• Korean Journal of Psychosomatic Medicine
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• v.19 no.2
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• pp.66-73
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• 2011

Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.1
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• pp.3-12
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• 2014

Objectives : We aimed to explore the relationship among fatigue and perceived stress, depressive mood in the working population. We also examined associations with demographic and life style factors and investigated the effect of individual coping skills on these associations. Methods : Fatigue Severity Scale(FSS), Perceived Stress Scale(PSS), Brief Encounter Psychosocial Instrument - Korean version(BEPSI-K), Beck Depression Inventory(BDI), Stress Coping Skill Questionnaire were administered to 621 civil servants. All of above and other demographic factors are self-administered questionnaire survey and this study is cross sectional. Results : Mean FSS score was 3.04 which was lower than 3.22, the severity cut off score. FSS, PSS, BEPSI-K, BDI were all higher in female. Subjects with active coping skills showed relatively low fatigue, perceived stress, depressive mood than those with passive coping skills. Logistic regression analyses indicated that the PSS, BDI, BEPSI-K in working population increase the risk of fatigue and regular exercise lowers the risk. Conclusions : Adults who were afflicted by stress, experienced depressive mood or were physically inactive were at much higher risk of feeling fatigue. Since no other large data sets are available for fatigue, the results from this study could serve a very useful purpose, to furnish a basis for comparison with future research results based on more complete data.

• Neonatal Medicine
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• v.18 no.2
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• pp.211-220
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• 2011

Purpose: Late-onset hypotension in preterm infants is not a rare condition. Late circulatory collapse due to adrenal insufficiency (AI) is one of the major causes of late-onset hypotension. We assessed the incidence and causes of late-onset hypotension. We also compared the clinical findings according to the presence of AI. Methods: In total, 244 preterm infants with a gestational age ${\leq}$32 weeks and who were admitted to the neonatal intensive care unit (NICU) of Seoul National University Boramae Hospital and Seoul National University Hospital from January 2009 to April 2011 were included. Clinical findings were analyzed retrospectively. Results: Forty-four infants (18%) suffered from late-onset hypotension. Hydrocortisone was administered to 30 infants (68.2%) and AI occurred in 16 infants (36.4%). Cesarean section, sepsis before hypotension, and gastrointestinal surgery were independently associated with late-onset hypotension. Intrauterine growth retardation (IUGR) was less frequent in the hydrocortisonetreated group than in infants not treated with hydrocortisone. The AI group had fewer IUGR infants, and the duration of hospitalization was shorter in the AI group than in infants who were not administered hydrocortisone. Blood pressure tended to normalize more quickly in the AI group, however, the difference was not significant. Conclusion: AI was a major cause of late-onset hypotension, and the use of hydrocortisone shortened the length of hospitalization.

• Journal of agricultural medicine and community health
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• v.35 no.3
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• pp.287-300
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• 2010

Objectives: We identified factors associated with any participation and with "good participation" (as assessed by frequency of attendance) in health promotion programs at a public health center in Korea. Methods: The subjects included 199 women who attended a baseline examination of health promotion programs during the first half of 2009. We collected data by structured interviews and physical examinations. Participation status was quantified by the frequency of attendance to the program. We classified the subjects as non-participants (0) and participants (1+ times), and as poor participants (0-29 times) and good participants (30+ times). Results: Of the 199 subjects, there were 57 (28.6%) non-participants, while 56 (28.1%) were classified as good participants. The factors that significantly affected participation status, as identified by univariate analysis, were personal factors (age, educational level, marital status, religion, living with someone, monthly income), environmental factors (method of access, accessibility of other facilities), body mass index, hypertension, perceived barriers to health, emotional salience, affectionate domain of social support, and depression. Multiple logistic regression analyses indicated that method of access was the most significant factor affecting participation in the health promotion program, and that the factors most highly associated with good participation were emotional salience, hypertension and body mass index. Conclusions: Our findings suggest that specific factors determine and enhance participation in health promotion programs offered by public health centers. These factors should be considered during the design and evaluation of health promotion programs that are offered by public health centers.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.27-33
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• 2005

Purpose : To determine incidence, characteristics and risk factors associated with intrauterine intraventricular hemorrhage(IU-IVH) among premature infants. Methods : The medical records of infants with intraventricular hemorrhage(IVH) admitted to the neonatal intensive care unit of Asan Medical Center from January 1999 to June 2003 were reviewed retrospectively. Infants whose IVH with cystic change were detected within five days of life were defined as the IU-IVH group. The control group included those without any IVH. Various maternal and neonatal factors were evaluated between the IU-IVH and control groups, and risk factors for IU-IVH were identified using multiple logistic regression analysis. Results : The incidence of IU-IVH was 49/1024(15.9%). Mothers who are younger, primiparous, use less antenatal steroid, and neonates with greater incidence of neonatal respiratory distress syndrome, had higher incidences of IU-IVH compared to neonates with normal neurosonography. Risk factors associated with IU-IVH included neonatal respiratory distress syndrome and placenta infarct by placenta biopsy. Most infants with IU-IVH were ${\geq}1,501g$, ${\geq}34$ weeks gestational age and had low grade IVH. The size of the cysts associated with IU-IVH remained the same or disappeared in 96 %. IU-IVH does not seem to affect short-term neurodevelopmental outcome although a longer period of follow-up is needed. Conculusion : IU-IVH occurred mostly in ${\geq}1,501g$, ${\geq}34$ weeks infants with grade I IVH without developmental delays. However, the high incidence of total IVH merits more attention in terms of awareness of its existence as an unusual IVH among premature infants.

• Journal of radiological science and technology
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• v.36 no.3
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• pp.209-217
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• 2013

Adiponectin (AdipoN), brain-derived nerotrophic factor (BDNF) and leptin (LeP) are mainly secreted from adipose tissue and are known to be involved in regulation of the development of obese. However, there are not many studies on the association between abdominal fat and neuropeptides such as AdipoN, BDNF and LeP. The aim of this study was undertaken to investigate the association between abdominal fat thickness, neuropeptides and cardiovascular disease (CVD) risk factors. The participants in the study were 138 male employees without CVD. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. We obtained subcutaneous fat thickness (SFT) and visceral fat thickness (VFT) by using ultrasonography and neuropeptides levels were measured with ELISA kit according to the method suggested by kit manufacturer. The mean SFT and VFT were $1.58{\pm}0.51$ and $4.52{\pm}1.44$ cm. The mean concentrations of AdipoN, BDNF and LeP were $3.14{\pm}3.52$ ng/ml, $24.11{\pm}8.52$ pg/ml and $4.27{\pm}2.38$ ng/ml, respectively. VFT were positively correlated with total cholesterol (r=0.217, p<0.05), LDL-cholesterol (r=0.271, p<0.01), triglyceride (r=0.233, p<0.05) and insulin (r=0.338, p<0.01), but was inversely correlated with HDL-cholesterol (r=-420, p<0.01). AdipoN levels were positively correlated with HDL-cholesterol (r=0.220, p<0.05) and were inversely correlated with total cholesterol (r=-0.196, p<0.05), LDL-cholesterol (r=-0.190, p<0.05), triglyceride (r=-0.199, p<0.05), SFT (r=-0.195, p<0.05) and VFT (r=-0.412, p<0.01). However, LeP levels showed a reverse trend to AdipoN. AdipoN level was significantly higher in non-obese participants (BMI<25 kg/m), but LeP concentration was significantly higher in obese participants (BMI>25 kg/m) than in non-obese. On multiple logistic regression analysis, obese were significantly associated with AdipoN (odds ratio=0.784) and LeP (odds ratio=1.494). These results suggested that AdipoN and LeP concentrations are affected abdominal fat and that dysfunction and/or declination in the production and secretion of neuropeptides might induced ultimately obese and CVD.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.451-469
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• 1996

To identify the drug abuse status and its determinant factors in high school boys in Taegu, the study was performed from April to May, 1995. Study population were selected by cluster sampling method and total 5,665 students replied to the self-administered questionnaire survey (2,207 in academic high school, 3,458 in business high school). The major findings were as follows; The proportion of drinking, smoking experience was 55.0%, 45.8%, respectively, and the proportion of current drinker, current smoker was 27.2%, 27.5%. The drinking, smoking experience rate of second grade students was higher than first grade and it was higher in business high school boys. The proportion of a stimulant, a hallucinogen, hemp leaf cigarets experience was 3.2%, 1.6%, 0.1%, respectively. Drug abuse had significant association with home environment(lower economic status, frequent move, death of father or mother, apart from family), parents environment(parents' indifference, parents' drinking and smoking, etc.), school life(lower school grades, intimate friend's drug abuse, etc.), generous attitude to drug abuse, higher level of stress. Students who replied that the law prohibited immature person(students) from drinking and smoking showed lower drug abuse rate. In multiple logistic regression analysis, second grade students, business high school students, parents' indifference, lower school grades, intimate friend's drug abuse, no recognition of the fact that the law prohibits high school students from drinking and smoking, generous attitude to drug abuse, higher level of stress were significantly related with alcohol abuse and smoking. Other drugs abuse were related with above factors. On consideration of above findings, to prevent students from drug abuse, we have to try together in house, school, and society.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.1
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• pp.15-22
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• 2009

Objectives : Prevalence of postpartum depressive disorders reaches approximately 10-15% of childbearing women. This preliminary study was intended to explore the relationships between postpartum depressive disorders and family adaptability and cohesion. Methods : Childbearing women(n=24) were assessed for risk factors for postpartum depression before and after childbirth prospectively. At gestational age between 36th and 40th week, the questionnaire about various factors before childbirth, Edinburgh postnatal depression scale(EPDS), Family adaptability-cohesion evaluation scale (FACES), and Beck anxiety inventory(BAI) were assessed. After childbirth, for the diagnosis of postpartum depressive disorders, a structured diagnostic interview according to MINI International Neuropsychiatric Interview was performed, furthermore, the questionnaire about various factors after childbirth, EPDS, and BAI were assessed at 4-6 weeks postpartum. Results : Among various factors and scales, family adaptability and cohesion, mood symptom and change during pregnancy were associated with postpartum depressive disorder in comparison with non-postpartum depressive disorder subjects. In addition, low family adaptability and cohesion and mood change during pregnancy were significantly associated factors with postpartum depressive disorder using logistic regression analysis. Conclusion : The results suggest the postpartum depressive disorder could be related with prenatal low family adaptability and cohesion. This preliminary study, however, includes only a few subjects, so that further large-sized study will be needed to replicate our results.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.585-590
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• 2003

Purpose : This study is designed to determine the prevalence of cardiovascular autonomic neuropathy and its relationship to risk factors in adolescents with diabetes mellitus(DM). Methods : Ninety-two diabetic patients(80 with type 1 DM and 12 with type 2 DM), ranging from eight to 26 years of age, were studied for cardiovascular autonomic function, and the relationship to age, duration of diabetes, glycated hemoglobin(HbA1c), urinary albumin excretion, and the presence of diabetic retinopathy and abnormal nerve conduction velocities(NCV) were analysed. Autonomic function was assessed by measuring heart rate variation during valsalva manoeuvre, deep breathing and standing from a lying position(30 : 15 ratio), and postural hypotension. Results : Among patients with type 1 DM, 22.5% had early, 8.7% had definite, and 1.3% had severe autonomic dysfunction, and among patients with type 2 DM, 16.7% had early, 8.3% had definite, and 8.3% had severe autonomic dysfunction. On logistic regression analysis including both type 1 and type 2 diabetic patients, the age of the patient(OR=1.133(1.003-1.279), P<0.05) and duration of diabetes(OR=1.148(1.009-1.307), P<0.05) significantly predicted cardiovascular autonomic dysfunction while HbA1c, blood pressure, urinary albumin excretion, and presence of diabetic retinopathy and abnormal NCV did not. The valsalva ratio was borderline or abnormal in 31.5% of patients, the heart rate variation on deep breathing in 41.3%, the 30 : 15 ratio in 14.1%, and postural hypotension in 9.8% of patients. The valsalva ratio and the heart rate variation on deep breathing significantly predicted cardiovascular autonomic dysfunction, but the 30 : 15 ratio and postural hypotension did not. Conclusion : Cardiovascular autonomic dysfunction was found in 32.6% of diabetic patients and 10.8 % of patients had definite or severe involvement. The risk of cardiovascular autonomic dysfunction increased with the patient's age and the duration of DM. This study suggests that the valsalva ratio and the heart rate variation on deep breathing are the most useful tests in evaluating the cardiovascular autonomic function in children and adolescents with DM.

• Clinical and Experimental Pediatrics
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• v.52 no.10
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• pp.1127-1135
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• 2009

Purpose : To observe the abnormal white matter findings on the magnetic resonance imaging (MRI) scans of very-low- birth-weight (VLBW) infant brains at term-equivalent age and to determine the clinical risk factors for the development of periventricular leukomalacia (PVL). Methods : In all, MRI was performed in 98 VLBW infants and the white matter abnormalities were observed. Clinical risk factors for cystic and noncystic PVL were determined. Results : MRI scans of 74 infants (75.5%) showed diffuse excessive high signal intensity (DEHSI) in the periventricular white matter, 17 (17.3%) lateral ventricle dilation, 5 (5.1%) and 11 (11.2%) focal punctate lesions and cystic changes in the periventricular white matter, respectively, 9 (9.1%), germinal layer hemorrhage (GLH) or subependymal cysts 3 (3.1%) intraventricular hemorrhage (>grade 2) 2 (2.0%) posthemorrhagic hydrocephalus and 2 (2.0%) periventricular hemorrhagic infarct. Gestational age (GA), 1-minute Apgar score, Clinical Risk Index for Babies-II (CRIB-II) score, and inotrope use, and GA, CRIB-II score, postnatal steroid administration, inotrope use, and abnormal white blood cell (WBC) count at admission were related to cystic PVL and noncystic PVL development, respectively (P<0.05). However, in logistic regression analysis, CRIB-II (odds ratio, 1.63, 295% confidence interval, 1.15-2.30 P=0.006) for cystic PVL, and GA (odds ratio 0.90, 95% confidence interval, 0.82-0.99 P=0.036) for noncystic PVL were only significant independently. Conclusion : White matter abnormalities could be observed on MRI scans of the VLBW infant brains at term-equivalent age, and CRIB-II and GA were only independently significant for cystic and noncystic PVL development, respectively.