• Title/Summary/Keyword: Neuropsychiatry

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마황복용 후 사상체질별 이상반응에 관한 임상연구 : 무작위배정 이중맹검시험 (Adverse Effects of Ephedra According to Sasang Typology in Healthy Adults : A Double-Blind Randomized Controlled Trial)

  • 이태호;형례창;양창섭;김락형;서의석;장인수
    • 대한한방내과학회지
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    • 제30권1호
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    • pp.144-152
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    • 2009
  • Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.

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Cardio-Ankle Vascular Index(CAVI), Ankle-Brachial Index(ABI)와 동맥경화 관련 요인과의 상관관계 연구 (The Relationship between Cardio-Ankle Vascular Index (CAVI), Ankle-Brachial Index (ABI), and Factors Related to Arteriosclerosis)

  • 이기향;강수빈;전상우;강세영
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.434-446
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    • 2020
  • Objectives: The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are non-invasive methods to evaluate cardiovascular disease and arteriosclerosis. This study investigated the relationship between CAVI, ABI, and factors related to arteriosclerosis. Methods: This study included 535 healthy adults who underwent health examinations in 2019. We analyzed the correlation between CAVI, ABI and clinical variables. Multiple regression analysis was performed on the independent clinical variables associated with CAVI and ABI. Results: The correlation analysis of CAVI showed that body mass index (BMI) and HDL-cholesterol (HDL-C) had a negative correlation, and the other variables had a significant positive correlation. The correlation analysis with ABI on the right side showed that age, diastolic blood pressure (DBP), gender, and LDL-cholesterol (LDL-C) had a significant positive correlation, while HDL-C had a significant negative correlation. There was no statistical significance on the left. In the multiple regression analysis, DBP, age, BMI, gender, and HDL-C were proved to be independent factors in CAVI (right) (R2=0.365); DBP, age, gender, BMI, fasting blood sugar, and total cholesterol in CAVI (left) (R2=0.357); and age, gender, DBP, and systolic blood pressure in ABI (right) (R2=0.133). There were no statistically significant factors in ABI (left). It could be inferred that smoking and drinking are determinants that play an important role in CAVI. Conclusion: CAVI showed a high correlation with gender, age, and blood pressure. A significant correlation between CAVI and serum lipid values could be observed, but this showed a low correlation coefficient. ABI showed a high correlation with age and DBP. These results support the use of CAVI and ABI as primary diagnostic devices in medical treatment.

우리나라 정신질환자의 의료이용 현황과 장기입원 관련 요인 (Medical Care Utilization Status and Associated Factors with Extended Hospitalization of Psychiatric Patients in Korea)

  • 서수경;김윤;박종익;이명수;장홍석;이선영;이진석
    • Journal of Preventive Medicine and Public Health
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    • 제42권6호
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    • pp.416-423
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    • 2009
  • Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

Effects of Korean Red Ginseng extract on tissue plasminogen activator and plasminogen activator inhibitor-1 expression in cultured rat primary astrocytes

  • Ko, Hyun Myung;Joo, So Hyun;Kim, Pitna;Park, Jin Hee;Kim, Hee Jin;Bahn, Geon Ho;Kim, Hahn Young;Lee, Jongmin;Han, Seol-Heui;Shin, Chan Young;Park, Seung Hwa
    • Journal of Ginseng Research
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    • 제37권4호
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    • pp.401-412
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    • 2013
  • Korean Red Ginseng (KRG) is an oriental herbal preparation obtained from Panax ginseng Meyer (Araliaceae). To expand our understanding of the action of KRG on central nervous system (CNS) function, we examined the effects of KRG on tissue plasminogen activator (tPA)/plasminogen activator inhibitor-1 (PAI-1) expression in rat primary astrocytes. KRG extract was treated in cultured rat primary astrocytes and neuron in a concentration range of 0.1 to 1.0 mg/mL and the expression of functional tPA/PAI-1 was examined by casein zymography, Western blot and reverse transcription-polymerase chain reaction. KRG extracts increased PAI-1 expression in rat primary astrocytes in a concentration dependent manner (0.1 to 1.0 mg/mL) without affecting the expression of tPA itself. Treatment of 1.0 mg/mL KRG increased PAI-1 protein expression in rat primary astrocytes to $319.3{\pm}65.9%$ as compared with control. The increased PAI-1 expression mediated the overall decrease in tPA activity in rat primary astrocytes. Due to the lack of PAI-1 expression in neuron, KRG did not affect tPA activity in neuron. KRG treatment induced a concentration dependent activation of PI3K, p38, ERK1/2, and JNK in rat primary astrocytes and treatment of PI3K or MAPK inhibitors such as LY294002, U0126, SB203580, and SP600125 (10 ${\mu}M$ each), significantly inhibited 1.0 mg/mL KRG-induced expression of PAI-1 and down-regulation of tPA activity in rat primary astrocytes. Furthermore, compound K but not other ginsenosides such as Rb1 and Rg1 induced PAI-1 expression. KRG-induced up-regulation of PAI-1 in astrocytes may play important role in the regulation of overall tPA activity in brain, which might underlie some of the beneficial effects of KRG on CNS such as neuroprotection in ischemia and brain damaging condition as well as prevention or recovery from addiction.

이명증 환자 중증도와 삶의 질의 상관 연구 (A study on the correlation between health related quality of life(QOL) and the severity of tinnitus patients)

  • 서은성;황충연;임규상;강형원;박민철;김남권
    • 한방안이비인후피부과학회지
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    • 제25권4호
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    • pp.45-56
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    • 2012
  • Objective : This study was done to investigate the correlation between general quality of life(QOL) and disease specific QOL of tinnitus patients. Methods : 2009 National health and nutrition survey(NHNS) data were employed for analyzing the mean estimates of total population and tinnitus sub-group patients, and predicting the regression equation of mapping between EQ-5D and disease severity. Baseline statistical analyses and normality tests were done by using Student t-test, Chi-square test, Shapiro-Wilk test and ladder test. Hierarchial regression analyses were performed using related variables and predicted the optimal regression equations. Statistical significance was achieved if the probability was less than 5%. Results : Firstly, the standardized prevalence of tinnitus patient in South Korea was 18.69% and over 90th age-group was relatively higher than other groups. Mean value of domestic QOL measured by EQ-5D was estimated as 0.9486 and QOL of tinnitus subgroup(0.9169) was lower than the non-tinnitus subgroup(0.9559), significantly. Stratified by age and sex, QOLs of all sub-groups with tinnitus were lower than without tinnitus sub-groups significantly. Regression equations from 2009 NHNS data were developed using hierarchial regression analysis which is as follows. $$Y_{EQ-5D}=0.9224-0.0079{\times}T1-0.0261{\times}T2-0.0951{\times}T3+\sum_{i=1}^{n}{\beta}_i{\times}X_i\\{\hspace{95}}(0.0106){\hspace{3}}(0.0037){\hspace{30}}(0.0072){\hspace{30}}(0.0038)$$ ($X_i$=Other explanatory variables except Tinnitus QOL1, 2, 3, ${\beta}$= Regression Coefficient of Model 4) Conclusion : We confirmed the correlation among THI and EQ-5D and HUI-III, and developed the inference for regression equation of EQ-5D.

결핵전문병원에 입원한 결핵환자의 우울증위험인자 (Risk Factors for Depression of Patients with Tuberculosis in Tuberculosis Specialty Hospital)

  • 왕정현;박철수;김봉조;이철순;차보석;이소진;이동윤;서지영;안인영;백종철;강형석;문성호
    • 정신신체의학
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    • 제23권2호
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    • pp.114-120
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    • 2015
  • 연구목적 결핵환자 중 우울증 고위험 환자와 저위험 환자의 비교연구를 통해 결핵환자의 우울증 위험요인을 밝히고자 했다. 방 법 57명의 결핵환자를 대상으로 벡 우울 검사 2판을 이용하여 우울증상을 평가하였다. 우울증 고위험군과 저위험군으로 나누어 이분형로지스틱회귀분석 및 계산도표를 작성하였다. 결 과 신체비만지수가 낮아질수록 우울증 고위험군에 속할 위험은 높았다. 결핵치료 임의중단력이 있을 경우 우울증 고위험군에 속할 위험은 6배 높았다. 우울증 과거병력이 있는 경우 우울증 고위험군에 속할 위험은 25배 높았다. Original C-index는 0.789였고 bias corrected C-index는 0.754로 상당한 일치를 보였다. 결 론 낮은 신체비만지수, 결핵치료 임의중단력, 우울증 과거병력은 결핵환자의 우울증 위험요인임을 밝혔다. 이는 결핵환자에 대한 정신건강의학과적 개입 및 치료를 위한 근거자료가 될 것이다.

인터넷 및 스마트폰의 미디어 기능과 청소년 우울과의 관련성 (The relationship between media function of internet and smartphone, and youth depression)

  • 홍연재;류승아;서재식;김윤지;강동묵;김영기;김지훈
    • 의료커뮤니케이션
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    • 제12권1호
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    • pp.73-84
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    • 2017
  • Purpose: As the internet use of teenagers become more common, the need for research on the relationship between the internet and youth depression has emerged. The purpose of this study is to investigate the relationship between internet use and adolescent depression. Methods: The subjects of this study were youth attending elementary($6^{th}$ grade), middle($2^{nd}$ grade), and high schools($2^{nd}$ grade) belonging to the Busan Metropolitan City Office of Education. Depression was assessed using the BDI depression scale. Internet functions were classified into 10 categories, and the degree of use by Internet functions was examined. The most frequently used Internet sites were surveyed. Univariate analysis using $X^2$ test and multivariate analysis using logistic regression analysis were conducted to find out the difference of internet and smartphone media function on depression according to elementary, middle and high school students. Results: Depression was higher of 13.2 times for students who use online transactions (goods purchase), 0.07 times for students who use 'bulletin board' activities in elementary students. Depression was higher of 1.55 times for those who use online transactions (purchasing goods), and 2.3 times for those who use adult sites for middle school students. Depression was higher of 2.1 times when using e-mail and 1.9 times when using other information retrieval for high school students. Conclusion: It is necessary to consider characteristics of internet utilizing pattern by school class in policy regulation and prevention program to reduce youth depression.

퇴행성 무릎관절염 변증도구의 신뢰도 평가 및 무릎 ROM, VAS, WOMAC과의 상관관계에 대한 탐색적 연구 (A Pilot Study to Evaluate the Reliability of Pattern Identification Tool for Knee Osteoarthritis and to Analyze Correlation between Pattern Identification Tool and Knee Range of Motion, Visual Analog Scale and Western Ontario & Mcmaster Universities Osteoarthritis Index)

  • 오승준;장은수;오영선;강위창;이은정;정인철
    • 한방재활의학과학회지
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    • 제29권3호
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    • pp.113-128
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    • 2019
  • Objectives To evaluate the pattern identification tool for knee osteoarthritis and to investigate the relationship between pattern identification tool and knee ROM (range of motion), VAS (visual analog scale) and WOMAC (Western Ontario & McMaster Universities osteoarthritis index). Methods We studied 50 patients who are diagnosed as degenerative osteoarthritis. With one patient dropping out, total of 49 patient went through pattern identification tool. Re-test of the pattern identification tool was implemented after about a week. The reliability was analyzed by calculating ICC (intraclass correlation coefficient). Also, reliability of each pattern identification score was calculated along with influence factor and correlation between knee ROM, VAS and WOMAC. Results Reliability of the pattern identification tool was evaluated as 'poor agreement beyond chance' with ICC value of 0.396. Reliablility of each pattern identification score was calculated and four out of five were measured 'good' with one 'moderate' reliability. Two of inter-item consistency were 'good', two were 'acceptable' and one was 'questionable'. Correlation between each pattern identification and knee ROM showed 'clear negative linear relationship' with two patterns. VAS showed 'clear positivie linear relationship' with all five patterns. WOMAC showed 'positivie linear relationship' with all five patterns. Conclusions According to the results, pattern identification tool for knee osteoarthritis seems to have meaningful relationship with other agnedas. Also, further research is needed to develop the tool.

지역사회 경증치매환자를 대상으로 한 전산화 인지재활 치료(COMCOG) 효과 (Effects of a Computer-based Cognitive Rehabilitation Therapy on Mild Dementia Patients in a Community)

  • 정원미;황윤정;윤종철
    • 한국노년학
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    • 제30권1호
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    • pp.127-140
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    • 2010
  • 본 연구는 시-지각 이론에 근거한 전산화 인지재활치료가 경증치매환자의 일상생활수행능력, 인지기능과 작업수행수준에 미치는 효과를 알아보고 치매환자를 위한 독립적인 지역사회에서의 적응을 위한 인지재활치료의 기초 자료를 제시하기 위함이다. 연구방법은 2009년 2월부터 2009년 8월까지 용인시 치매예방관리센터에 내원한 경증 치매환자 14명을 대상으로 5주 동안 주 2회, 총 10회 가정 방문하여 전산화인지재활치료를 실시하였다. 전산화인지재활치료는 시-지각이론의 틀에 근거하여 실시하였다. 알쯔하이머치매군과 비알쯔하이머치매군을 대상으로 치료 전후의 일상생활수행능력, 인지기능과 작업수행기능에 미치는 효과를 검증하기 위한 유사 실험연구로써 단일군 전후실험설계를 적용하였다. 연구결과는 첫째, 전산화인재활치료 실시 전에 비하여 실시 후에 경증치매환자의 일상생활수행능력, 인지수준판별검사 등의 인지기능과 작업수행 만족도가 통계적으로 유의하게 증가하였다(p<.05). 둘째, 비알쯔하이머치매군에 비하여 알쯔하이머치매에서 인지기능의 변화에 유의한 효과가 있었다(p<.05). 따라서 시-지각 이론의 틀에 근거한 전산화 인지재활치료는 지역사회에 거주하는 경증치매환자의 전반적인 인지기능 및 일상생활수행능력 향상에 효과적으로 보인다. 또한 인지기능과 일상생활독립성의 증가로 인하여 작업수행에 대한 만족감도 증가에도 효과적이었다. 앞으로 지역사회에 거주하는 경증치매환자의 기능향상을 위한 보다 다양한 인지재활 프로그램에 대한 연구가 필요하다.

Assessment of Mild Cognitive Impairment in Elderly Subjects Using a Fully Automated Brain Segmentation Software

  • Kwon, Chiheon;Kang, Koung Mi;Byun, Min Soo;Yi, Dahyun;Song, Huijin;Lee, Ji Ye;Hwang, Inpyeong;Yoo, Roh-Eul;Yun, Tae Jin;Choi, Seung Hong;Kim, Ji-hoon;Sohn, Chul-Ho;Lee, Dong Young
    • Investigative Magnetic Resonance Imaging
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    • 제25권3호
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    • pp.164-171
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    • 2021
  • Purpose: Mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD). Brain atrophy in this disease spectrum begins in the medial temporal lobe structure, which can be recognized by magnetic resonance imaging. To overcome the unsatisfactory inter-observer reliability of visual evaluation, quantitative brain volumetry has been developed and widely investigated for the diagnosis of MCI and AD. The aim of this study was to assess the prediction accuracy of quantitative brain volumetry using a fully automated segmentation software package, NeuroQuant®, for the diagnosis of MCI. Materials and Methods: A total of 418 subjects from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease cohort were included in our study. Each participant was allocated to either a cognitively normal old group (n = 285) or an MCI group (n = 133). Brain volumetric data were obtained from T1-weighted images using the NeuroQuant software package. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate relevant brain regions and their prediction accuracies. Results: Multivariate logistic regression analysis revealed that normative percentiles of the hippocampus (P < 0.001), amygdala (P = 0.003), frontal lobe (P = 0.049), medial parietal lobe (P = 0.023), and third ventricle (P = 0.012) were independent predictive factors for MCI. In ROC analysis, normative percentiles of the hippocampus and amygdala showed fair accuracies in the diagnosis of MCI (area under the curve: 0.739 and 0.727, respectively). Conclusion: Normative percentiles of the hippocampus and amygdala provided by the fully automated segmentation software could be used for screening MCI with a reasonable post-processing time. This information might help us interpret structural MRI in patients with cognitive impairment.