• 대한임상독성학회지
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• 제9권2호
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• pp.77-80
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• 2011

Purpose: The purpose of this study was to investigate the relationship between patients with a neuropsychiatric history and features of their suicide attempt, in order to analyze the risk associated with psychiatrist prescribed drugs Methods: We retrospectively investigated cases of intentional overdose drug ingestion in patients greater than 14 years of age who visited OO emergency medical center between January 1, 2008 and July 31, 2010. We evaluated patient medical records to ascertain their age, sex, neuropsychiatric history, and components of ingested intoxicant. Information regarding any suicide reattempt was obtained after discharge through follow up telephone survey. SPSS version 13.0 was used for statistical analysis. Fisher's exact test was performed with p<0.05 considered statistically significant. Results: Ninety-six of 209 patients (46%) had a past history of psychological problems. Among those 96 patients with a history of psychological problems, 46(48%) used an overdose of the medicine prescribed by their psychologist in order to attempt suicide. However, for patients without a history of psychological problems, intoxication by neuropsychiatric drugs was insignificant. Neuropsychiatric patients required greater follow up care after discharge and exhibited significantly more suicide reattempts. Conclusion: This study revealed that patients sometimes use the medicine prescribed by their psychologist to attempt suicide. Therefore, an exhaustive plan to control the medicines prescribed to psychiatric patients should be established.

• 생물정신의학
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• 제3권2호
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• pp.302-308
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• 1996

A case of rapid cycling mania secondary to gamma-knife radiosurgery for the treatment of refractory epilepsy was reported. A 21-year old woman who had a gamma-knife radiosurgical operation for the treatment of refractory seizure two years ago was admitted because of manic episodes. Although seizure was relieved, manic symptoms like decreased need for sleep, elated mood, unprovoked laughing, grandiose delusion and bizarre behaviors were developed 11 months after the operation. These symptoms recurred lour rimes for eight months. There were no past personal and family history of mood disorders. Laboratory examinations including electroencephalogram ana endocrinological study did not show any abnormal findings. The rapid cycling secondary manic was relieved by lithium. She was then discharged after 5 months. Mood change was not significant during follow-up while hypomania emerged by dose reduction. The secondary mania seemed to be caused or triggered by the right temporal lobe damage induced by gamma-knife radiosurgery.

• 정신신체의학
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• 제23권1호
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• pp.66-69
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• 2015

정상뇌압수두증은 보행장애, 요실금 및 치매 등의 전형적인 세 가지 증상 외에도 추체외로 증상과 다양한 신경심리 증상이 동반될 수 있다. 이 사례는 불안과 정동증상으로 치료 중 보행장애와 요실금 증상을 보였던 46세 여자 환자에서 항파킨슨 약물의 사용과 기존 정신과 치료 약물의 중단에도 불구하고 증상의 호전이 없었으나, 뇌 컴퓨터 단층 촬영상 뇌실의 확장 소견이 보였고 시험적 뇌척수액 배액에 의해서 수일 내에 증상들이 극적으로 호전되어 정상뇌압수두증을 감별해야 했던 경우이다. 뚜렷한 대뇌 실질의 위축 소견이 없으나 뇌실이 확장되어 있을 경우 추체외로 증상과 신경심리 증상이 있을 경우 정상뇌압수두증의 전형적 세 가지 증상을 보이지 않는다 하더라도 정상뇌압수두증의 가능성을 고려해서 시험적 뇌척수액 배액 등의 시술이 진단과 치료에 도움이 될 수 있음을 보여주는 사례라고 생각된다.

• 생물정신의학
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• 제2권1호
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• pp.115-122
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• 1995

This study was performed to know the relationship between neurologic soft signs (NSS) and clinical variables such as psychopathology. history of illness, and premorbid social adjustment in patients with schizophrenia. The authors evaluated NSS in 31 patients with schizophrenia using the structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale- Korean Version(NES-K). Relationships between NSS and clinical variables such as duration of illness, intensity of precipitating stressors, duration of outpatient treatment, schooling, peer relationship, total duration of unemployment, total days of psychiatric admission, age, total days of being medicated, age at the first psychiatric admission, frequency of admissions, content of treatment, social adjustment, and severity of symptoms were analyzed. Differences between paranoid and non-paranoid schizophrenics were examined. In addition, Differences between patients with schizophrenia who have predominant positive symptoms and who have predominant negative symptoms were examined too. Total scores of NES-K were correlated with lower schooling (${\gamma}$=0.44, p<0.01). Scores of motor coordination subcategory were correlated with poor peer relationship(${\gamma}$=0.67, p<0.001). Other clinical variables were not correlated with any scores of NES-K. Paranoid and non-paranoid schizophrenics were not different in scores of NES-K. Also positive and negative schizophrenics were not different in scores of NES-K. Most clinical variables except schooling and peer relationship were not related with NSS. This results indicated that the meaning of these signs was not fully be understood. Introduction of the new classification concepts such as deficit or non-deficit syndrome will be helpful to elucidate the meaning of NSS in patients with schizophrenia.

• 혜화의학회지
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• 제26권1호
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• pp.1-10
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• 2017

Objectives: The aim of this study is (1) to investigate the historic changes and pharmacological efficacies of Woohwangchungsim-won and (2) to discuss the necessities for Woohwangchungsim-won's clinical applications. Methods: This study was performed through (1) investigating the ancient literature records related with Woohwangchungsim-won and analyzing Woohwangchungsim-won's composition, dosage and indications, (2) searching articles about Woohwangchungsim-won on 10 major Korean web and 3 major foreign web article search engines and analyzing Woohwangchungsim-won's pharmacological efficacies and indications. Results: Woohwangchungsim-wom has been used for cerebrovascular diseases such as stroke and palpitation. Also, there are some ancient literature records of Woohwangchungsim-won's clinical applications in neuropsychiatric disorders such as depression and bipolar disorder. In addition, there have been a number of experimental studies which demonstrate Woohwangchungsim-won's neuroprotective effect on cerebral cortex and hippocampus injury. So, it is possible to infer that Woohwangchungsim-won can be used for the treatments of neuropsychiatric disorders associated with neuronal cell death in cerebral cortex and hippocampus. But there have been no or less experimental studies which demonstrate the pharmacological efficacy of Woohwangchungsim-won on such disease. Conclusion: It is necessary that further experimental studies which demonstrate Woohwangchungsim-won's pharmacological efficacy on neuropsychiatric disorders should be done and Woohwangchungsim-won's clinical applications should be expanded on the basis of those related experimental results.

• 한국간담췌외과학회지
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• 제27권3호
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• pp.301-306
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• 2023

Backgrounds/Aims: Postoperative delirium (POD) is a common complication that increases mortality and morbidity in older patients. This study aimed to evaluate the clinical significance of post-cholecystectomy delirium in older patients. Methods: This retrospective study included 201 patients aged > 75 years who underwent cholecystectomy for acute or chronic cholecystitis between January 2016 and December 2019. Patients were divided into the POD (n = 21) and non-POD (n = 180) groups, and their demographic features and clinical results were compared. Results: The mean patient age was 78.88 years; the female/male ratio was 44.8%/55.2%. Laparoscopic surgery was performed in 93.5% of patients. The univariate analysis showed that lower body mass index (BMI), immobilized admission status, neuropsychiatric disease history, preoperative intervention (percutaneous drainage), high C-reactive protein, hypoalbuminemia, neutrophilia, hypo-/hyperkalemia, and longer operative time were more frequently observed in the POD group. The multivariate analysis showed that lower BMI (odds ratio [OR], 2.796; p = 0.024), neuropsychiatric disease history (OR, 3.019; p = 0.049), hyperkalemia (OR, 5.972; p = 0.007), and longer operative time (OR, 1.011; p = 0.013) were significant risk factors for POD. Conclusions: POD was associated with inflammation degree, general condition, poor nutritional status, electrolyte imbalance, and stressful conditions. Recognizing risk factors requiring multidisciplinary team approaches is important to prevent and treat POD.

• 한국임상약학회지
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• 제21권4호
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• pp.353-363
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• 2011

The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.

• Journal of Yeungnam Medical Science
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• 제14권1호
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• pp.220-226
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• 1997

저자들은 경련을 주소로 내원한 특발성 부갑상선 기능저하증에서 뇌기저핵, 소뇌, 뇌실 주위의 광범위한 석회침착을 보인 환자를 치험하여 방사선학적 뇌단층촬영상 특징적 소견과 그 병태생리 및 임상증상과의 연관관계를 문헌고찰과 함께 보고 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제4권2호
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• pp.199-206
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• 2001

목적: 윌슨병으로 진단 받은 환자들의 진단 당시의 임상 양상의 분포, 발병 연령과 검사 소견들을 파악하고, 또한 초기 발견의 중요성을 고찰하고자 본 연구를 시행하였다. 방법: 1990년 1월부터 10년간 부산 백병원에 입원하여 윌슨병으로 진단 받은 환자 20례를 대상으로 진단 당시의 증상과 증상 발현시기, 진단까지의 기간, 검사 소견 등을 후향적으로 조사하였다. 결과: 20명의 환자들 중에 간 증상 단독 발현은 12명(60%), 그 중 2명은 우연히 AST/ALT가 증가된 것을 발견한 경우였으며, 신경 증상 단독 발현은 2명(10%), 신경 정신증상과 간 증상이 같이 나타난 경우는 4명(20%), 혈액 증상이 주된 경우 1명(5%), 그리고 증상이 없으며 AST/ALT도 정상이나 가족 검진에서 혈중 ceruloplasmin이 감소된 것을 발견한 경우가 1명(5%) 있었다. 모든 환자들에게서 혈중 ceruloplasmin의 농도는 유의하게 낮았다. 가족력은 5례에서 있었다. 간 증상은 진단시 이미 간경화로 진행한 것을 초음파로 진단한 경우가 12명(60%)이었으며, 이 중 2명이 진단 후 1년 내에 사망하였다. 결론: 윌슨병은 빠른 진단과 치료가 중요하다. 그러나 다른 유전성 대사질환들과는 달리 전체 신생아의 선별검사는 의미가 없으며, 환자가 있는 가족에서 혈중 ceruloplasmin과 소변 내 구리, 간 효소 수치와 각막을 검사하는 것이 좋다. 소아기에 간염의 증상이나 지속적으로 증가된 간 효소 수치를 보일 때 또는 가족 중에 원인이 밝혀지지 않은 간질환의 가족력이 있을 때에는 윌슨병을 의심해 보아야 하겠다. 또한 청소년기 이후에 추체외로 증상이나 소뇌 증상 등 운동 신경계의 증상을 호소하든지 혈액 이상, 소변 검사상 이상이 복합적으로 나타나는 경우 등에서도 혈중 ceruloplasmin을 꼭 확인해 보아야 한다. 그 외에 신경 증상 및 정신 증상을 주소로 내원한 경우에도 간기능 검사를 꼭 시행해 보아야 하겠다.

• Journal of Preventive Medicine and Public Health
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• 제24권1호
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• pp.86-92
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• 1991

To test if exposure history to rifle fire or cannonade training during military duty can induce hearing loss, history of personal military service and histroy of gunshot exposure were asked to 228 male college students with self -administrative questionnaire. Otoscopic examination and Rinne's test were performed if any abnormal finding was detected by pure-tone audiometry. Average hearing threshold levels of 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz and threshold levels at 4,000 Hz were calculated for 112 students who were remained after exclusion of cases with history of ear disease, of ototoxic drug administration, and of neuropsychiatric disease, and mean of those were compared between group of students who have completed military duty (completed group) and group of those who have not (not-completed group), and between group exposed (exposed group) and group unexposed to gunshot sound (unexposed group). Mean of average hearing threshold level and mean of threshold levels at 4,000 Hz of completed group and those of exposed group were higher than those of not-completed group and unexposed group, respectively. Proportion of cases that average threshold level was greater than 40 dB or threshold levels at 4,000 Hz was greater than 50 dB were higher also in completed group and exposed group than in duty not-completed group and unexposed group, respectively Multiple linear regression analysis including age, duration of military service, degree of gunshot sound exposure as independant variables and average hearing threshold level as dependant variable, was performed in order to estimate the effect of age on hearing, and any considerable effect of age on hearing could not be found. In conclusion, hearing impairment can be induced by rifle fire or cannonade training.