• 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.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.19-29
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• 2010

Objectives：Authors hypothesized that bipolar tendency of non-psychiatric person would be associated with stress vulnerability. To test the hypothesis, we compared perceived stress level, Type A Behavioral Pattern (TABP) and unhealthy lifestyle between person with and without bipolar tendency. Methods：The study cohort consisted of 1987 subjects without past and current psychiatric history. In this study, bipolar tendency was determined by MDQ response which requires endorsement of at least 7 of the 13 "yes or no" questions. We compared the scores of Perceived Stress Scale, A/B lifestyle questionnaire, and unhealthy lifestyle(alcohol, smoking, lack of exercise, irregular meal) between MDQ positive and negative respondents. Results：We identified the bipolar tendency group determined by the MDQ positive response were 329 subjects(16.6%). The overall score of the bipolar tendency group was significantly high on the A/B lifestyle questionnaire compared to the non-bipolar tendency group(125.4 vs. 115.9, p<0.001), and the rate of the subjects defined as TABP was also significantly high(41.3% vs. 30.1%, p<0.001). In comparison of subjectively perceived stress level, the bipolar tendency group was observed to be significantly higher than the non-bipolar tendency group (18.5% vs. 16.5%, p<0.001). The bipolar tendency group was significantly higher than the non-bipolar tendency group on the rate of answering：'irregular eating habit' (20.1% vs. 14.3%, p=0.002), '4-or-more-times alcohol intake per week' (29.8% vs. 16.5%, p<0.001), 'currently smoking' (41.9% vs. 23.0%, p<0.001), '2-or-less-times physical exercises per week' (63.2% vs. 55.1%, p=0.007). Conclusion：By clinical diagnosis, even a person who does not meet the criteria of bipolar disorder has a high risk of stress-related behavioral pattern, and perceived stress when possessing bipolar tendencies such as the (hypo) maniac tendency or affective instability. Such individual has significantly higher risk of having unhealthy life-style such as smoking, drinking, irregular eating habit and lack of exercise compared to non-bipolar tendency group. Since these risk factors lead to increase the risk of obesity, metabolic syndrome, diabetes, and cardiovascular diseases, the individual with the bipolar tendency requires a more effort to manage stress and to maintain healthy lifestyle.

• Journal of Genetic Medicine
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• v.8 no.1
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• pp.71-75
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• 2011

A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.

• Korean Journal of Biological Psychiatry
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• v.20 no.2
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• pp.45-53
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• 2013

Objectives Non-major depression with fewer symptoms than required for a Diagnostic and Statistical Manual of Mental Disorders-4th edition diagnosis of major depressive disorder (MDD) has consistently been found to be associated with functional impairment. In this study, we aim to estimate the cognitive impairment and the quality of life in elderly patients with subsyndromal depression (SSD) compared with non-depressive elderly (NDE). Methods The Korean version of Mini International Neuropsychiatric Interview was administered to 194 outpatients with depression and 108 normal controls. SSD is defined as having five or more current depressive symptoms with core depressive symptoms (depressive mood or loss of interest or pleasure) during more than half a day and more than seven days over two weeks. Depression was evaluated by the Korean form of Geriatric Depression Scale of a 15-item short version. Global cognition was assessed by Mini-Mental State Examination in the Korean version of CERAD assessment packet (MMSE-KC). Subjective cognitive impairment was assessed by the Subjective Memory Complaint Questionnaire. Quality of life was evaluated by the Korean Version of Short-Form 36-Item Health Survey. Results The mean score of the MMSE-KC in the SSD group was lower than that in the NDE group with adjustment for age, gender, and education [F = 4.270, p = 0.04, analysis of covariance (ANCOVA)]. If we defined those having Z-score of MMSE-KC < -1.5 as a high risk group of cognitive impairment, the odds ratio for the high risk group of cognitive impairment was 1.86 [95% confidence intervals (CI) 1.04-3.34] in SSD and 7.57 (95% CI 3.50-16.40) in MDD compared to NDE. The scores of physical component summary (F = 9.274, p = 0.003, ANCOVA) and mental component summary (F = 53.166, p < 0.001, ANCOVA) in the SSD group were lower than those in the NDE group with adjustment for age, gender, and education. Conclusions The subjects with SSD, as well as those with MDD, showed impairment of global cognition and also experienced low quality of life in both physical and mental aspects, compared to the NDE group.

• Journal of Veterinary Clinics
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• v.29 no.6
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• pp.509-512
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• 2012

A 4-year-old female Korean short hair cat weighing 6.5 kg presented for evaluation of urinary incontinence and stranguria. On physical examination, stranguria was observed concurrently with urinary bladder distention. Abdominal radiographs revealed two small uroliths in the urinary bladder. Urinary bladder sludge was detected on abdominal ultrasound. Urine analysis indicated hematuria and bacteriuria. The cat was treated with a 4-week course of a combination of antibiotics and urinary bladder irrigation using normal saline; however, response to treatment was minimal. Excretory urography was performed to identify a congenital disorder. A small diverticulum, located to the urinary bladder apex, was identified. A tentative diagnosis of a vesicourachal diverticulum was made. Surgical exploration of the abdomen was performed and a triangular-shaped diverticulum was apparent at the urinary bladder apex. Cystotomy was performed to remove two small uroliths. Partial cystectomy was then performed for diverticulectomy. Approximately 2 cm diameter of a part of the apex was removed. Normal urination was regained 5 days postoperatively. The follow-up was completed by physical examination 2 years after surgery. There was no evidence of stranguria and urinary incontinence.

• Journal of Korean Academy of Nursing
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• v.2 no.1
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• pp.115-129
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• 1971

As the result of a survey conducted by the author on the status of tile 12 educational institutions for mentally retarded children in Korea and their quartering facilities as well as on 934 children accommodated in such institutions, the following conclusion has been reached: 1) More than a half (approximately 58 percent) of the facilities for mentally retarded children are concentrated in Seoul. About eighty-three percent of these facilities are private establishments, of which 70 percent have their proprietors concurrently as their superintendents. Although these facilities were first established as many as 22 years ago, it has been only five or six years since education was actually started for mentally restarted children. 2) Out of a total of 179 employes, teachers number 99, there by constituting approximately 57.6 percent. Out of them, however, only 32 teachers or 2.8 percent have special teachers licenses. Thus, each teachers has to take care of an average of 29 children. This is excessive a number of children per teachers in view of the special nature of this education, there by indication how urgent it would be to secure more teachers lot this field. 3) Out of the mantally retarded children investigated 57.6 percent suffer from physical disorder in addition to mental retardation, 53.0 percent from mental alienation illnesses besides retardation, and 25 pent from physical, mental disorders in addition to retardation. It is therefore necessary to maintain medical and nursing facilities together with educational facilities. however, two places have no medical facilities at all, and four other places, without medical personnel, have to receive medical support from nearby hospitals or clinics. 4) The total number of children in the surveyed facilities is 934, who can be broken down into 58.7 percent boys and 41.3 percent for girls. They are classified into 12.5 percent for idiot, 37.7 percent for imbeciles, 32.7 percent for morons, and 17.3 percent for thoes children on borderline. Their average age is 13.9 years. 5) As the result of education, the illiteracy rate of mentally retarded children has decreased from 78.1 percent to 32.1 percent while the percentage of those taking the primary school course has increased for 12.2 per cent to 33.5 percent. As a result, it has been learned that education is definitely necessary for Retarded children though it may be a difficult task. 6) The children who have mentally retarded children among their brothers or sisters constitute 6.3 percent of the total number. The corresponding rate for boys is 3.5 percent while that for girls is a remarkably higher rate 10.6 percent. Through studies on the causes of their mental retardation, it has been learned that 39.6 percent of them is of the inherent type and 35.3 percent is of the environmental type. Control and improvement of health of mothers and children, early diagnosis and early treatment are believed to be very important because they could prevent or alleviant much of these conditions. 7) The storage age of teachers and employes is 35.3 years, an indication that a great proportion of them is experienced in a way or another as their major difficulty or problems in serving with these special school, 22.5 percent cited inadequate payment 24.5 gave the inadequate public understanding, and 22.5 percent pointed out the lack of understanding on the part of give parents.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.117-128
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• 2013

Objectives The purpose of this study is analyzing internal research trends of abnormal postures and providing problems of researches forward. Methods 6 Korean databases were searched for articles of abnormal postures, irrespective of publication year and 30 research were systematically reviewed. An analytical method such as descriptive statistics and an acutal number and percentage was used. Results We collected 30 studies. 16 studies were published within the last four years. 2012 saw 7 studies, the highest number of studies. Clinical research is the major research method. 26 studies were clinical research. The studies can be categorized according to the characteristic of the research content such as research of related factors or physical characteristics, research of treatment or programs, etc. 16 studies were about research of treatment or programs, the most number of studies. 11 studies were about research of related factors or physical characteristics, and 3 studies were about other issues. Conclusions Since the connection among postural abnormality, pain, and musculoskeletal system disorder has been raising, it is important to conduct a continued, methodical study.

• Journal of Veterinary Clinics
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• v.32 no.3
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• pp.251-254
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• 2015

A 3-year-old castrated male Spitz dog (8.4 kg) was referred for hindlimb lameness. The dog had undergone corrective surgery for bilateral medial patellar luxation 6 weeks prior to presentation. Intermittent lameness of both hind limbs was evident on general inspection. Physical examination revealed moderate pain and crepitus upon flexion and extension of the stifle joints. Radiography revealed features consistent with distal deviation of the cartilage flaps and effusion in both stifle joints. Detachment and deviation of both osteochondral blocks were suspected based on the physical and radiographic findings. Arthroscopy confirmed failed osteochondral blocks (right $1.5cm{\times}0.9cm{\times}0.2cm$, left $1.3cm{\times}0.9cm{\times}0.1cm$), which were removed. After removal of the osteochondral blocks, the stepped trochlear grooves were located and debrided using an arthroscopic burr, to prevent patellar tracking disorder. The dog resumed normal ambulation without medial patellar luxation 2 weeks postoperatively, and there were no complications. Arthroscopy is an effective surgical modality for the diagnosis and treatment of canine joint disorders. It offers a magnified view of the joint, which allows accurate evaluation of intra-articular structures. In addition, arthroscopic surgery can reduce the postoperative complications associated with surgical wound.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.26-33
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• 1992

The carpal tunnel syndrome is one of the most common peripheral nerve entrapment syndromes. The typical symptoms are pain, numbness and paresthesia in the median nerve territory of the hand. Recently, it is widely recognized that occupational factor is regarded as the important cause of the carpal tunnel syndrome. Clinical study is performed in the 42 female workers who is repetitively working at packing department in a rayon manufacturing factory from November 1991 till March 1992. The study included a questionnaire, physical examinations, and the neurophysiological test. The summary of the results obtained was as follows : 1. Among 42 packing workers, 9 workers(21.4%) were diagnosed as carpal tunnel syndrome by electromyography. The affected side was bilateral in 4 workers(9.5%), right in 4 workers(9.5%), and left in one worker(2.4%). 2. Among 42 subjects, 28 workers(66.7%) complained the clinical symptoms related to carpal tunnel syndrome, 11 workers(26.2%) showed positive Phalen sign, and 7 workers(16.7%) showed positive Tinel sign. 3. Researchers regard electromyographic finding as the gold standard for diagnosis of carpal tunnel syndrome. The sensitivity and specificity of the clinical symptoms to diagnose the carpal tunnel syndrome were 0.89, 0.39 respectively. If the carpal tunnel syndrome is diagnosed by the combination of the positive findings of the symptoms and the physical examinations, either Tinel or Phalen sign, the sensitivity and specificity were 0.67 and 0.76 respectively. Considering above results, though this small number of workers is not adequate for epidemiologic conclusions, carpal tunnel syndrome seems to be an important occupational disorder among packing workers in a rayon manufacturing factory.

• Korean Journal of Occupational Health Nursing
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• v.15 no.1
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• pp.14-29
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• 2006

Purpose: The purposes of this study were to survey the extent of pain and discomfort in the musculoskeletal system among visiting housekeepers, above all concerning neck, shoulder, back, wrist, knee, and arm pain and to find possible relations between symptoms and various working conditions. Method: A questionnaire was answered by 174 woman visiting housekeepers living in Kyeonggi-do and Seoul from December 1, 2003 to February 30, 2004. The symptoms of musculoskeletal system were coded by the pain index which illustrates the extent of the symptoms, and analyzed in view of NIOSH guideline and Kim, et. al.'s notion. Result: 1. As to the complaint rate of subjective musculoskeletal symptoms by body region, the figure was the highest for shoulder with 78.2%, followed by back with 66.7%, knee 53.6%, neck 56.3%, wrist 40.2%, and arm 29.2%, respectively. The logistic analysis showed shoulder pain and arm pain have no relation with working and health conditions, and back pain was significantly related to current health condition. In same way, knee pain and wrist pain were found to be mainly related to marital status. 2. Following the NIOSH guideline, the positive rate of subjective musculoskeletal symptoms was found out in following order: shoulder 69.5%, back 59.2%, knee 54%, neck 46%, wrist 32.8%, and arm 25.3%. To investigate the main cause of each disease, the symptoms were classified by pain index, where the value of more than 3 comes to the NIOSH case, and analyzed in term of complaint rate using discrete logistical method : shoulder pain was highly related to the housekeeping time after work, back pain was to current health condition and the heavy weight carrying and neck, wrist, arm pain were commonly related to the ordinary health condition. For knee pain, working speed was a main cause. 3. In view of Kim et. al.'s standard, where the pain index is over 7, the positive rate was showed in order slightly different from previous analyses : shoulder 33.3%. knee 29.9%, back 28.2%, neck 17.2%, wrist 17.2%, and 16.7%. From the logistical analysis, insufficient rest was shown as the main cause of shoulder, back, arm and wrist pain. For neck pain, ordinary health condition was mainly related. In case of knee pain, any apparent relation is not found. Conclusion: According to the logistic regression analysis of musculoskeletal system, there was strong suggestion that the less insufficient physical rest, the more significant disorder complaint. This means that the most musculoskeletal symptom among the visiting housekeepers can be prevented and cured by sufficient physical resting.