, and Globus Pharyngeus Symptom Scale (GPS) after use of Mucomyst® for 4 and 8 weeks. Results The GPS, RSI, RFS, and VAS score significantly decreased serially in patients who finished 8 week-inhalation treatment. The GPS improvement gap was significantly correlated with initial GPS (p<0.001) in multiple regression analysis. Conclusion Inhaled Mucomyst® therapy was effective for the reduction of both subjective and objective findings in refractory globus patients. This study might suggest new treatment option for patients with globus. However, further thorough studies would be needed to assess the real effect of inhaled Mucomyst® treatment as a standard treatment for globus.

A Study on the Rational Improvement of the Regulation and System about Embryo Preservation (배아 보존에 관한 합리적 제도 개선을 위한 연구)

  • Baik, Sujin;Moon, Hannah;Park, Inkyoung;Cha, Seunghyun;Park, Joonseok;Lee, Gyeonghun;Park, Chun-seon;Cho, Heesoo;Kim, Myung-Hee
    • The Korean Society of Law and Medicine
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    • v.22 no.3
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    • pp.57-95
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    • 2021
  • Korea's period for preservation of embryos is up to five years (the Bioethics Act). However, the study reviewed domestic and foreign laws and drew issues due to the recent demand that the development of related science and technology and the period limitation limit the rights of consent holder for embryo production. the first issue is that preserved embryos are intended for pregnancy, and it is important to ensure that the autonomy of the consent holder is protected through careful consideration based on information such as scientific evidence. the second is that regulations regarding the obligation to manage embryonic preservation institutions are needed. the third is to create a social atmosphere in which embryo creation, preservation, and disposal take place in a minimum range, considering the special status of embryos. based on this issue, the first of the proposals for rational improvement of the regulation and system about embryo preservation is the introduction of an environment in which sufficient explanation and appropriate consent can be exercised and to extend the reasons for the extension of the period, rather than specifying the specific period in law. the second is that institutionalization is necessary considering not only the obligation to manage preservation institutions but also the overall site, such as concerns that may arise as a result. lastly, we propose the introduction of a management method considering the future use of embryos, such as transfer to provide research purposes and donation of pregnancy purposes by others. this process should be a method of sufficient social discussion and consensus, as well as a general consideration of the family relationship with the born child.

Image Analysis of Angle Changes in the Forearm during Elbow Joint Lateral General Radiography: Evaluation of Humerus Epicondyle and Elbow Joint (팔꿉관절 측방향 일반촬영에서 아래팔뼈 각도 변화에 따른 영상 분석 : 위팔뼈 위관절융기와 팔꿉관절 평가)

  • Hyo-Soo Shin;Hye-Won Jang;Jong-Bae Park;Ki Baek Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.4
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    • pp.607-614
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    • 2023
  • Clear overlapping of the bilateral epicondyle and proper separation of the elbow joint are crucial for obtaining accurate lateral general radiographs of the elbow. However, due to the complex anatomical structure of the elbow, achieving optimal positioning is challenging, leading to the need for repeated x-ray examinations. Therefore, the purpose of this study was to investigate the angle of the forearm in patients where accurate lateral images of the elbow joint can't be obtained after vertical incidence using a styrofoam device during elbow joint lateral x-ray imaging. Twenty patients were enrolled in our study following the established protocol. First, a vertical x-ray at an angle of 0° between the forearm and the table was taken (control group). Here, if the lateral image of the elbow joint was deemed inadequate, the forearm angle was adjusted using custom-made styrofoam supports with 5° and 10° inclinations (experimental groups). For the evaluation method, two assessors utilized a 5-point Likert scale to assess the images. The reliability of the assessments was analyzed using Cronbach's alpha coefficient. As a result, patients with inadequate overlap of the bilateral epicondyle and separation of the elbow joint in the initial examination (control group) were able to obtain the best images when setting a 10° angle between the forearm and the table. The subjective evaluation was 1.6 ± 0.8 points at 0°, 2.7 ± 0.8 points at 5°, and 4.4 ± 1.3 points at 10°, respectively. The reliability analysis for the angles of 0°, 5°, and 10° yielded Cronbach's alpha values of 0.867, 0.697, and 0.922, respectively. In conclusion, when it is not possible to obtain accurate images using the conventional position and X-ray beam direction, it is considered that by initially acquiring images with an angle of 10° between the forearm and the table, and gradually decreasing the angle while obtaining images, it would be possible to achieve the optimal image while reducing the number of repeat examinations.

Clinical Observation on East-West Integration Treatment in Stroke and Brain Disease (중풍 뇌 질환의 한 방향 협진에 관한 임상적 고찰)

  • Shin, Ae-sook;Lee, ln-whan;Kim, Na-hee;Kim, Hye-rni;Kim, Min-kyung;Sim, So-ra;Cho, Seung-yeon;Park, Seong-uk;Park, Jung-mi;Bae, Hyung-sup;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.11 no.1
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    • pp.9-17
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    • 2010
  • Objectives : This study was aimed to evaluate the current status of East-West integrated treatment in stroke and brain disease and to discuss further plans. Methods : The medical records of patients who visited the stroke and brain disease center at Kyung Hee University, East-West Neo Medical Center from May 2006 to August 2010 were evaluated. The general characteristics of patients who underwent integrated treatment, trend in the number of cross referrals were initially evaluated. Later major disorders, the reasons of referrals and the number of visits in outpatients were analyzed. Results : 1. 3496 patients were referred from the eastern medical hospital to the western medical hospital and 2440 patients from the western medical hospital to the eastern medical hospital. The number of patients reached a peak alter the opening of the hospital and has decreased from then on. Referrals of female patients were more than those of male patients and patients over 50 years old were the most. 2. Admitted patients with stroke of chronic stage were most commonly referred from the eastern medical hospital to the western medical hospital and cerebral infarction was most common from the western medical hospital to the eastern medical hospital. Among the outpatients cerebral infarction topped from east to west, and stroke of chronic stage from west to east. 3. 36.6% of the patients from east to west received integrated treatment more than 3 times and 28.6% from west to east. Headache was the second most common reason to be referred from west to east and 36.7% of patients didn't continue to have either of the treatment and 30.3% received eastern treatment only, Conclusions: According to this study, chronic stroke management was successfully performed in the outpatient clinic in the form of East-West integration treatment. Further research on other diseases such as headache is recommended.

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Alveolar ridge preservation using granulation tissue for esthetic implant restoration on maxillary anterior tooth (상악 전치부의 심미적 임플란트 수복을 위한 육아 조직(Granulation tissue)을 이용한 치조제 보존술)

  • Lee Chang Kyun
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.16-22
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    • 2023
  • Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

Quasi-breath-hold (QBH) Biofeedback in Gated 3D Thoracic MRI: Feasibility Study (게이트 흉부자기 공명 영상법과 함께 사용할 수 있는 의사호흡정지(QBH) 바이오 피드백)

  • Kim, Taeho;Pooley, Robert;Lee, Danny;Keall, Paul;Lee, Rena;Kim, Siyong
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.72-78
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    • 2014
  • The aim of the study is to test a hypothesis that quasi-breath-hold (QBH) biofeedback improves the residual respiratory motion management in gated 3D thoracic MR imaging, reducing respiratory motion artifacts with insignificant acquisition time alteration. To test the hypothesis five healthy human subjects underwent two gated MR imaging studies based on a T2 weighted SPACE MR pulse sequence using a respiratory navigator of a 3T Siemens MRI: one under free breathing and the other under QBH biofeedback breathing. The QBH biofeedback system utilized the external marker position on the abdomen obtained with an RPM system (Real-time Position Management, Varian) to audio-visually guide a human subject for 2s breath-hold at 90% exhalation position in each respiratory cycle. The improvement in the upper liver breath-hold motion reproducibility within the gating window using the QBH biofeedback system has been assessed for a group of volunteers. We assessed the residual respiratory motion management within the gating window and respiratory motion artifacts in 3D thoracic MRI both with/without QBH biofeedback. In addition, the RMSE (root mean square error) of abdominal displacement has been investigated. The QBH biofeedback reduced the residual upper liver motion within the gating window during MR acquisitions (~6 minutes) compared to that for free breathing, resulting in the reduction of respiratory motion artifacts in lung and liver of gated 3D thoracic MR images. The abdominal motion reduction in the gated window was consistent with the residual motion reduction of the diaphragm with QBH biofeedback. Consequently, average RMSE (root mean square error) of abdominal displacement obtained from the RPM has been also reduced from 2.0 mm of free breathing to 0.7 mm of QBH biofeedback breathing over the entire cycle (67% reduction, p-value=0.02) and from 1.7 mm of free breathing to 0.7 mm of QBH biofeedback breathing in the gated window (58% reduction, p-value=0.14). The average baseline drift obtained using a linear fit was reduced from 5.5 mm/min with free breathing to 0.6 mm/min (89% reduction, p-value=0.017) with QBH biofeedback. The study demonstrated that the QBH biofeedback improved the upper liver breath-hold motion reproducibility during the gated 3D thoracic MR imaging. This system can provide clinically applicable motion management of the internal anatomy for gated medical imaging as well as gated radiotherapy.

Efficacy and safety of oxcarbazepine in epileptic children (소아 간질 환자에서 oxcarbazepine의 효용성과 안전성)

  • Shin, Hye Kyung;Lee, Yoon;Lee, Jee-Yeon;Choi, Wooksun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.2
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    • pp.162-169
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    • 2008
  • Purpose : Oxcabarzepine (OXC), newly recommended antiepileptic drug, has been prescribed for patients with partial seizures and generalized tonic clonic seizures in Korea from 1999. There are limited reports about an efficacy of OXC therapy in epileptic children in Korea. This study evaluated the efficacy and safety of OXC in the light of our experience. Methods : The patients, who had visited the pediatric neurology clinic of Korea University Guro Hospital from January 2001 to December 2006, were included. The data of 144 patients who were administrated OXC as monotherapy or polytherapy, was summarized retrospectively and we evaluated the efficacy and safety of OXC. Results : After 6 months of OXC therapy, 77 patients (53.5%, n=144) achieved seizure freedom, 48 patients (33.3%) experienced >50% improvement. After 12 months of OXC therapy, cessation of seizure was observed in 88 patients (61.1%, n=133), and 27 patients (18.8%) manifested an improvement. Monotherapy group showed superior efficacy to polytherapy one. The frequent side effects of OXC were drowsiness (20.1%), headache (12.5%), dizziness (9.7%) and rash (8.3%). They did not related to patient's age or sex, and dosage of OXC. Twenty four patients (16.7%) experienced hyponatremia, but which were neither symptomatic nor significant one. Conclusion : The efficacy and safety of OXC in our patients were excellent and had less significant side effects than established international one. We expect this report contributes toward OXC therapy in epileptic children.

A clinical analysis of juvenile dermatomyositis; focus on clinical manifestations at diagnosis (소아기 피부근염의 임상적 고찰; 진단시 임상증상을 중심으로 한 고찰)

  • Lee, So Young;Bang, Ji Seok;Kim, Hee Seok;Kim, Joong Gon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1116-1124
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    • 2007
  • Purpose : Juvenile dermatomyositis (JDM) is the most common of the idiopathic inflammatory myopathies in children. The purpose of this study is to observe demographic, initial presentations, duration of time between disease onset and diagnosis, clinical manifestations and laboratory findings at diagnosis of patients with JDM. Methods : Forty seven patients identified at Seoul National University Children's Hospital from January 1986 to May 2007. Medical records were reviewed retrospectively focusing on initial presentations, clinical manifestations and laboratory findings at the time of diagnosis of patients with JDM. Results : Male and female patients were 25 and 22, respectively and sex ratio was 1.14:1. The average age at the time of diagnosis was 6.51 years. Skin rash (94%) was the most common symptom, followed by the proximal muscle weakness (89%). The disease activity score was 10.8. The duration between the onset of the skin rash and the muscle weakness and diagnosis was 7.18 and 4.70 months, respectively. The serum muscle enzymes, LDH, AST, CK and aldolase, were elevated in the patient with JDM. Autoimmune antibodies, antinuclear antibody, anti SSA antibody and anti SSB antibody, were negative findings. Electromyography findings were consistent with JDM in 88% of the patients, the muscle biopsy was in 91% and all MRI findings were compatible with those of patients with JDM. The most common symptom besides musculocutaneous lesions was the calcinosis (62.5%). The most common site of calcinosis was the pelvic area and buttocks. Conclusion : This study shows that the major symptoms are proximal muscle weakness and cutaneous lesion, and they are important to diagnose JDM.

Hyeongok's Sabeetang Was Combined According to the Theory for Properties and Tastes of Herbal Medicines (현곡(玄谷) 사비탕(瀉脾湯)의 구성한약과 그 기미배오(氣味配伍) 분석)

  • Park, Tae-Yeol;Kim, Gyeong-Cheol;Shin, Soon-Shik
    • Herbal Formula Science
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    • v.15 no.1
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    • pp.137-144
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    • 2007
  • Background and Objectives : There are three kinds of formulas for purging the spleen to cure its sthenic syndrome based on the types of preparation formulas : Sabeetang, Sabeehwan, Sabeesan and Sabeeeum. Another formulas called Sahwangtang, Sahwangsan. Sahwangeum is to purge the yellow colour of spleen. There are 8 kinds of Sabeetang, 3 kinds of Sabeehwan, 3 kinds of Sabeesan, 1 kind of Sabeeeum, 4 kinds of Sahwangtang, 7 kinds of Sahwangsan, and 1 kind of Sahwangeum. Combination of herbal medicines, carried out in formulas for purging the spleen, consists of various kinds depending on medical scientists' personal experience in medical treatment without any general principles, which makes it difficult to apply it to clinical use. The objectives of this study lie in theoretical establishment of Sabeetang for curing the sthenic syndrome of spleen through analyzing the component medicines and combination principles of Hyeongok's Sabeetang, and furthermore, maximizing the clinical use of Sabeetang. Methods : This study analyzed the component medicines and combination principles of Hyeongok's Sabeetang based on the theory for properties and tastes of herbal medicines from the ${\ulcorner}$Yellow Emperor's Canon of Internal Medicine${\lrcorner}$ , the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine, and the five elements doctrine. Hyeongok's Sabeetang is an odd prescription, composed of 7 kinds of ingredients : No.1 Rhizoma Coptidis (2don;7.5g), No.2 Fructus Gardeniae (1don;3.75g), No.3 Ramulus Cinnamomi (1don), No.4 Gypsum Fibrosum (1don), No.5 Fructus Aurantii Immaturus (1don), No.6 Cortex Magnoliae Omcinalis (1don), and No.7 Radix Et Rhizoma Rhei (1don) Results : There are three methods for curing the sthenic syndrome of spleen according to the five elements doctrine : purging the spleen, purging the lung and invigorating the liver. First, if you suffer from the sthenic syndrome of the spleen, you need to purge your spleen. There are two available methods, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each imply the bitter taste and the cool property purge the spleen. In the case of taste purgation, two herbal medicines with bitter taste. Rhizoma Coptidis and Fructus Gardeniae, are combined into the principal and assistant herbal medicine, respectively. For property purgation, three herbal medicines with the cool property, Gypsum Fibrosum, Fructus Aurantii Immaturus and Radix Et Rhizoma Rhei, are combined into adjuvant herbal medicines. Secondly, if you suffer from the sthenic syndrome of the spleen, you need to purge your lung which is child in the mother-child relationship in inter-promotion among the five elements. There are two methods to purge the lung, including taste and property purgation according to the theory for properties and tastes of herbal medicines. They each mean the pungent taste and the warm property purge the lung. Therefore, it is important to use pungent herbal medicines for taste purgation and warm ones for property purgation. Both pungent and warm herb and property invigoration to invigorate the liver with warm property. Therefore, it is important to use pungent herbal medicines for taste invigoration and warm ones for property invigoration. Both pungent and warm herbal medicines, Ramulus Cinnamomi and Cortex Magnoliae Officinalis, were combined to invigorate the liver and purge the lung. In addition, Gypsum Fibrosum are combined as dispatcher herbal medicine, leading all the herbal medicines composing the formula to the spleen. Conclusions : First, to cure the sthenic syndrome of the spleen, the methods of purging the spleen and the lung, and invigorating the liver should be used according to the five elements doctrine. Secondly, herbal medicines appropriate for those treatment methods should be chosen according to the theory for properties and tastes of herbal medicine and thirdly, the combination of those herbal medicines should be carried out according to the theory for principal herbal medicine, assistant herbal medicine, adjuvant herbal medicine, dispatcher herbal medicine. As a good example, Hyeongok's Sabeetang is combined according to the above theories. In conclusion, this formula was created by applying to the theory for properties and tastes of herbal medicines.

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