• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.59-63
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• 2019

Purpose The motion due to respiration of patients undergoing PET/CT is a cause of artifacts in image and registration error between PET and CT images. The degree of displacement and distortion for tumor, which affects the measurement of Standard Uptake Value (SUV) and lesion volume, is especially higher for tumors that is small or located at the base of lungs. The purpose of this study was to evaluate the usefulness of prone position in the correction of image distortion due to respiration of patients in PET/CT. Materials and Methods The imaging equipment used in this study was PET/CT Discovery 600 (GE Healthcare, MI, USA). 20 patients whose lesions were identified in the middle and lower lungs from May to August 2018 were enrolled in this study. After acquiring whole body image in the supine position, additional images of the lesion area were obtained in the prone position with the same conditions. SUVmax, SUVmean, and volume of the lesion were measured for each image, and the displacement of the lesion on PET and CT images were measured, compared, and analyzed. Results The SUVmax, SUVmean, and volume, and displacement of the lesion were $4.72{\pm}2.04$, $3.10{\pm}1.38$, $4.68{\pm}3.20$, and $4.64{\pm}1.88$, respectively for image acquired in the supine position and $5.89{\pm}2.42$, $3.97{\pm}1.65$, $2.13{\pm}1.09$, and $2.24{\pm}0.84$, respectively for image acquired in the prone position, indicating that, for all the lesions imaged, SUVmax and SUVmean were higher and volume and displacement were smaller in the images acquired in prone position compared to those acquired in supine one(p<0.05). Conclusion These results showed that the prone position PET/CT imaging improves the quality of the image by increasing the SUV of the lesion and reducing the respiratory artifacts caused by registration error between PET and CT images. It is considered that the PET/CT imaging in the prone position is helpful in the diagnosis of the disease as an economical and efficient methods that correct registration error for the lesions in basal lung and reduce artifacts.

• Journal of the Korean Society of Radiology
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• v.13 no.3
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• pp.339-348
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• 2019

The purpose of this study was to investigate the effect of carotid artery ultrasound Respectively. The carotid intima-media thickness is known to have a significant correlation with cardiovascular disease and cerebrovascular disease. We investigated the relationship between carotid intima - media thickness, body mass index, waist circumference, the blood lipid value, fasting blood glucose, glycated hemoglobin, and blood pressure using carotid artery ultrasound. The carotid artery ultrasound was considered to be abnormality of IMT thickness over 0.8 mm and the presence or absence of atherosclerotic plaque was evaluated. Serological tests were used to compare the geologic value, fasting blood glucose level, and glycated hemoglobin. As a result, waist circumference (=.022), low density cholesterol (=.004), fasting blood glucose level (.019), and glycemic index (.002) were analyzed as predictors of atherosclerosis. In the ROC curve analysis, sensitivity was 87.80% (95% CI: 73.8-95.9), specificity was 41.67% (95% CI: 30.2-53.9), sensitivity was 78.05% (95% CI: 62.4-89.4) in low density lipoprotein, Specificity was 50.00% (95% CI: 38.0-62.0), sensitivity was 73.11% (95% CI: 57.1-85.8), specificity was 61.11 (95% CI: 48.9-72.4) and sensitivity was 82.93%-91.8) and a specificity of 43.06% (31.4-55.3). In logistic regression analysis, the risk of atherosclerosis was 0.248 times at waist circumference (WC)> 76 cm, 3.475 times at low-density lipoprotein (LDL-C) ${\geq}124mg/dL$, 0.618 at HbA1c> 5.4% It appeared as a times. We suggest that prospective study of carotid artery ultrasound should be performed for the effective prevention of cardiovascular diseases.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.1
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• pp.26-33
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• 2021

Objectives : This study was designed to investigate datas related to panic attack and treatment in emergency room of panic disorder patients who visited emergency room for panic attack. Methods : A retrospective analysis of medical records was conducted on 92 patients with panic disorder who visited Chungju Konkuk university hospital emergency department due to panic attack and had bodily symptoms from 1st January 2010 to 31th December 2019. In addition to demographic characteristics and comorbid disorders, triggering stressors and alcohol consumption were corrected as pre-panic attack datas, bodily symptoms at the time of panic attack were corrected as datas during attack, electrocardiogram trial, consultation with psychiatrist, admission and information of used psychotropic drugs were corrected as post-attack data. Depending on size of data, Chi-square test or Fisher's exact test was used. Collected data was analyzed using R 4.03. Results : Cardiovascular disease was accompanied by 5.4% and depressive disorder was the most common coexisting mental disorder. Among triggering stressors, economic problem/work-related stress was significantly higher in men than women (𝛘²=4.322, p<0.005). The most common physical symptom during attack was circulatory (65.2%), followed by respiratory (57.6%), numbness-paralysis (33.7%), dizziness (19.6%), gastro-intestinal (14.1%) and autonomic symptom (12.0%). Electrocardiogram was taken at higher rate when patients complained circulatory symptom (𝛘²=8.46, p<0.005). The psychotropic drug most commonly used in emergency room was lorazepam, used in 92.1%. Conclusions : The most common bodily symptom during panic attack was circulatory symptom and the most common triggering stressor in men was economic problem/work-related stress. The most commonly used psychotropic for panic attack was lorazepam.

• Sleep Medicine and Psychophysiology
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• v.28 no.2
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• pp.78-85
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• 2021

Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

• Journal of Nutrition and Health
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• v.56 no.2
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• pp.168-183
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• 2023

Purpose: Cardiovascular disease is one of the major causes of death not only in Korea but also worldwide. Atherogenic index of plasma (AIP) has been extensively investigated, but studies on nutritional intake and eating habits are scarce. The purpose of this study was to analyze the general characteristics, dietary habits, and nutritional status of Korean adults based on their AIP values using data from the 2013-2015 Korea National Health and Nutrition Examination Survey. Methods: A total number of 3,040 adults in their 20s and 30s were included as study subjects. They were divided into quintiles according to their AIP values. Comparisons were then made among the general information, eating habits, and nutritional intake statuses of the groups. Results: The averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, smoking, and exercise in men. As for women, the averages of AIP were different by age, obese status, education, occupation, alcohol drinking frequency, and smoking status. Except for high-density lipoprotein (HDL)-cholesterol, higher AIP values in men were associated with significant increasing trends in health indicators, including systolic and diastolic blood pressure, fasting blood glucose, insulin, hemoglobin A1c, total cholesterol, triglyceride, and low-density lipoprotein (LDL)-cholesterol. As for women, as AIP increased, systolic and diastolic blood pressure, fasting blood glucose, insulin, total cholesterol, triglyceride, and LDL-cholesterol showed significant increasing trends except HDL-cholesterol. HDL-cholesterol showed a significant decreasing trend as AIP increased in men and women. In the high AIP group of women, the frequency of breakfast was lower, whereas the frequency of alcohol beverage consumption was higher. Conclusion: Among young adults, the risk of arteriosclerosis was higher in obese, smoking, and non-exercise individuals. More frequent alcohol drink consumption in women is associated with a higher risk of arteriosclerosis. Therefore, weight and lifestyle management are necessary for the prevention of atherosclerosis among young adults.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.1
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• pp.10-18
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• 2023

Objectives : The purpose of this study is to investigate the characteristics of patients referred for delirium and depressive disorder and to find direction of improvement of consultation-liason psychiatry in general hospital. Methods : We performed a retrospective computed chart review of the 4,966 inpatients hospitalized at Konkuk University Hospital who were referred to the Department of Psychiatry from August 1, 2005 to December 31, 2011. Results : Depressive disorder shows the order of frequency of consultation type Parallel-Complementary-Mending. Delirium shows the order of frequency of consultation type Mending-Parallel-Complementary. When comparing 'follow up consultation' and 'without follow up consultation' group within the depressive disorder, the proportion of men in the 'follow up consultation' group was higher. In the analysis of the consultation type, the 'follow up consultation' group showed the order of consultation type Parallel-Mending- Complementary, and type Parallel-Complementary-Mending in the 'without follow up consultation' group. When comparing 'follow up consultation' and 'without follow up consultation' group within the delirium, the proportion of the surgical field in the 'follow up consultation' group was higher. In the analysis of the consultation type, both group showed the order of consultation type Mending-Parallel- Complementary. Conclusions : Doctors in each department and psychiatrists should pay attention to delirium symptoms that may occur in surgical inpatients and preventive measures should be taken. Screening tests should be conducted in medical patients to properly evaluate coexisting psychiatric diseases. Risk factors of Delirium and Depressive disorder should be identified from the time of hospitalization, and actively discussing treatment plans and early interventions could improve the quality of medical services.

• Korean Journal of Psychosomatic Medicine
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• v.31 no.2
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• pp.125-133
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• 2023

Objectives : This study aims to compare the mental health of adolescents living in child care institutions (orphanages) and youth shelters, to provide basic data for appropriate psychiatric interventions for each facilities. Methods : The sample consisted of 157 adolescents in child care institutions and 31 adolescents in Youth Shelters who completed the Korean version of the Youth Self Report (K-YSR). We compared the K-YSR scores between the two groups and also examined factors related to suicidality. Results : Adolescents in youth shelters were older and had higher rates of drinking (p<0.001), smoking (p<0.001), and "abnormal sleep" (p=0.007) than adolescents in child care institutions. They also showed higher 'suicidality' (p=0.004) and K-YSR scores. On the other hand, adolescents in child care institutions have lower 'suicidality', but they have higher 'suicidality' when they have 'abnormal sleep' (OR 4.194; p=0.006), 'abnormal diet' (OR 2.503; p=0.010), and 'concerns about weight gain' (OR 2.503; p=0.010). Additionally, 17.6% of participants in the study showed 'suicidality'. The 'suicidality' group had a higher overall K-YSR score than the non-suicidal group, and had higher 'abnormal sleep' (OR 3.766; p=0.014) and 'concern about weight gain' (OR 2.864; p=0.032). Conclusions : Adolescents in youth shelters appear to have more serious clinical difficulties than adolescents in child care institutions, so prompt psychiatric intervention is needed. Additionally, it is necessary to consider mental health assessments including suicidality when adolescents in child care institutions complain of sleep, eating, or weight gain problems.

• Sim-seong Yeon-gu
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• v.28 no.2
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• pp.107-138
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• 2013

The purpose of this article is to awaken our colleagues to the culture and mind issues that have been forgotten or neglected by contemporary psychiatry under the prevalence of materialistic orientation. Cultural psychiatry too, though it has been contributed a great deal to widen the mental vision of psychiatry, has revealed several limitations in its approach. In the course of one sided search for culture specific factors in relation to mental health, conventional cultural psychiatry has neglected an effort to explore the common root underlying the different cultures and the common foundation of human mind. Cross sectional comparisons of the cultures alone have inevitably prevented the global considerations to culutre and mind in historical aspects and the dynamic interactions between mind and culture more in depth. The author suggested that the total view of mind and total approach of analytical psychology of C.G. Jung might be capable to replenish those limitations. Author explained the ways of C.G. Jung's observations and experiences of non-western culture and his concepts of culture and mind. The author demonstrated Jung's view of culture with the example of Filial Piety, Hyo, the Confucian moral norm which can be regarded as components of the collective consciousness though connected with archetypal patterns of behavior of intimacy between parent and child. In regard to the coexistence of multi-religious cultures in Korea the author made a proposal of 'culture spectrum' model for understanding value orientations of person in religious cultures. He identified in case of the Korean 4 types of cultural spectrums: Person with predominantly the Buddhist culture; with the Confucian; with the Shamanist; and with the Christian culture. The author also made an attempt to depict the dynamic interactions of different religious cultures in historical perspectives of Korea. Concepts of mind from the Eastern thoughts were reviewed in comparison with Jung's view of mind. The Dao of Lao Zi, One Mind by Wonhyo, the Korean Zen master from the 7th century, the Diagram of the Heaven's Decree by Toegye, a renowned Neo-Confucianist of Korea from the 16th century and his theory of Li-Ki, were explored and came to conclusion that they represent certainly the symbol of the Self in term of C.G. Jung. The goal of healing is 'the becoming whole person'. Becoming whole person means bringing the person as an individual to live not only within the specific culture but also to live in the world beyond the culture which is deeply rooted in the primordial foundation of human mind.

• Tuberculosis and Respiratory Diseases
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• v.43 no.4
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• pp.600-612
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• 1996

Background : Recent studies deported that untreated patients with obstructive sleep apnea syndrome had high long-term mortality rates, and cardiovascular complications of these patients clad a major effect on mortality. Several data indicates that obstructive sheep apnea syndrome contributes to the development of diurnal systemic hypertension. But the pathophysiological mechanism of the development of systemic hypertension in these patients is still uncertain. This study was performed to evaluate the possible role of sympathetic nervous system activity for the development of systemic hypertension in patients with obstructive sleep apnea syndrome. Method : 35 patients with obstructive sleep apnea syndrome(OSAS) and 13 Control subjects(control) were included in this study. 21 patients of OSAS were normotensives(OSAS-NBP), and 14 patients of OSAS were hypertensives(OSAS-HBP). Full night polysomnography was undertaken to all subjects. We measured plasma norepinephrine(NE) and epinephrine(EP) concentrations during waking and sleep, using high performance liquid chromatography, in all patients and control subjects. Results : In OSAS, OSAS-NBP and control, plasma NE and EP concentrations during sleep were lowed than during waking(p<0.01). But, in OSAS-HBP, these was no difference between during waking and sleep. Plasma NE concentrations during sleep of OSAS, OSAS-NBP and OSAS-HBP were higher than Control(p<0.05). In OSAS-HBP, daytime systolic blood pressure correlated with plasma NE concentration during sleep(r=0.7415, p<0.01), arid correlated inversely with mean arterial oxygen saturation(r=-0.6465, p<0.05) or arterial oxygen saturation nadir(r=-0.6) 14, p<0.05) during sleep. Conclusion : The sympathetic activity during sleep of obstructive sleep apnea syndrome patients was higher than control subjects. In obstructive sleep apnea syndrome patients with systemic hypertension, there was no diurnal variation of sympathetic activity, and there was correlation between daytime systolic blood pressure and sympathetic activity during sleep. These data suggests that chronic hyperactivity of sympathetic nervous system may contribute to the development of diurnal systemic hypertension in patients with obstructive sleep apnea syndrome.

• Childhood Kidney Diseases
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• v.5 no.2
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• pp.136-146
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• 2001

Purpose : One of the most difficult problems in the care of children with nephrotic syndrome remains the occurrence of relapses, despite initial response to steroids. Constantinescu reported that rapidity of initial response to steroid therapy could predict fewer relapses in the first year. So we evaluated the changes in serum lipid abnormalities in children with corticosensitive nephrotic syndrome before steroid treatment and the correlation between serum lipid levels and renal function, days to remission. Methods . We analyzed the Medical records of children who were managed by us between October 1994 and August 2000. In 33 patients with corticosensitive nephrotic syndrome, we evaluated the correlation between serum lipid levels and renal function [Creatinine clearance(Ccr)] and proteinuria before steroid treatment, and days to remission defined as the third day when the patient's urine becomes protein free. Results : There were 21 males and 12 females. Median age at presentation was 6.4 years (range: 1.8-17.3 years). Median days to remission were 15.4 days (range 4-42 days) on Prednisolone $60mg/m^2$ daily. The increased levels of triglyceride, total cholesterol, LDL cholesterol, apolipoprotein B, total cholesterol/HDL cholesterol, Lipoprotein(a) were observed. But the level of HDL cholesterol was not increased. Serum albumin was decreased a]id proteinuria was increased before steroid treatment. But Ccr was not decreased. There were negative correlation between serum albumin and total cholesterol (r = -0.5157, P<0.005), LDL cholesterol (r = -0.5543, P<0.005), total cholesterol/HDL cholesterol (r = -0.4506, P<0.01), lipoprotein(a) (r = -0.4570, P<0.025), apolipoprotein B (r = -0.5297, P<0.025), apolipoprotein B/apolipoprotein Al (r = -0.5851, P<0.01), apolipoprotein B/HDL cholesterol (r = -0.4961, P<0.05) before steroid treatment. There was no correlation between proteinuria and serum lipid profiles. Also Ccr and serum lipid profiles were not correlated. There was positive correlation between days to remission and HDL cholesterol (r = +0.4511, P<0.05), apolipoprotein B (r = +0.5190, P<0.05), apolipoprotein B/HDL cholesterol (r = +0.7169, P<0.005). Conclusions : This results reveal that HDL cholesterol, apolipoprotein B and apolipoprotein B/HDL cholesterol can be used as a predictive factor in corticosensitive nephrotic syndrome. We could not determine the significant level of these lipids for insufficient patients number, but these level may predict future relapses of corticosensitive nephrotic syndrome patients and thus may allow to better management and treatment protocols. More data and long term follow up studies should be needed. (J Korean Soc Pediatr Nephrol 2001;5 : 136-46)