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Treatment Strategies for Depression during Pregnancy and Lactation (임신과 수유기 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.14 no.2
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    • pp.91-98
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    • 2007
  • Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

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Effects On Labor Pain and Duration of Delivery Time for Primipara Women treated by Hob-Gog(Li-4) Pressure (합곡(合谷 LI-4)지압이 초산부의 분만 통증정도와 소요 시간에 미치는 효과)

  • Kim, Young-Ran;Lee, Sun-Hye;Kang, Jin-Sun;Jung, Geum-Ok;Ju, Young-Ah
    • Women's Health Nursing
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    • v.7 no.3
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    • pp.331-347
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    • 2001
  • The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.

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Effect of the Early Traumatic Experience on the Mental Health of the Elderly (조기경험이 노인 정신건강에 미치는 영향)

  • Lee, Kwang-Hun;Lee, Jung-Hoon;Lee, Jong-Bum;Park, Byung-Tak;Cheung, Seung-Douk
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.67-77
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    • 1990
  • This study was intended to analyse the relation between the psychic traumatic experience and the psychological health of the aged. The authors carried out this study by means of the combined anxiety-depression scale(CADS) and the preadolescence traumatic experience scale(PTES) with 278 aged men and women residing in Taegu from September to October 1988. The results were as follows : 1. Based on the scores avaluated by CADS, the scores of the both groups showed that comparative group was accounted for $40.15{\pm}6.19$, while the experimental group for $57.75{\pm}6.37$, which showed significantly higher score in the experimental group(p<0.001). 2. The experimental group showed significantly higher early experience score than the comparative group in the dietary difficulty, alcoholism among family members, disunion between husband and wife, trouble between mother and children, early mother loss, parent's indifference and unwanted birth(p<0.001). 3. The experimental group showed higher early experience score than the comparative group by sex, age, marital status and grown location(p<0.001). 4. When the subjects were included in the unemployed and in the middle or low classes and their parents were engaged in agriculture and commercial business and believing in buddhism or non-religion, showed higher experience score (p<0.001).

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Study on the Recognition of Brucellosis for Rural Residents (일부 농촌지역 주민의 브루셀라증 인지도)

  • Lim, Hyun-Sul;Min, Young-Sun
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.51-62
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    • 2005
  • Objectives: This study was conducted to understand the recognition on brucellosis in rural communities and to apply the results to counterplan for brucellosis control and prevention. Methods: The authors conducted a questionnaire survey from September 8 to 13, 2004 among the residents in 2 rural communities: 507 people at Gigye-myeon and 521 people at Buk-myeon. The authors developed a questionnaire which investigated age, gender, general recognition of brucellosis, status of cattle breeding, compensation for loss due to brucellosis and so on. Results: The study group contained 195 (19.0%) stock breeders (veterinarians and cattle merchants were included) and 833 (81.0%) non-stock breeders. For the question, 'Have you ever heard about brucellosis or do you know about brucellosis?', 283 respondents (27.5%) replied affirmatively. For the question, 'Do you know that pregnant women who suffer brucellosis may have a miscarriage?', 98 respondents (35.1%) replied affirmatively. For the question, 'Have your cattle ever aborted or calved a premature calf?', 28 respondents (14.9%) replied affirmatively. For the question, 'Have you ever handled an abortus or a premature calf with your bare hands?', 10 respondents (5.3%) replied affirmatively. For the question, 'Do you know that the government compensates for slaughter loss due to brucellosis?', 46 respondents (25.0%) replied affirmatively. Conclusions: Many people were ignorant about brucellosis. Therefore, their ignorance must be corrected by a publicity campaign. Some stock breeders handled the cattle abortus with their bare hand. Stock breeders must wear protective equipment during working. The authors expect that this study will assist in establishing both a safe cattle breeding environment and preventive strategies for diminishing the incidence of brucellosis.

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Necessity of Education for Emergency Medical Technicians to Improve Awareness of Early Symptoms of Stroke and Assessment of Stroke Patients (응급구급대원에서 뇌졸중 조기증상 인지 및 환자평가 향상을 위한 교육 필요성)

  • Lee, Jeong-Mi;Lee, Jang-Yeol;Park, Seong-Bin;Lee, Young-Hoon;Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.130-141
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    • 2013
  • Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

The Effects of e-Business on Business Performance - In the home-shopping industry - (e-비즈니스가 경영성과에 미치는 영향 -홈쇼핑을 중심으로-)

  • Kim, Sae-Jung;Ahn, Seon-Sook
    • Management & Information Systems Review
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    • v.22
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    • pp.137-165
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    • 2007
  • It seems high time to increase productivity by adopting e-business to overcome challenges posed by both external factors including the appreciation of Korean won, oil hikes and fierce global competition and domestic issues represented by disparities between large corporations and small and medium enterprises (SMEs), Seoul metropolitan and local cities, and export and domestic demand all of which weaken future growth engines in the Korean economy. The demands of the globalization era are for innovative changes in businessprocess and industrial structure aiming for creating new values. To this end, e-business is expected to play a core role in the sophistication of the Korean economy through new values and innovation. In order to examine business performance in e-business-adopting industries, this study analyzed the home shopping industry by closely looking into the financial ratios including the ratio of net profit to sales, the ratio of operation income to sales, the ratio of gross cost to sales cost, the ratio of gross cost to selling, general and administrative (SG&A) expense, and return of investment (ROI). This study, for best outcome, referred to corporate financial statements as a main resource to calculate financial ratios by utilizing Data Analysis, Retrieval and Transfer System (DART) of the Financial Supervisory Service, one of the Korea's financial supervisory authorities. First of all, the result of the trend analysis on the ratio of net profit to sales is as following. CJ Home Shopping has registered a remarkable increase in its ratio of net profit rate to sales since 2002 while its competitors find it hard to catch up with CJ's stunning performances. This is partly due to the efficient management compared to CJ's value of capital. Such significance, if the current trend continues, will make the front-runner assume the largest market share. On the other hand, GS Home Shopping, despite its best organized system and largest value of capital among others, lacks efficiency in management. Second of all, the result of the trend analysis on the ratio of operation income to sales is as following. Both CJ Home Shopping and GS Home Shopping have, until 2004, recorded similar growth trend. However, while CJ Home Shopping's operating income continued to increase in 2005, GS Home Shopping observed its operating income declining which resulted in the increasing income gap with CJ Home Shopping. While CJ Home Shopping with the largest market share in home shopping industryis engaged in aggressive marketing, GS Home Shopping due to its stability-driven management strategies falls behind CJ again in the ratio of operation income to sales in spite of its favorable management environment including its large capital. Companies in the Group B were established in the same year of 2001. NS Home Shopping was the first in the Group B to shift its loss to profit. Woori Home Shopping has continued to post operating loss for three consecutive years and finally was sold to Lotte Group in 2007, but since then, has registered a continuing increase in net income on sales. Third of all, the result of the trend analysis on the ratio of gross cost to sales cost is as following. Since home shopping falls into sales business, its cost of sales is much lower than that of other types of business such as manufacturing industry. Since 2002 in gross costs including cost of sales, SG&A expense, and non-operating expense, cost of sales turned out to have remarkably decreased. Group B has also posted a notable decline in the same sector since 2002. Fourth of all, the result of the trend analysis on the ratio of gross cost to SG&A expense is as following. Due to its unique characteristics, the home shopping industry usually posts ahigh ratio of SG&A expense. However, more than 80% of SG&A expense means the result of lax management and at the same time, a sharp lower net income on sales than other industries. Last but not least, the result of the trend analysis on ROI is as following. As for CJ Home Shopping, the curve of ROI looks similar to that of its investment on fixed assets. As it turned out, the company's ratio of fixed assets to operating income skyrocketed in 2004 and 2005. As far as GS Home Shopping is concerned, its fixed assets are not as much as that of CJ Home Shopping. Consequently, competition in the home shopping industry, at the moment, is among CJ, GS, Hyundai, NS and Woori Home Shoppings, and all of them need to more thoroughly manage their costs. In order for the late-comers of Group B and other home shopping companies to advance further, the current lax management should be reformed particularly on their SG&A expense sector. Provided that the total sales volume in the Internet shopping sector is projected to grow over 20 trillion won by the year 2010, it is concluded that all the participants in the home shopping industry should put strategies on efficient management on costs and expenses as their top priority rather than increase revenues, if they hope to grow even further after 2007.

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Effect of Ondansetron Alone and Combination of Naltrexone and Ondansetron on Alcohol Intake in C57BL/6 Mice (Naltrexone과 ondansetron의 병합투여가 C57BL/6형 생쥐의 알코올 섭취량에 미치는 영향)

  • Kim, Hyeun-Kyeung;Kim, Sung-Gon;Kang, Cheol-Joong;Park, Sang-Ick;Kim, Won-Ho
    • Journal of Life Science
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    • v.17 no.11
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    • pp.1576-1581
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    • 2007
  • Dopamine reward pathway projecting from ventral tegmental area to nucleus accumbens is well known as playing an important role in alcohol dependence. It is supposed that this dopamine pathway is modulated by $5-HT_3$ nervous system, and it was reported that ondansetron (OND), $5-HT_3$ receptor antagonist, reduced drinking amount and increased abstinence rate in alcohol-dependent patients. The purpose of this study is to investigate the effect of combination of OND and naltrexone (NTX), non-specific opioid receptor antagonist, on alcohol intake in C57BL/6 mice. In 40 C57BL/6 mice in the state of alcohol dependence, vehicle, while OND 0.01 mg/kg, or NTX 1.0 mg/kg administrated respectively, or OND 0.01 mg/kg and NTX 1.0 mg/kg administrated simultaneously for ten days, medication effects on 2-hr alcohol, 22-hr water, 24-hr food intake and body weight were studied. When vehicle group was compared with 3 medication groups respectively, using a repeated measure ANOVA, NTX alone and vehicle groups showed a significant medication by time interaction (p=0.042) in 2-hr alcohol intake, but in the other 2 groups, OND and NTX combination group and OND alone group, there was no significant interaction with vehicle group in 2-hr alcohol intake. From these results, it is suggested that there is no effect on alcohol intake in mice treating with OND, and naltrexone#s suppression effect on alcohol intake in mice is attenuated when treating with OND and NTX simultaneously. It is supposed that a further study looking at the interactions of serotonin, dopamine and opioid nerves systems will be needed.

The Physiological Efficacy of Aloe Gel (Aloe Gel의 생리 효과에 대한 고찰 - Gel의 다당류와 미량 성분을 중심으로 -)

  • 서화중
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.6
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    • pp.1026-1038
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    • 1995
  • Although aloe lost a lot of its previous popularity in modern clinical uses as medicine numerous scientific researches still have claimed the beneficial properties(curing and general tonic effect) of aloe gel. Whereas considerable contradictory reports have helped to confuse the aloe gel issue and continually aroused controversy about aloe gel efficacy. However health food, cosmetic and medicinal products made from aloe gel are widely available in the world market especially in U.S.A. so the growing of Aloe plant and the processing of A. vera gel have become big industries in some countries. In some previous papers the salicylic acid, one of the common trace gel components, was thought to have an analgetic and antinflammatory effect. Large amount of Mg ion in the gel was suggested to act as anesthetic, Mg-lactate as antihistamic, and Aloctin A(a glycoprotein) as wound healer by promoting the cell growth. The carboxypeptidase and bradykinase activity in the gel were proposed to have the pain relieving and antiinflammatory effect. But any of thes etheories concerining the physiological action of the trace gel components has not been demonstrated by modern pharmacology, and failed to be supported by clinical research. It was suggested by some research workers that trace amount of anthraquinone compounds in the gel play an important role to act as false substrate inhibitors for PG and TX production(antiprostanoid effect), by which, they believed, inflammation, burn and frostbite, and infected wound could be healed. This hypothesis has not been substantiated. Butthe suggested antimicrobial action, antidiabetic, and antidotic effect of aloe gel are likely to be attributed to the trace anthraquinone compounds. In a lot of recent experimental reports it has been claimed that aloe gel polysaccharides(acetylglucomannan, acetylmannan, and glycoprotein) have the antimicrobial, antinflammatory, antitumour, and infected wound healing effect by immunoenhancement. It is hoped that these effects will be soon documented in clinical studies, then the controversy on aloe gel beneficial effect will cease. In the 30 days subchronic toxicity test the lowest observed adverse effect level of acemannan(acetylmannan) on dog was 5.0 mg/kg, IP. But the aloe gel is generally agreed to be harmless and non toxic even for the internal use such as health food. In the case of idiosynrasy one must keep the delayed type hypersensitivity reaction of aloe gel in mind. In conclusion it seem to be impossible to simply refuse a lot of evidences made by research workers who have claimed aloe gel's beneficial effects and to deny the fact that there had been long therapeutic histories of Aloe plants.

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Evaluation of Psychosocial Impact and Quality of Life in BRCA Mutation Family (BRCA 돌연변이 가계의 심리상태 및 삶의 질 평가)

  • Han, Sang-Ah;Kim, Sai-Rhee;Kang, Eun-Young;Kim, Jeong-Hyun;Ha, Tae-Hyeon;Yang, Eun-Joo;Lim, Jae-Young;Han, Won-Shik;Noh, Dong-Young;Kim, Sung-Won
    • Journal of Genetic Medicine
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    • v.7 no.1
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    • pp.67-77
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    • 2010
  • Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.

PROSPECTIVE CLINICAL EVALUATION OF THREE DIFFERENT BONDING SYSTEMS IN CLASS V RESIN RESTORATIONS WITH OR WITHOUT MECHANICAL RETENTION (접착제와 와동형성의 차이에 따른 5급 복합레진 수복의 전향적 임상연구)

  • Lee Kyung-Wook;Choung Sae-Joon;Han Young-Chul;Son Ho-Hyun;Um Chung-Moon;Oh Myoung-Hwan;Cho Byeong-Hoon
    • Restorative Dentistry and Endodontics
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    • v.31 no.4
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    • pp.300-311
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    • 2006
  • The purpose of this study is to evaluate prospectively the effect of different bonding systems and retention grooves on the clinical performance of resin restorations in non-carious cervical lesions (NCCLs). Thirty-nine healthy adults who had at least 2 NCCLs in their premolar areas were included in this study. One hundred and fifty teeth were equally assigned to six groups: (A) Scotchbond Multi-Purpose (SBMP, 3M ESPE, St. Paul, MN, USA, 4th generation bonding system) without retention grooves; (B) SBMP with retention grooves; (C) BC Plus (Vericom Co., Anyang, Gyeonggido, Korea, 5th generation bonding system) without retention grooves; (D) BC Plus with retention grooves; (E) Adper Prompt (3M ESPE, Seefeld, Germany, 6th generation bonding system) without retention grooves; (F) Adper Prompt with retention grooves. All cavities were filled with a hybrid composite resin. Denfil (Vericom Co., Anyang, Gyeonggido, Korea) by one operator. Restorations were evaluated at baseline and at 6-month recall, according to the modified USPHS (United States Public Health Service) criteria. Additionally, clinical photographs were taken and epoxy resin replicas were made for SEM evaluation. At 6-month recall, there were some differences in the number of alpha ratings among the experimental groups. But, despite the differences in the number of alpha ratings, there was no significant difference among the 3 adhesive systems (p < 0.05). There was also no significant difference between the groups with or without mechanical retention (p < 0.05). Follow-ups for longer periods than 6 months are needed to verify the clinical performance of different bonding systems and retention grooves.