• Title/Summary/Keyword: Major psychiatric disorder

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Heart Rate Variability and Lipid Profile in Patients with Major Depressive Disorder (주요우울장애 환자에서의 심박변이도와 혈중 지질 농도와의 연관성)

  • Ahn, Eun-Jung;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.27-34
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    • 2012
  • Objectives: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. Methods: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. Results: In serum lipid profile test, MDD group showed higher cholesterol ($197.68{\pm}42.94$ mg/dL vs. $176.85{\pm}34.68$ mg/dL, p=0.044), TG ($139.45{\pm}92.54$ mg/dL vs. $91.4{\pm}65.68$ mg/dL, p=0.018), LDL ($130.03{\pm}33.18$ vs. $106.62{\pm}27.08$, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant ($32.82{\pm}14.33$ ms vs. $40.36{\pm}21.40$ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group ($1.13{\pm}0.11$ vs. $0.91{\pm}0.18$, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). Conclusions: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.

The necessary & method of scrotoplasty in female to male transgender (여성에서 남성으로의 성전환증에서 음낭성형술의 필요성과 방법)

  • Kim, Seok-Kwun;Moon, In-Sun;Kwon, Yong-Seok;Lee, Keun-Cheol
    • Archives of Plastic Surgery
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    • v.36 no.4
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    • pp.437-444
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    • 2009
  • Purpose: Transgender is a disorder of gender identity, who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. There is a persistence discomfort and sense of inappropriateness about one's assigned sex in a person who has reached puberty. Transgender is a psychiatric problem, but surgical method provides more satisfactory adjustment for patients. In gender reassignment surgery for female to male transgender, mastectomy, nipple reduction, hysterectomy, oophorectomy and phalloplasty are included. And as the final operation, recommended for scrotoplasty and artificial testes insertion. So we investigated the necessity and method of scrotoplasty in the final operation of female to male transgender. Method: The authors have long term follow-up of 75 cases female to male transgender during January, 1991 to February, 2008. Among them, 13 cases were evaluated in this study. During phalloplasty, the labium major skin preserved. And this labium majoral skin flap was made for the neoscrotum. At least six months later, artificial testes were inserted in neoscrotum with local anesthesia. Middle sized (3 cm diameter) artificial testes(silicon gel or carving soft silicone implant) were used because of the limitation of the neoscrotum. We evaluated the questionnaire and interview about the postoperative satisfaction in configuration of reconstructed scrotum, and the necessity of operation, the postoperative psychosocioeconomic improvement and limitation of body exposure activities such as swimming, public bathing. Results: Based on this study, satisfaction of reconstructed scrotum after scrotoplasty was improved(92%). The necessity of scrotoplasty was in 92.3% and the postoperative psychosocioeconomic well - being improvement was 77% in answers. Less limitation of activities requiring body exposure was 54% in answers. Most of the patients were satisfied with the results of surgical operation inspite of the operative procedure had some postoperative complications. Conclusion: This study was reported that the scrotoplasty in female to male transgender is not only a conversion of external genitalia but also an improvement of psychosocial state. Most patients sincerely hope to this operation, so we improve our surgical method for more good results.

Angiotensin-Converting Enzyme(ACE) Gene Polymorphism and Seasonal Variation in Mood and Behavior (기분과 행동의 계절성 변동과 Angiotensin-Converting Enzyme(ACE) 유전자 다형성)

  • Jeon, Hye-Yeon;Lee, Heon-Jeong;Kang, Seung-Gul;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.14 no.1
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    • pp.26-32
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    • 2007
  • Objectives: Angiotensin-converting enzyme (ACE) gene polymorphism has been reported to be associated with depression and therapeutic outcome in depression. The purpose of this study was to determine whether ACE gene polymorphism is associated with seasonal variation in mood and behavior in a young Korean college student sample. Methods: 297 young Korean medical students were recruited in this study. All subjects were free of major medical and psychiatric problems. They were genotyped for the ACE gene polymorphism and evaluated the seasonal variation in mood and behavior by the Seasonality Pattern Assessment Questionnaire (SPAQ). Results: Global Seasonality Score (GSS) of SPAQ between three genotypes were not different. However, comparison of the group that showed seasonality of mood and behavior during winter with the group that did not showed seasonality indicated significant difference in genotype distribution ($x^2=6.79$, p=0.034). The D allele non-carrier (ll genotype) frequency was significantly higher in winter seasonality group than non-seasonality group ($x^2=6.59$, p=0.010;odds ratio [OR]=2.27, 95% confidence interval [CI] 1.20-4.28). Conclusion: These results suggest that the ACE gene polymorphism is related to winter-type seasonality in a Korean population.

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NLRP3 Inflammasome in Neuroinflammatory Disorders (NLRP3 인플라마좀 작용 기전 및 신경 질환에서의 역할)

  • Kim, Ji-Hee;Kim, YoungHee
    • Journal of Life Science
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    • v.31 no.2
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    • pp.237-247
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    • 2021
  • Immune responses in the central nervous system (CNS) function as the host's defense system against pathogens and usually help with repair and regeneration. However, chronic and exaggerated neuroinflammation is detrimental and may create neuronal damage in many cases. The NOD-, LRR-, and pyrin domain―containing 3 (NLRP3) inflammasome, a kind of NOD-like receptor, is a cytosolic multiprotein complex that consists of sensors (NLRP3), adaptors (apoptosis-associated speck like protein containing a caspase recruitment domain, ASC) and effectors (caspase 1). It can detect a broad range of microbial pathogens along with foreign and host-derived danger signals, resulting in the assembly and activation of the NLRP3 inflammasome. Upon activation, NLRP3 inflammasome leads to caspase 1-dependent secretion of the pro-inflammatory cytokines IL-1β and IL-18, as well as to gasdermin D-mediated pyroptotic cell death. NLRP3 inflammasome is highly expressed in CNS-resident cell types, including microglia and astrocytes, and growing evidence suggests that NLRP3 inflammasome is a crucial player in the pathophysiology of several neuroinflammatory and psychiatric diseases, such as Alzheimer's disease, Parkinson's disease, multiple sclerosis, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and major depressive disorder. Thus, this review describes the molecular mechanisms of NLRP3 inflammasome activation and its crucial roles in the pathogenesis of neurological disorders.

Effects of Stress-Induced Sterile Inflammation on the Development of Depression (스트레스로 유발된 무균 염증이 우울증 발생에 미치는 영향)

  • Mi Kyoung Seo;Jung Goo Lee;Dae-Hyun Seog;Se Young Pyo;Won Hee Lee;Sung Woo Park
    • Journal of Life Science
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    • v.33 no.12
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    • pp.1062-1073
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    • 2023
  • Although depression is a common psychiatric disorder that negatively affects individuals and societies, its exact pathogenesis is not well understood. Stress is a major risk factor for depression and is known to increase susceptibility by triggering inflammation. Indeed, many preclinical and clinical studies have suggested a strong link between depression and inflammation. Depression is associated with increased levels of pro-inflammatory cytokines, such as interleukin (IL-)1β, IL-6, IL-12, tumor necrosis factor-α, and interferon-γ, and decreased levels of the anti-inflammatory IL-4, IL-10, and transforming growth factor-β. Administering pro-inflammatory cytokines causes depression-like behaviors in rodents. Conversely, administering anti-inflammatory drugs appears to ameliorate depressive symptoms. Although the importance of inflammation as a mediator of depression has been demonstrated, the mechanisms by which inflammation is activated in depression remain unclear. To address this issue, recent studies have focused on the importance of stress-induced sterile inflammation. Sterile inflammation refers to the activation of inflammatory processes due to physical and/or psychological stress in the absence of pathogens. Stress promotes the release of endogenous factors known as damage-associated molecular patterns (DAMPs), thereby triggering sterile inflammation. In turn, DAMPs are recognized by pattern recognition receptors, leading to the production of pro-inflammatory cytokines. Here, we review the role of DAMPs in depression based on preclinical and clinical evidence on the dysregulation of sterile inflammation.

A Study on Satisfaction level with Herbal Public Health Services and its Improvement Plans (한방공중보건서비스 만족도와 개선방안)

  • Lee, Jae-Won;Koo, Jin-Suk;Seo, Bu-Il
    • Korean Journal of Oriental Medicine
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    • v.18 no.2
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    • pp.65-89
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    • 2012
  • Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

Low Frequency Noise Induces Stress Responses in the Rat (흰쥐에서 저주파소음에 의한 스트레스 반응)

  • Choi, Woong-Ki;Lee, Kyu-Sop;Joung, Hye-Young;Lee, Young-Chang;Sohn, Jin-Hun;Lee, Bae-Hwan;Pyun, Kwang-Ho;Shim, In-Sop
    • Science of Emotion and Sensibility
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    • v.10 no.3
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    • pp.411-418
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    • 2007
  • Exposure to low frequency noise(LFN) can lead to vibroacoustic diseases(VADs), which include a systemic disease with lesions in a broad spectrum of organs and a psychiatric condition. It is known that VAD is an established risk factor for the development of many psychological conditions in humans and rodents, including major depression and anxiety disorder. The present study investigated the effects of LFN on neuronal stress responses in the rat brain. The neuronal expression of the proto-oncogene c-fos in the paraventricular nucleus(PVN) of the hypothalamus and tyrosine hydroxylase(TH) in the LC was observed. The immunocytochemical detection of the Fos protein and TH has been used as a marker of neuronal activation in response to stress. In addition, corticosterone concentration was evaluated by using an enzyme-linked immunosorbent assay(ELISA). The LFN groups were exposed to 32.5Hz and 125Hz of noise(4hr/day for 2days). The numbers of c-fos and TH-immunoreactive cells in the PVN and LC were significantly increased in the LFN groups(32.5Hz and 125Hz) compared to the normal group. Corticosterone concentration in plasma was also increased in LFN groups. The present results demonstrated that exposure with LFN produced a pronounced increase in expression of c-Fos and TH in stress-relevant brain areas. These results suggest that the neural characteristics involved in LFN are similar to those activated by typical processive stressors. These results also suggest that the central and peripheral activations by LFN may be related to LFN-related negative behavioral dysfunctions such as VADs.

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