• The Korean Journal of Applied Statistics
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• v.24 no.6
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• pp.1045-1054
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• 2011

During clinical trials a researcher is frequently able to observe a disease symptom in a subject as well as a severity score for those who experienced a symptom after a fixed length of treatment. The traditional method to evaluate a decreasing trend in proportion, when there is an intrinsic order in the treatment groups (for example control and two or more treatment groups) is a Cochran-Armitage test, while the method to evaluate a decreasing trend in continuous non-normal data is a Jonckheere-Tersptra test. The Cochran-Armitage test emphasizes the dichotomous data of symptom occurrence and the Jonckheere-Tersptra test emphasizes the continuous non-normal data of severity symptom scores. In this paper we propose new test statistics that consider the combined evidence from a symptom occurrence and disease severity score. We illustrate these methods with example data of schizophrenic inpatients that demonstrated antipsychotic-drug induced constipation. A small-scale simulation is conducted to compare the new trend tests with other trend tests.

• Anxiety and mood
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• v.11 no.2
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• pp.136-142
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• 2015

Objective : Subjective tinnitus is defined as an acoustic sensation perceived without any external source. Patients with tinnitus have often experienced psychological distress and low quality of life. However, the connection between psychiatric characteristics and tinnitus has not yet been established. The purpose of this study was to investigate the relationship of psychiatric characteristics with tinnitus severity. Method : A total of 124 patients with tinnitus were included in the study. Demographic and clinical characteristics were retrospectively collected in the otolaryngology clinic. The self-reported scales including the Tinnitus Handicap Inventory, the Hospital Anxiety and Depression Scale and the Anxiety Sensitivity Index were used in this study. Results : The Pearson product moment correlation revealed significant correlations between tinnitus severity and psychiatric characteristics including depression (r=0.26, p<0.01), anxiety (r=0.38, p<0.01), anxiety sensitivity (r=0.27, p<0.01). After controlling for age, sex and awareness of tinnitus, tinnitus severity was positively correlated with anxiety (partial r=0.39, p<0.01) and anxiety sensitivity (partial r=0.28, p<0.01). These correlations remained significant in male but not in female patients. Conclusion : Results of the present study indicated that not only anxiety symptoms but also anxiety sensitivity could relate to tinnitus severity. Our findings have implications for the understanding of the psychiatric characteristics in patients with tinnitus.

• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.200-208
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• 2017

The purpose of this study was to examine the relationship of the severity, depression and to identify factors influencing quality of sleep in Restless Legs Syndrome(RLS) patients. A total of 303 consecutive RLS patients were assessed by self questionnaires and participant's medical records were reviewed for obtaining their clinical information. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. The quality of sleep was positively correlated with symptoms(r=. 21, p<.001) and depression(r=. 37, p<.001). The results of multiple regression analysis showed that significant variables influencing the quality of sleep were depression(${\beta}=.35$, p<.001), age(${\beta}=.21$, p<.001), and severity(${\beta}=.15$, p=.005). The explanation power of this regression model was 21.0% and it was statistically significant. As a result, to improve their sleep quality, the nursing interventions are required for RLS patients who have the depression, age, and severity.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.366-372
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• 2018

Background: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. Methods: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients' vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. Results: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression ($VE_p$) was 58.1% (95% confidence interval, 31.3% to 88.0%). Conclusion: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.

• Korean Journal of Biological Psychiatry
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• v.26 no.1
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• pp.14-21
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• 2019

Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.407-414
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• 2018

Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

• Clinical and Experimental Reproductive Medicine
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• v.46 no.3
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• pp.125-131
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• 2019

Objective: To investigate serum 25-hydroxyl vitamin D (25(OH)D) and vitamin D-binding protein (VDBP) concentrations in women with endometriosis according to the severity of disease. Methods: Women with mild endometriosis (n = 9) and advanced endometriosis (n = 7), as well as healthy controls (n = 16), were enrolled in this observational study. Serum total 25(OH)D concentrations were analyzed using the Elecsys vitamin D total kit with the Cobas e602 module. Concentrations of bioavailable and free 25(OH)D were calculated. Concentrations of VDBP were measured using the Human Vitamin D BP Quantikine ELISA kit. Variables were tested for normality and homoscedasticity using the Shapiro-Wilk test and Leven F test, respectively. Correlation analysis was used to identify the variables related to total 25(OH)D and VDBP levels. To assess the effects of total 25(OH)D and VDBP levels in the three groups, multivariate generalized additive modeling (GAM) was performed. Results: Gravidity and parity were significantly different across the three groups. Erythrocyte sedimentation rate (ESR) and CA-125 levels increased as a function of endometriosis severity, respectively (p= 0.051, p= 0.004). The correlation analysis showed that total 25(OH)D levels were positively correlated with gravidity (r = 0.59, p< 0.001) and parity (r = 0.51, p< 0.003). Multivariate GAM showed no significant relationship of total 25(OH)D levels with EMT severity after adjusting for gravidity and ESR. However, the coefficient of total 25(OH)D levels with gravidity was significant (1.87; 95% confidence interval, 0.12-3.63; p= 0.040). Conclusion: These results indicate that vitamin D and VDBP levels were not associated with the severity of endometriosis.

• Clinical and Molecular Hepatology
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• v.24 no.4
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• pp.392-401
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• 2018

Background/Aims: Leptin is associated with metabolic disorders, which predispose one to non-alcoholic fatty liver disease (NAFLD). The role of leptin in NAFLD pathogenesis is not fully understood. We aim to investigate the association between serum leptin level and severity of NAFLD using U.S. nationally representative data. Methods: Data were obtained from the United States Third National Health and Nutrition Examination Survey. NAFLD was defined by ultrasound detection and severity of hepatic steatosis in the absence of other liver diseases. The severity of hepatic fibrosis was determined by NAFLD fibrosis score (NFS). We used multivariate survey-weighted generalized logistic regression to evaluate the association between leptin level and the degree of NAFLD. We also performed subgroup analyses by body mass index (lean vs. classic NAFLD). Results: Among 4,571 people, 1,610 (35%) had NAFLD. By ultrasound findings, there were 621 people with mild, 664 with moderate, and 325 with severe steatosis. There were 885 people with low NFS (<-1.455, no significant fibrosis), 596 with intermediate NFS, and 129 with high NFS (>0.676, advanced fibrosis). Leptin levels for normal, mild, moderate and severe steatosis were $10.7{\pm}0.3ng/mL$, $12.1{\pm}0.7ng/mL$, $15.6{\pm}0.8ng/mL$, $16{\pm}1.0ng/mL$, respectively (trend P-value<0.001). Leptin levels for low, intermediate, and high NFS were $11.8{\pm}0.5ng/mL$, $15.6{\pm}0.8ng/mL$, $28.5{\pm}3.5ng/mL$, respectively (trend P-value<0.001). This association remained significant even after adjusting for known demographic and metabolic risk factors. In the subgroup analysis, this association was only prominent in classic NAFLD, but not in lean NAFLD. Conclusions: Serum leptin level is associated with the severity of NAFLD, especially in classic NAFLD patients.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.263-269
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• 2021

Purpose: There have been increasing concerns about serious traffic accidents on highways. The purpose of this study was to analyze factors affecting traffic accidents on highways and the severity of the resulting injuries. Methods: This retrospective study was conducted at a regional trauma center. We reviewed 594 patients who had been in 114 traffic accidents on highways from January 2018 to June 2020. We collected demographic data, clinical data, accident-related factors, and meteorological data (weather and temperature). Results: Environmental risk factors were found to be significantly associated with the incidence of traffic accidents on highways. Injury severity and the death rate were higher in sedans than in any other type of vehicle. Tunnels were the most common location of accidents, accounting for 47 accidents (41.2%) and 269 injured patients (45.3%). The injury severity of individuals riding in the driver's seat (front seat) was high, regardless of vehicle type. Three meteorological risk factors were found to be significantly associated with traffic accidents: rainy roads (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.84-3.29; p=0.01), icy or snowy roads (OR 5.12; 95% CI 2.88-7.33; p<0.01), and foggy conditions (OR 2.94; 95% CI 2.15-4.03; p<0.05). Conclusions: The injury severity of patients was affected by seat position and type of vehicle, and the frequency of accident was affected by the location. The incidence of traffic accidents was strongly influenced by meteorological conditions (rain, snow/ice, and fog).

• Korean Journal of Biological Psychiatry
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• v.23 no.4
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• pp.130-139
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• 2016

Objectives The objective of this study is to investigate differences of clinical characteristics between a healthy female control group and female panic disorder (PD) patients with early sexual abuse history (PD+S) and without early sexual abuse history (PD-S). Methods We examined data from 83 patients diagnosed with PD and 20 healthy control subjects. We divided the patients with PD into PD+S (32 patients) and PD-S (51 patients) to compare demographic and clinical characteristics. The following instruments were applied: the Stress coping strategies, the Beck Depression Inventory (BDI), the Panic Disorder Severity Scale, the Anxiety Sensitivity Index-Revised (ASI-R), the Albany Panic and Phobia Questionnaire (APPQ) and the NEO-neuroticism. Results Compared to the PD-S, the PD+S group showed higher scores in neuroticism and the APPQ. And, in the PD+S group, the scores of neuroticism were correlated with the ASI-R and APPQ subscale scores and the APPQ total scores were associated with the scores of BDI. Conclusions This study shows that female PD+S patients have higher scores in neuroticism and the APPQ than the PD-S group, and these factors are associated with the panic-related symptoms severity. It emphasizes the need of specific strategies considering the childhood abuse history such as early sexual abuse in clinical approach among patients with PD.