• Korean Journal of Biological Psychiatry
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• v.2 no.1
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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.

• Tuberculosis and Respiratory Diseases
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• v.67 no.5
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• pp.402-408
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• 2009

Background: Pre-B-cell colony enhancing factor (PBEF) has been suggested as a novel biomarker in sepsis and acute lung injury. We measured the PBEF in bronchoalveolar lavage (BAL) fluid of acute critically ill patients with lung infiltrates in order to evaluate the clinical utility of measuring PBEF in BAL fluid. Methods: BAL fluid was collected by bronchoscope from 185 adult patients with lung infiltrates. An enzyme-linked immunosorbent assay was then performed on the collected fluids to measure the PBEF. Results: Mean patient age was 59.9 ${\pm}$14.5 years and 63.8% of patients were males. The mean concentration of PBEF in BAL fluid was 17.5 ${\pm}$88.3 ng/mL, and patients with more than 9 ng/mL of PBEF concentration (n=26, 14.1%) had higher Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores on the BAL exam day. However, there were no significant differences in clinical characteristics between survivors and non-survivors. In patients with leukocytosis (n=93) seen on the BAL exam day, the linear regression analysis revealed a significant, positive relationship between PBEF and APACHE II ($r^2$=0.06), SOFA score ($r^2$=0.08), Clinical Pulmonary Infection Score ($r^2$=0.05), and plateau pressure in patients on ventilators ($r^2$=0.07) (p<0.05, respectively). In addition, multivariate regression analysis with PBEF as a dependent variable showed that the plateau pressure ($r^2$=0.177, p<0.05) was correlated positively with PBEF. Conclusion: The PBEF level in the BAL fluid may be a useful, new biomarker for predicting the severity of illness and ventilator-induced lung injury in critically ill patients with lung infiltates and leukocytosis.

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.23-48
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• 2020

Objectives : This study aimed to suggest distinct signs of Greater yin disease (tàiyīnbìng, 太陰病) by researching the etymology of three terms: zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), which are exclusive found only in Greater yin disease (太陰病) in Gangpyeong-shanghanlun, but not in other categories. Methods : We studied the etymologies of the three terms that are unique in Greater yin disease, then found some pathological signs that are related with them through the four mental illness cases, which include somatization, obsessive-compulsive behavior, delusion, and panic disorder. Results : Based on the definitions of each term, we diagnosed the four patients who had mental illnesses as having Greater yin disease, and we observed meaningful improvements after administering herbal medication. After Gyejigajakyak-tang administration, the Insomnia Severity Index (ISI) score decreased from 18 to 7 and the Beck's Anxiety Index (BAI) score decreased from 36 to 18 in the first case, the ISI score decreased from 27 to 16 and the BAI score decreased from 50 to 33 in the second case, and the ISI score decreased from 23 to 4 and the BAI score decreased from 34 to 5 in the third case. In the last case, the ISI and BAI scores were 16 and 22, respectively, at the first visit, and it was found that the scores had changed to 6 and 22, respectively, at the last visit. Conclusions : We found that the unique terms in Greater yin disease, including zi-tong (自痛), jie-ying (結硬), and yin-er (因爾), can be interpreted as groundless arbitrary assumption, resting strong tension, and psychological projection based on the etymological hypothesis. Therefore, we suggest these as specific signs of Greater yin disease.

• The Journal of Pediatrics of Korean Medicine
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• v.33 no.3
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• pp.69-81
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• 2019

Objectives The purpose of this study is to examine 33 cases of chronic sinusitis in children who were treated with Korean medicine. Methods Herbal medicine, acupuncture, and nebulizer and laser therapy were used to treat chronic sinusitis, and a plain radiography (paranasal sinus water's view) was used to confirm improvement of the children's sinusitis. Then, the data was classified by sex, age, frequency and duration of common cold, severity of sinusitis, duration of treatment, pattern identification and so on. Results There were 72.7% boys and 27.3% girls. The average age of children is $4.48{\pm}2.18years$. 70% of the children had common cold more than once a month, and 85.1% of the children from the study group had common cold lasting more than a week. The sinusitis severity score ranged from 10 to 200. 81.8% were more than 100. Duration of the treatment was $157.21{\pm}83.4day$, duration of herbal medicine treatment was $79.3{\pm}31.23day$, rate of herbal medicine was $62.12{\pm}29.21%$. The frequency of acupuncture, nebulizer and laser therapy ranged from 1 time to 11 times but was much lower than expected. Conclusions 33 cases of chronic sinusitis in children were treated with Korean medicine, and cure of the illness was confirmed by PNS water's view, and clinical characteristic of the patients with chronic sinusitis was analyzed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.2
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• pp.74-82
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• 2019

Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

• Safety and Health at Work
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• v.7 no.3
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• pp.213-217
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• 2016

Background: The objective of this study is to identify high-risk groups for industrial accidents by setting up 2003 as the base year and conducting an in-depth analysis of the trends of major industrial accident indexes the index of industrial accident rate, the index of occupational injury rate, the index of occupational illness and disease rate per 10,000 people, and the index of occupational injury fatality rate per 10,000 people for the past 10 years. Methods: This study selected industrial accident victims, who died or received more than 4 days of medical care benefits, due to occupational accidents and diseases occurring at workplaces, subject to the Industrial Accident Compensation Insurance Act, as the study population. Results: According to the trends of four major indexes by workplace characteristics, the whole industry has shown a decreasing tendency in all four major indexes since the base year (2003); as of 2012, the index of industrial accident rate was 67, while the index of occupational injury fatality rate per 10,000 people was 59. Conclusion: The manufacturing industry, age over 50 years and workplaces with more than 50 employees showed a high severity level of occupational accidents. Male workers showed a higher severity level of occupational accidents than female workers. The employment period of < 3 years and newly hired workers with a relatively shorter working period are likely to have more occupational accidents than others. Overall, an industrial accident prevention policy must be established by concentrating all available resources and capacities of these high-risk groups.

• Health Policy and Management
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• v.31 no.4
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• pp.472-478
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• 2021

Background: Early identification of patients who are highly likely to develop severe illness among confirmed cases of coronavirus disease 19 (COVID-19) can be expected to lead to effective treatment. This study therefore aimed to determine whether the presence of nonalcoholic fatty liver disease (NAFLD) has an impact on the exacerbation of COVID-19 symptoms. Methods: The study used the Korean National Health Insurance claim data for treatment of COVID-19 patients in 2020. NAFLD includes nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). The outcome variables used were hospitalization and the use of medical devices. Hospitalization was defined by a length of stay exceeding one day and the use of medical devices was defined as one or more uses of a ventilator or extracorporeal membrane oxygenation. Multivariable logistic regression analysis was performed to determine if there was a difference in the hospitalization and use of medical devices of COVID-19 patients depending on the presence of NAFLD. Results: The odds ratio of hospitalization was 1.059, indicating slightly higher odds of hospitalization for patients with NAFL or NASH compared to those without the conditions, but it was not statistically significant (0.969-1.156). On the other hand, the odds ratio of use of medical devices was high at 1.667 and was statistically significant (1.111-2.501). Conclusion: The study results found NAFLD to be a risk factor that can exacerbate symptoms in COVID-19 patients. Accordingly, it is necessary to identify NAFLD patients through preemptive screening and provide them with appropriate treatments.

• Tuberculosis and Respiratory Diseases
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• v.84 no.2
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• pp.115-124
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• 2021

Background: This study aimed to determine the parameters for worsening oxygenation in non-severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: This retrospective cohort study included cases of confirmed COVID-19 pneumonia in a public hospital in South Korea. The worsening oxygenation group was defined as that with SpO₂ ≤94% or received oxygen or mechanical ventilation (MV) throughout the clinical course versus the non-worsening oxygenation group that did not experience any respiratory event. Parameters were compared, and the extent of viral pneumonia from an initial chest computed tomography (CT) was calculated using artificial intelligence (AI) and measured visually by a radiologist. Results: We included 136 patients, with 32 (23.5%) patients in the worsening oxygenation group; of whom, two needed MV and one died. Initial vital signs and duration of symptoms showed no difference between the two groups; however, univariate logistic regression analysis revealed that a variety of parameters on admission were associated with an increased risk of a desaturation event. A subset of patients was studied to eliminate potential bias, that ferritin ≥280 ㎍/L (p=0.029), lactate dehydrogenase ≥240 U/L (p=0.029), pneumonia volume (p=0.021), and extent (p=0.030) by AI, and visual severity scores (p=0.042) were the predictive parameters for worsening oxygenation in a sex-, age-, and comorbid illness-matched case-control study using propensity score (n=52). Conclusion: Our study suggests that initial CT evaluated by AI or visual severity scoring as well as serum markers of inflammation on admission are significantly associated with worsening oxygenation in this COVID-19 pneumonia cohort.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.279-285
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• 2005

Objectives : This study was performed to evaluate the efficacy and safety of MPH-OROS and parental satisfaction for treatment of children with ADHD Method : The 569 participants were clinically diagnosed for ADHD using DSM-IV criteria. We switched current medication to MPH-OROS or introduced MPH-OROS for treatment of ADHD. We assessed the clinical global impression severity of illness (CGI-S), the clinical global impression severity of improvement(CGI-I). And the parents of participants measured the Korean version of Conners rating scale at baseline, the 1 st week and the 3rd week after MPH-OROS trial. At the 3rd week, the parents measured the parent satisfaction questionnaire. Results : $13\%$ of participants dropped out because of several causes including side effects. The change of CGI-S was significantly decreased. Using CGI-I, the improvement was $72.3\%$ at the 1st week and $87.4\%$ at the 3rd week. The total score of the Korean version of Conners parent rating scale was significantly decreased. The participants complaining one or more of side effects were 119$(20.7\%)$, and the most common side effect was anorexia. The $94\%$ of parents replied that they were overall satisfied with MPH-OROS trial. Also the advantages of MPH-OROS of parental report were the long duration of the drug, the improvement of schoolwork and attitude, the improvement of home behavior and homework and the improvement of overactivity. Conclusion : MPH-OROS is effective and well-tolerated in actual clinical use for ADHD.

• Korean Journal of Psychosomatic Medicine
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• v.26 no.2
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• pp.172-178
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• 2018

Objectives : This study aimed to describe the use of over-the-counter (OTC) drugs and to identify predictors for their use in the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,099 subjects. Data regarding socio-demographic status, medical condition, cognition, mood disorder and use of OTC drugs were collected using self-administered questionnaire and from a specific semi-structured interview by a trained nurse. Data regarding use of OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to examine factors associated with the use of OTC drugs. Results : The use of OTC drugs were reported by 35.4% of the subjects. Analgesics (13.6%) was the most frequent drugs. Depression (OR=1.10, 95% CI=1.10-1.87) and comorbidities measured by cumulative illness rating scale (CIRS) (OR=1.08, 95% CI=1.03-1.12) were significantly associated with the use of OTC drugs in the elderly living alone. Conclusions : Depression and severity of underlying medical conditions could be a predictor of the use of OTC drugs in the elderly living alone. The clinicians should be vigilant regarding the potential use of nonprescription medications in the elderly.