• Title/Summary/Keyword: 의과대학병원

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Association between Impulsivity and Medical Lethality of Suicide Attempts among Suicide Attempters (자살시도자들에서 충동성과 자살시도의 의학적 치명도와의 관계)

  • Park, Ji Won;Suh, Kyung Hoon;Son, Kyung Hoon;Han, Jae Hyun;Jeon, Yeong Ju;Jung, Yu Jin;Lee, Won Joon;Seong, Su Jeong;Han, Chang Hwan;Cho, Gyu Chong;Hwang, Jae Yeon
    • Korean Journal of Biological Psychiatry
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    • v.25 no.4
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    • pp.118-124
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    • 2018
  • Objectives Although impulsivity has long been thought as an important factor influencing suicidal behaviors, it is unknown whether impulsivity increases the risk of dying from suicidal behaviors and what specific component among constructs of impulsivity contributes to the risk of dying among suicide attempters. Methods To elucidate the association between impulsivity and medical lethality of suicide attempt among suicide attempters, we consecutively recruited 46 suicide attempters who visited an emergency room of a general hospital located in a metropolitan area, Seoul, Republic of Korea, due to suicide attempts and consented to participate in this study. Then we assessed medical lethality with the Beck Lethality Scale (LS) and impulsivity with the Korean version of the Barratt Impulsiveness Scale-11-Revised (BIS). Demographic variables were obtained from medical records and structured social work reports for suicide attempters. Results Although total scores of the BIS did not correlate with LS scores, only the scores of self-control, that is one of the Barrett's six theoretical constructs of impulsivity in which the higher score indicates less self-control and more impulsivity, had a significant positive correlation with scores of LS (p = 0.003). The association remained significant after adjusting for variables known to affect suicide lethality such as job status, recent alcohol consumption, diagnosis of depressive disorders, and having a plan for suicide (${\beta}=0.429$, p = 0.009). Conclusions Not impulsivity in general, but poor self-control, in particular, predicts lethal suicidal behaviors among suicide attempters. The degree of self-control should be evaluated when assessing patients with elevated suicide risk, and proper measures should be installed to prevent possible future lethal suicide attempts.

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Human Understanding is Expected of the Physician: Proposing a Model of Disease Development (의사에게 요구되는 인간이해를 통합한 질병발생모델의 제안)

  • Sang-Heum Park;Samel Park;Jin Young Kim;Hyeon Ah Lee;Sang Mi Lee;Tae Hoon Lee;Sang Byung Bae;Sung Hae Chang;Si Hyong Jang;Sung Wan Chun;Jong Ho Moon
    • The Korean Journal of Medicine
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    • v.99 no.2
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    • pp.84-95
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    • 2024
  • In Harrison's Principles of Internal Medicine, human understanding is emphasized as one of three necessary characteristics that a physician must have. Inflammation, which is caused by inflammatory inducers (inf-ids), is a fundamental feature of disease at the cellular and molecular levels. Inflammation protects the body, but excessive or prolonged inflammation can be damaging and can cause disease. Humans are repeatedly exposed to external and internal environmental factors that generate inf-ids throughout their lives. External environmental factors include microbial and non-microbial inf-ids, as well as stressors that inevitably arise during social interactions. Internal environmental factors include the adaptive physiological response that is present from birth. Inf-ids may also be produced by the four-step habit loop, which consists of a cue (e.g., stressor), emotions, routine act (adaptive response), and a reward. Immune cells in the circulatory system and in tissues may have positive and negative effects in inflammatory responses. However, low-grade inflammation may be difficult to detect. We propose a model of disease development that integrates external and internal environmental factors from the perspective of human understanding.

Comparison of Mismatch Negativity According to Suicidal Ideation in Patients With Major Depressive Disorder (주요우울장애 환자에서 자살사고 동반 여부에 따른 부적격 짝맞추기 음성파의 비교)

  • Lee, Minji;Lee, Yeon Jung;Hwang, Jaeuk;Woo, Sung-il;Kim, Min Jae;Kang, Byungjoo;Kim, Younggeun;Hahn, Sang-Woo
    • Anxiety and mood
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    • v.17 no.2
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    • pp.84-91
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    • 2021
  • Objective : Mismatch negativity (MMN) is known to reflect several abnormalities of cognitive functioning. This study is aimed to investigate the differences in MMN among major depressive disorder (MDD) patients with or without suicidal ideation. Methods : Sixty-seven patients with MDD were recruited into this study. MMN was measured by a 64-channel electroencephalography (EEG) using oddball paradigm over the front-central area. Clinical characteristics were assessed using the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Beck Scale for Suicide ideation (SSI-BECK). Patients were divided into two groups, no suicidal ideation (N=12) and suicidal ideation (N=55), depending on the presence of suicide ideation in SSI-BECK questionnaires. Results : The MMN latencies were significantly longer in the MDD patients with suicidal ideation than in the MDD patents without suicidal ideation (p<0.05). The MMN amplitudes were not significantly different between the two groups. Conclusion : Suicidal ideation may be associated with longer MMN latencies, and it suggests that MMN may play a potential role in assessing the suicidal risk among MDD patients.

Association between Smoking and Delayed Neuropsychological Sequelae in Acute Carbon Monoxide Poisoning (급성 일산화탄소 중독 환자들에서 흡연과 지연성 신경정신과학적 후유증 발생의 상관관계)

  • Kim, Hak Myeon;Choi, Sung Woo;Nah, Sang Un;Choi, Hyo Jeong;Lim, Hoon;Kim, Gi Woon;Han, Sang Soo;Lee, Young Hwan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.102-107
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    • 2018
  • Purpose: This study examined the association between smoking and delayed neuropsychological sequelae (DNS) in acute carbon monoxide (CO) poisoning. Methods: Patients admitted to the medical center emergency department from March 2016 to March 2017 because of CO poisoning were examined retrospectively. The patients were divided into two groups: DNS and Non-DNS group. Multiple factors were analyzed to explain DNS, which was assessed by motor disturbances, cognitive impairment, dysphagia, Parkinson-like syndromes, epilepsy, and emotional lability in CO poisoning. Results: A total of 120 patients were included. The factors related to DNS were smoking (pack-years) (p=0.002) and initial carbon monoxide-hemoglobin level (p=0.015). On the other hand, after multivariate logistic regression analysis, smoking (Odds ratio 1.07; 95% CI, 1.02-1.13; p=0.004) was the only factor associated with DNS. Conclusion: Smoking is a very reliable factor for predicting the occurrence of DNS. A history of smoking in patients who suffer from CO intoxication is important. If a patient smokes, treatment should be started actively and as soon as possible.

A Case of Segmental Vitiligo Occurring Where Herpes Zoster Occurred Previously as an Isotopic Response (제목을입력해주세요대상포진 발생 부위에 발생한 분절형 백반증 1예: Isotopic 반응)

  • Kim, Jung Yup;Lee, Yun Ho;Lim, Jae Yun;Choi, Ju-Yeon;Min, Joon Hong;Choi, Young Jun;Nam, Jae-Hui;Kim, Won-Serk;Lee, Ga-Young
    • Korean journal of dermatology
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    • v.56 no.9
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    • pp.543-547
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    • 2018
  • Wolf's isotopic response is defined as the occurrence of a new skin disorder at the site of another unrelated skin disease that has already healed. In most cases of isotopic response, the initial dermatosis is herpes infection, and the most frequent second dermatoses are granulomatous reactions. Various interpretations of this phenomenon have been attempted. However, the exact mechanism has not been identified yet. Herein, we report a case in which the secondary disease was segmental vitiligo that appeared over the same dermatomes of herpes zoster. A 71-year-old woman presented with well-defined, depigmented patches on the left chest and back. She had been diagnosed with herpes zoster on the same dermatomes and treated with an antiviral agent 3 years ago. Histological examination showed decreased basal melanin pigments and melanocytes. Consequently, the patient was diagnosed with segmental vitiligo based on the clinical and histological findings.

Inflammatory Endobronchial Myofibroblastic Tumor: A Case Report (기관지 내 염증성 근섬유모세포 종양: 증례 보고)

  • Soo Won Nam;Yeon Joo Jeong;Geewon Lee;Ji Won Lee;Jung Seop Eom;Jeong Su Cho;Won Young Park;So Min Park
    • Journal of the Korean Society of Radiology
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    • v.81 no.1
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    • pp.219-224
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    • 2020
  • Inflammatory myofibroblastic tumor is a rare benign lesion that accounts for 0.04-1% of all lung tumors and usually appears as a solitary pulmonary nodule or mass. Here, we report the case of an endobronchial inflammatory myofibroblastic tumor in a 21-year-old man with a focus on the imaging findings and a review of previous literature.

Neuroimaging Findings of First-Visit Headache Patients (두통 초진 환자에서 신경영상검사 소견)

  • Kim, Byung-Su;Kim, Soo-Kyoung;Kim, Jae-Moon;Moon, Heui-Soo;Park, Kwang-Yeol;Park, Jeong Wook;Sohn, Jong-Hee;Song, Tae-Jin;Chu, Min Kyung;Cha, Myoung-Jin;Kim, Byung-Kun;Cho, Soo-Jin
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.294-301
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    • 2018
  • Background: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. Methods: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. Results: Among 1,080 patients (mean age: $47.7{\pm}14.3$, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p<0.001). Conclusions: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.