• Journal of Sasang Constitutional Medicine
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• v.10 no.1
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• pp.215-233
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• 1998

The object of this study is 27 patients who had been treated in the Oriental Medical Hospital at Dong Eui Medical Center during 6 months from January 1998 to June 1998. We proceeded the judgment of Sasang Constitution by Questionaire of Sasang Constitution Classification II(QSCC II). The following conclusion were made in comparison with Questionaire of Sasang Constitution Classification II(QSCC II) and Questionaire of Pusan Sasang seminar. 1. The subject of "the facial type is small and sharp" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 2. The subject of "the walking form is fast and shake the body" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 3. The subject of "the skin type is white and thin" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group, and the frequency of Taeumin group is low marks. 4. The subject of "the skin type is tender and dry" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 5. The subject of "the image of face is smart" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and the frequency of Soyangin group is low marks. 6. The subject of "the sweating type is not sweatier" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soeumin group is less than Soyangin group. 7. The subject of "the desire of eating is changeable accoding to emotion" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 8. The subject of "the health is changeable accoding to the type of stool" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Soyangin group and the frequency of Taeumin group is low marks. 9. The subject of "the type of voiding is changeable accoding to the drinking when they have a fever" is significant differences in Sasang Constitution classification. The frequency of Taeumin group and Soyangin group is less than Soeumin group. 10. The subject of "the skin type is soft" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is more than Taeumin group and Soyangin group. 11. The subject of "the chief complaint is the forgetfulness" is significant differences in Sasang Constitution classification. The frequency of Soeumin group is less than Taeumin group and Soyangin group.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.44-52
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• 2011

Purpose: Cytogenetic analysis of spontaneous abortions (SABs) provides valuable information to establish the causes of fetal loss, information that is essential to provide accurate reproductive and genetic counseling couples. Such analysis also provides information on the frequencies and types of chromosomal abnormalities and associated risks of recurrence. However, there have only been a few reports of chromosomal abnormalities in small samples of SABs in the Korean population. Here, we report the incidence and spectrum of chromosomal abnormalities for cases of 470 SAB in Korea. Material and Methods: Between 2005 and 2010, a total of 470 products of conception (POC) resulting from SABs were submitted to our laboratory for cytogenetic analysis from various medical sites in Korea. The incidences and types of specific chromosomal abnormalities were determined. The abnormalities were distinguished by gestational age at the time of SAB and by maternal age. Results: The frequency of chromosomal abnormalities in POCs was 54.3% (255/470), including 228 (89.3%) numerical and 27 (10.7%: 3 balanced and 24 unbalanced) structural abnormalities. Among the numerical abnormalities, trisomy was predominant (67.0%), followed by monosomy X (12.5%), polyploidy (8.2%), triple X (0.8%), and autosomal monosomy (0.8%). The overall sex ratio (male: female) among the 470 POCs with normal and abnormal karyotypes were 0.58 and 0.65, respectively. Trisomies were identified for each autosome, with the exceptions of 1, 3, and 19. Among the 171 autosomal trisomies, trisomy 16 was the most common (19.9%), followed by trisomy 22 (13.5%), trisomy 21 (12.3 %), trisomy 15 (9.9%), and trisomies 18 and 13 (5.3%). The frequency of chromosomal abnormalities decreased with gestational age and increased with maternal age, but only because of increases in trisomies and complex abnormalities. Conclusions: We have presented a large collection of cytogenetic data for SABs collected during the past 6 years and provided a database for prenatal genetic counseling of parents who have experienced SABs in Korea.

• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.95-102
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• 2008

Objectives : Diabetes patients suffer from severe stress in maintaining the diet therapy and exercise therapy as well as the disease itself, and this stress has bad effects on controlling the glucose level and causes high prevalence rate of depressive and anxiety disorders. These symptoms again have deleterious effects on blood glucose control. A lot of researches about the relationship between glycemic control and symptoms of depression and anxiety and about the positive effects of the treatments of depression and anxiety disorder on glycemic control in diabetic patients are being performed. In Korea, the research regarding the relationship between glycemic control and depression and anxiety symptoms are seldom performed. In this study, we tried to find out the correlation between the glycemic control and depressive symptom and anxiety symptom. Methods : The study included 65 patients(male 34, female 31) with Diabetes in outpatient clinic of the Department of Endocrinology in Dankook University Hospital. We used the HbA1c levels to check glycemic control through blood sample analysis and used Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). Results : Among the 65 Diabetes patients, 21(32.30%) had mild depressive symptoms, and 6(9.23%) had moderate or severe depressive symptoms. The relation of HbA1c and BDI was not statistically significant, but was significant between HBA1c and BAI, (R=0.567, P<0.001). In the linear regression analysis, BAI had an effect on HbA1c($\beta=0.533$, T=5.012, P=0.00), but BDI, diabetes complications, diabetic morbid period and BMI had no effect on HbA1C. The relationship between HbA1c and BDI was not statistically significant, but the relationship between HbA1c and BAI was statistically significant(R=0.254, P<0.001). Conclusions : In this study, the rates of diabetic patients with depressive symptoms were higher, but those with anxiety symptoms were not higher than the general population. We could not find out significant relationship between depressive symptom and glycemic control, but found the significant relationship between the anxiety symptom and glycemic control in diabetic patients.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.37-44
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• 2001

Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

• Sleep Medicine and Psychophysiology
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• v.15 no.1
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• pp.25-32
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• 2008

Objectives: A few studies have compared REM sleep-dependent obstructive sleep apnea syndrome (REM-OSA) with sleep stage non-dependent apnea syndrome (SND-OSA). Despite that REM-OSA might be more common in women than men, no studies have examined the probable characteristics of women patients with obstructive sleep apnea syndrome (OSAS). This study aimed at finding out the characteristics of REM-OSA in women by comparing it with SND-OSA. Methods: Fifty-three subjects diagnosed as OSAS (AHI>5 ; AHI : apnea-hypopnea index) with nocturnal polysomnography at the Center for Sleep and Chronobiology of the Seoul National University Hospital between October 2004 and February 2006 were studied. Of them, 44 subjects with OSAS severity of mild (52 and AHI-NR<15 (AHI-R : AHI during REM sleep, AHI-NR : AHI during non-REM sleep). We compared REM-OSA group with SND-OSA as well as the criteria-determined REM-OSA cases with the visually-determined ones. Results: Among 44 subjects, 28 persons (63.6%) turned out to have REM-OSA by our criteria and 24 persons (54.5%) by visual determination. Statistically significant differences (p<0.05) were found between REM-OSA and SND-OSA groups in AHI, hypopnea index, total sleep time, total wake time, sleep efficiency index, percents of stage 1, 2 and REM sleep, and REM latency. Percent of stage REM sleep (%REM) turned out to have influence on AHI ratio (AHI-R/AHI-NR) (B=0.537, p=0.002). REM-OSA was likely to be diagnosed in milder severity of OSAS (${\chi}^2=13.117$, p<0.001) and those with higher %REM (${\chi}^2=11.325$, p=0.001). There was no significant difference between the criteria-determined and the visually-determined cases of REM-OSA. Conclusion: We suggest that REM-OSA and SND-OSA patients be differentiated in terms of pathophysiology and treatment strategies. Visual determination of REM-OSA might be useful as the screening procedure of REM-OSA. Further studies on women with OSAS and REM-OSA need to be done.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.167-176
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• 2007

Objectives:A considerable number of pharmacogenetic studies have been performed in recent years to define the association of antipsychotic drug response with dopamine receptor polymorphisms. The purpose of this study was to investigate the relationship between the therapeutic response to antipsychotic drugs and the polymorphisms of the dopamine D2, D3, and D4 receptor genes(DRD2, DRD3 and DRD4, respectively). Methods:We conducted retrospective chart review of 200 consecutively hospitalized patients with the diagnosis of schizophrenia(DSM-IV) who were treated with various antipsychotics(94% atypical antipsychotics) at Bugok National Hospital, Korea. The patients were divided into two groups, responders and non-responders, by responsiveness to antipsychotic drugs according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. We analyzed the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48 bp repeat polymorphism in the DRD4. Results:Among the total patients of 200, 141(70.5%) were categorized as responders. There were no significant differences in the frequencies of the DRD2, DRD3, and DRD4 alleles and genotypes between responders and non-responders. Conclusion:These results suggest that the Ser311Cys polymorphism in the DRD2, the Ser9Gly polym- orphism in the DRD3, and the exon III 48bp repeat polymorphism in the DRD4 are not associated with the therapeutic response to antipsychotic drugs in Korean schizophrenic patients. A larger prospective study is needed to elucidate the association between antipsychotic response and dopamine receptor gene polymorphism.

• Journal of Sasang Constitutional Medicine
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• v.11 no.2
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• pp.361-376
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• 1999

1. Backgrounds and Purpose : Pruritus, one of the most common dermatological symptoms, was clinically examined with a view to a better understanding of its characteristics for more accurate treatment. 2. Method : For 22 months from November in 1997 to September in 1999 we selected outpatients who had consulted for itchiness more than twice in the department of Sasang Constitution of the Pundang Oriental medical hospital, Dongkook University, and 59 of those (35 males and 24 females) were confirmed of their course of treatment. From their medical records and history, we learned the general characteristics and patterns of pruritus, and the qualities and effects of its various treatments. 3. Result and Conclusion : Pruritus was more complained by men than by women and the largest age groups were 20's and 30's. For its suffering period, the duration of 1 month to less than 1 year was the greatest, and most patients had already experienced western medical care. Itchiness affected them almost day and night. In addition, many patients had abnormal bowel habits as a general symptom. According to Sasang Constitution, the Soeumin gave sleep disturbance and indigestion; the Soyangin showed a different pattern in their tongue coatings and bowel habits; the Taeumin had different tongue coatings and sweating pattern. The commonly prescribed herbal formula for pruritus was Gakhangjungisan, Yangkyuksanhwatang, Chungsimyonjatang. As for their efficiency, 61.0 % of patients improved, whereas 39.0 percent did not. Patients aged over 30 showed a more significant improvement than those of 20 years or under, and the duration of less than 1 year was more significantly improved than that of 1 year or more. Those who had no experience in western medical care or had been continuously treated showed a more significant improvement than those with intermittent treatments, and severe pruritus was more significantly improved than mild pruritus.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.212-219
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• 1999

Objective：This study is designed to get clinical guidelines for management of children with TBI by examining neuropsychiatric sequelae of TBI, determining whether the severity of TBI, type of treatment, and enviornmental factors are related to those sequelae, and defining the adequacy of public psychological tests as evaluating tools for them. Method：This is chart review of 47 children, aged 5 to 14 years, referred to a psychiatric outpatient clinic for neuropsychiatric evaluation at least 6 months after TBI. Data on the initial GCS score, associated injury, treatment type, and duration of hospital stay are obtained from medical records. EEG, MRI, intelligent test, and several psychological tests are administrated at the point of assessment. Results：1) Cognitive symptoms outnumber externalizing behavioral, emotional, and somatic symptoms, with no significant differences of frequencies of those 4 categorical symptoms between mild injury group and moderate to severe group. 2) Children treated with non-surgical method(p<0.01) complain more cognitive symptoms than the others. 3) Behavioral symptoms are related to younger age(p<0.05), and to anticonvulsant medication(p<0.05). 4) Children with associated injury complain emotional symptoms more frequently(p<0.05). 5) More somatic symptoms are presented by children with no medication(p<0.05), and with higher I.Q(p<0.05). 6) Low I.Q is correlated to low GCS score (p<0.05). Cognitive impairment is confirmed in 25 in 42 children complaining cognitive symptoms though I.Q test and BGT, whose hospital stay is longer than the others(p<0.05). 7) emotional disturbance is confirmed in 22 in 25 children showing emotional problems through psychological tests, who complain cognitive symptoms more frequently(p<0.05). Conclusion：This findings suggest that even mild TBI children need to be followed-up and treated as complaining neuropsychiatric symptoms over 6 months after injury, and shorter hospital stay is recommended for cognitive and emotional status of children, and for better evaluation of neuropsychiatric sequelae of TBI, more specific tests should be included in neuropsychological test tools.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.112-122
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• 2003

Objectives：Considerable data indicate that diminished serotonergic activity is related to aggressive behavior. In order to understand the biological etiology in conduct disorder, we studied the relationships of plasma serotonin and 5-HIAA levels in conduct disorders to measures of aggression, violation of rules and oppositional defiant behavior. Methods：Subjects were selected from inpatients and outpatients department of the Division of Child and Adolescent Psychiatry of Seoul National University Hospital. 41 conduct disorders(18 childhoodonset type, 23 adolescent-onset type) and 23 normal controls were included in this study. For the assessment of aggression, rule violation and oppositional behavior, parents completed the rating scale for conduct disorder and oppositional behavior based on the DSM-IV diagnostic criteria. Plasma serotonin and 5-HIAA levels were determined by HPLC with electrochemical detection. Results：1) Plasma 5-HT and 5-HIAA levels were not significantly different among childhood-onset conduct disorder, adolescent-onset conduct disorder and normal control subjects. 2) No significant correlations were found between plasma 5-HT levels and aggression or rule violation. 3) Plasma 5-HT levels showed significant positive correlations with oppositional behavior both in childhood-onset conduct disorder and adolescent-onset conduct disorder. 4) Age-related changes were not found in plasma 5-HT and 5-HIAA levles. Conclusion：Our findings do not support the hypothesis that dysregulation of serotonergic function may be associated with aggresson. Instead, our data suggest that serotonergic function is more closely related with oppositional behavior than aggression.