• 대한불안의학회지
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• 제8권2호
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• pp.93-98
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• 2012

Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.

• 대한간호학회지
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• 제30권6호
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• pp.1389-1399
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• 2000

Massage therapy is a traditional, alternative and nonphamacological means of promoting rest and relaxation. However, nursing intervention by massage for middle-aged women is rarely practiced by nurses. The purpose of this research was to examine the effects of the hand and arm massage as an independent nursing intervention tool for middle- aged women. The data used in this research were collected from forty-nine subjects using a nonequivalent control group non- synchronized design. Twenty-four persons for the experimental group and Twenty-five persons for the control group were selected from D city and C city from July 1997 to September 2000. Subjects' ages were between forty and fifty-six years old with mean the age of 45.6. Hand and arm massage developed by Cayce and Reilly was applied to the experimental group for a session of 15 minutes two or three times a week for four weeks. The instruments used for the measurement of the subjects' stress, anxiety, depression and the middle-life crisis were Langners's 22-item Self-rating Depression Scale, and Kim's Middle Life Crisis Scale(1988). These psychological factors were measured before and after the implementation of hand and arm massage. The data were analyzed with mean$\pm$s.d, percent, t-test, and a paired t-test. The results were summarized as follows; 1. Before the treatment, there were no significant differences between the two groups. 2. After the treatment, there were significant differences in the stress and the occurrence of mid life crisis between the two groups. The findings suggest that the use of the life crisis. Therefore, it is recommended that hand and arm massage be used as an independent nursing intervention tool for middle-aged women. For further research, is needed replication of this concept of research with different subjects in a larger population. Also, it is recommended to investigate the effects of massage with aroma therapy for the berefit of decreasing womens' stress level further.

• 대한한방내과학회지
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• 제39권4호
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• pp.814-821
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• 2018

Thyroid cancer is one of the most common cancers in Korea, and thyroidectomy is the first-line treatment. Hypoparathyroidism is a common complication of thyroidectomy and can cause symptoms such as numbness, spasm, and anxiety, but these issues have seldom been reported in the Korean medical literature. The present case was a 53-year-old thyroid cancer patient who complained of numbness caused by hypoparathyroidism, general weakness, fatigue, and postoperative pain after total thyroidectomy. The patient was treated with Korean medicine treatment, including herbal medicine, acupuncture, cupping, and moxibustion, and her changes in clinical symptoms were measured with a numeric rating scale (NRS), the Karnofsky performance status scale (KPS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). After treatment, her clinical symptoms were improved, leading to an improvement in her quality of life. Therefore, Korean medicine may be effective in the treatment of thyroid cancer patients who experience numbness caused by hypoparathyroidism, general weakness and fatigue after total thyroidectomy.

• 동의신경정신과학회지
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• 제5권1호
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• pp.41-60
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• 1994

The objective of this paper is to verify clinical effects of Lyu's Soyosan(柳氏逍遙散) and Lyu's Kwipithang(柳氏歸脾湯). They were prescribed to the enperimental student group suffering from mental stress and annoyed by psychological instability. From the biochemical examination before and after medication, we measure the amount of hormonal variation in thyroid hormone(TSH, $T_4$) and adrenocortical hormone(ACTH, cortisol) The results are as follows. 1. The average of self-rating anxiety scale(SAS) in test group is $41.00\;{\pm}\;7.84$. This value is statistical significant and higher than one of normal person(age 20-39). The average of a global assesment of recent stress(GARS) scale is $28.62\;{\pm}9.00$. There is statistical correlation coefficient between SAS and GARS (p < 0.001). 2. Both Lyu's Soyosan(柳氏逍遙散) and Lyu.s Kwipithang (柳氏歸脾湯) groups show statistically significant reduction of total cholesterol and triglyceride level in serum lipid after ten day medication. 3. It is observed that Lyu's Soyisan(柳氏逍遙散) and Luy's Kwipithang (柳氏歸脾湯) groups have increasing tendency of TSH. The statistically significant reduction of $T_4$ was found in two groups after ten day medicaton. 4. It is observed that Lyu's Soyosan(柳氏逍遙散) and Lyu's kwipithang (柳氏歸脾湯) group have statistically significant reduction of serum cortisol level after ten day medication, Both groups have statistically significant reduction of plasma ACTH level after twenty day medication. From these results, it is verified that both Lyu's Soyosan(柳氏逍遙散) and Lyu's Kwipithang (柳氏歸脾湯) have anti-stress effects against psychological instability and mental stress. The Lyu's Soyosn(柳氏逍遙散) shows special effectiveness in depression of liver-energy(肝氣鬱結) and the Lyu's Kwipitang (柳氏歸脾湯) is also effective in deficiency heart-blood(心血不足).

• 정신신체의학
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• 제4권1호
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• pp.13-20
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• 1996

This study was performed to explore the frequency of panic attack induced by sodium lactate in alcohol dependence patients and to compare the extent of blunted growth hormone reponses after clonidine infusion with that of normal controls. The authors investigated 10 alcohol dependence patients receiving inpatient care in Hangang Sacred Heart Hospital from March 2, 1993 to August 31, 1993 and 10 normal controls. The disagnosis of alcohol dependence was based on DSM-III-R. Thirty minutes after the sodium lactate infusions clonidins were administrated. Venous bloods were sampled before the sodium lactate infusions, and 30, 45, 60, 90 minutes after the administrations of clonidine. Plasma growth hormone levels were measured by RIA method. The results were as follows : 1) In the questionaires of Hamilton Anxiety Rating Scale, Hamilton Depression Raing Scale, CAGE, Korean MAST, the scores of alcohol dependent patients were higher than those of normal controls. 2) Sixty percent of alcohol dependence patients and twenty percent of normal controls had panic attacks induced by sodium lactate. 3) All panic attacks induced by sodium lactate were relieved after clonidine infusions. 4) There were blunted growth hormone responses after clonidine infusions in alcohol dependence patients who had sodium lactate induced panic attacks like panic disorder patients. These results suggest that alcohol dependence patients may have noradrenergic abnormality same as panic disorder patients and two disorder may have high biological correlations each other.

• 생물정신의학
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• 제22권4호
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• pp.163-172
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• 2015

Objectives This study was aimed to examine the multidimensional relationship between auditory verbal hallucinations (AVHs) and Positive and Negative Syndrome Scale (PANSS) factors of psychopathology in the patients with schizophrenia. And we explored the differences between assessments to hallucination by the clinicians and patients. Methods 82 patients with schizophrenia who were assessed by the Hamilton Program for Schizophrenia Voices Questionnaire (HPSVQ), Psychotic Symptom Rating Scale-Auditory Hallucination (PSYRATS-AHS), and the PANSS were recruited. Hwang's five-factor model of PANSS, items and total scores of hallucination scales, Kim's and Haddock's factor models of hallucination were applied to examine the correlations between psychopathology and AVHs. AVH-positive patients was 50 in PANSS-HPSVQ group and 24 in PANSS-PSYRATS-AHS. These two groups were separately analyzed. Results Among the five factors of the PANSS, negative and depression/anxiety factors were correlated with the total scores of HPSVQ and PSYRATS-AHS, and positive and autistic preoccupation factors were correlated only with the total score of PSYRATS-AHS. The activation factor was correlated with none of the total scores of HPSVQ/PSYRATS-AHS. These correlation patterns of a total score of HPSVQ/PSYRATS-AHS were same in the emotional factor of HPSVQ and physical factor of PSYRATS-AHS respectively. In the items which showed significant correlations, correlation coefficients of PANSS-PSYRATS-AHS group ranged between 0.406-0.755 and those of PANSS-HPSVQ ranged between 0.283-0.420. Conclusions This study suggested that the psychopathological domains of schizophrenia were differentially correlated with AVHs and the assessment of AVHs by clinicians and patients showed substantial differences which should be integrated into the therapeutic interventions.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.236-245
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• 2011

Objectives : The objective of this study was to evaluate the relationship of the parenting stress with their children's characteristics for typically developing preschool children. Methods : Parents of 38 preschool children (mean age : 4.4${\pm}$0.7 years, 22 boys) completed the Korean Parenting Stress Index, the Korean Child Behavior Checklist, the Conners Parent and Teacher Rating Scale-Abbreviated form (CPRS and CTRS), the Junior Temperament and Character Inventory, the Children's Sleep Habit Questionnaire and the Social Responsiveness Scale. All 38 children performed the Comprehensive Attention Test (CAT). Results : The children's inattentive and hyperactive problems, as measured by the CBCL, CPRS and CAT, had positive correlation with parenting stress. Both internalizing and externalizing behavioral problems were associated with parenting stress. Of the child's temperament dimensions, Novelty Seeking and Harm Avoidance were positively correlated with parenting stress, but Persistence and Cooperativeness were negatively correlated with parenting stress. Sleep anxiety and other sleep characteristics showed a correlation with parenting stress. Social Motivation and Communication were also positively related to parenting stress. Conclusion : Our results suggest that parenting stress could be related to the children's cognition, emotion, behavioral characteristics, sleep habits and social development. These results could assist in the development of interventions to improve the parental well-being in typically developing preschool children.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.119-128
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• 2024

Background: In pediatric dentistry, fear and anxiety are common among children. Local anesthetics (LA) are widely used to control pain and reduce discomfort in children during dental treatment. Topical anesthetics play a vital role in reducing pain and the unpleasant sensation of a needle puncture in children. Peppermint oil has been extensively used for various diseases. However, its anesthetic properties remain unknown. Peppermint oil, used in mouthwashes, toothpastes, and other topical preparations has analgesic, anesthetic, and antiseptic properties. This study aimed to compare and evaluate pain perception following the topical application of peppermint oil versus lignocaine spray before an intraoral injection in children, aged 8-13 years. Method: Fifty-two children, aged between 8-13 years, who required local anesthesia for dental treatment were divided into two groups of 26 each by simple random sampling (Group 1: 0.2% peppermint oil and Group 2: lignocaine spray). In both groups, physiological measurements (e.g., heart rate) were recorded using pulse oximetry before, during, and after the procedure. Objective pain measurement (Sound Eye Motor (SEM) scale) during administration and subjective measuremeant (Wong-Baker Faces Pain Rating Scale (WBFPRS)) after LA administration were recorded. This was followed by the required treatment of the child. Physiological parameters were compared between the two groups using an independent t-test for intergroup assessment and a paired t-test and repeated-measures ANOVA for intragroup comparisons. The Mann-Whitney U test was used to analyze the pain scores. Results: Intragroup mean heart rates, before, during, and after treatment were statistically significantly different (P < 0.05). However, the intergroup mean pulse rates did not differ significantly between the two groups. The mean WBFPS score in the lignocaine spray group was 4.133 ± 2.06 was statistically different from that of the peppermint oil group (0.933 ± 1.03; P < 0.001^*). The mean SEM score was significantly lower in the peppermint oil group than that in the lignocaine spray group (P = 0.006). No negative effects were observed in this study. Conclusion: 0.2% peppermint oil was effective in reducing pain perception.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권2호
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• pp.101-108
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• 2024

Background: Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Methods: Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. Results: When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Conclusion: Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

• 수면정신생리
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• 제19권1호
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• pp.27-34
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• 2012

목 적 : HRV 검사는 교감 신경과 부교감 신경의 억제 체제에 의해 조절되는 심박변이도를 측정하고 분석하는 도구로서, 현재 민감하고 비침습적인 도구로 인정받고 있다. 우울증 환자들은 불안, 우울과 같은 정신적 스트레스를 지속적으로 받으면서 자율신경계 억제 기전의 교란을 받게 된다. 우울증은 또 심혈관 질환의 이환과 사망률을 예측하는 독립적 예측인자라고 보고되고 있다. 본 연구에서는 HRV 검사를 통하여 정상인과 우울증 환자 사이에서 HRV와 lipid level 사이의 상관관계를 알아보려고 하였다. 방 법 : 2011년 7월부터 2012년 3월까지 서울의료원 정신건강의학과 우울증 클리닉에 내원한 외래 및 입원 환자 중, 만 19세 이상 65세 이하 환자(42명)를 대상으로 하였고, 환자들과 나이, 성별을 일치시킨 병원에서 근무하는 직원 중 정신과 과거력과 신체 질환이 없는 사람(32명)을 대상으로, HRV, 혈중 지질 농도, HAM-A(hamilton anxiety scale), HAM-D(hamilton depression scale)를 조사하였다. 우울증 환자군과 정상대조군을 독립표본 t-검정 및 카이제곱-검정을 시행하여 비교하였다. Pearson 상관 분석을 이용하여 우울 증상의 심각도, HRV 세부지표, 혈중 지질 농도 간의 상관관계를 살펴보았다(p<0.05). 결 과 : 우울증 환자군과 정상대조군 사이에 인구학적 변인은 차이가 없었으며, 우울증 환자군에게서 HAM-D & HAM-A 점수가 높았다. 혈중 지질 농도 검사에서, 우울증 환자군이 정상군보다 cholesterol, TG, LDL 수치가 유의하게 높게 측정되었다. HRV 시간영역 분석(time domain analyses)에서, 우울증 환자군이 정상군보다 SDNN이 낮게 나왔으나 유의한 차이는 보이지 않았다. 한편, ApEn(approximate entrophy)이 정상군보다 우울증 환자군에서 유의하게 높았으며, ApEn은 LDL, HAM-D, HAM-A와 유의한 상관관계를 보였다. 결 론 : 우울증 환자군의 HRV에서 ApEn이 정상대조군보다 높게 측정되었다. ApEn은 최근에 개발된 비선형적 분석으로 HRV 신호가 얼마나 복잡한 지를 통계적으로 정량화한 수치이며, 데이터 양이 적고, 잡음이 많은 생리학적 데이터를 분석하기에 적합하다고 알려져 있다. 본 연구에서는 ApEn이 우울증 환자군에서 유의하게 높게 나왔으며, ApEn이 LDL, HAM-D, HAM-A와도 상관관계를 갖는 것으로 나타났다. 향후, HRV를 임상적 상황에서 실용적으로 사용하는 연구에 있어, ApEn을 새로운 평가 도구로서 주목할 필요가 있겠다.