• 생물정신의학
• /
• 제24권4호
• /
• pp.225-234
• /
• 2017

Objectives Local gyrification reflects the early neural development of cortical connectivity, and is regarded as a potential neural endophenotype in psychiatric disorders. Several studies have suggested altered local gyrification in patients with bipolar I disorder (BD-I). The purpose of the present study was to investigate the alterations in the cortical gyrification of whole brain cortices in patients with BD-I. Methods Twenty-two patients with BD-I and age and sex-matched 22 healthy controls (HC) were included in this study. All participants underwent T1-weighted structural magnetic resonance imaging (MRI). The local gyrification index (LGI) of 66 cortical regions were analyzed using the FreeSurfer (Athinoula A. Martinos Center for Biomedical Imaging). One-way analysis of covariance (ANCOVA) was used to analyze the difference of LGI values between two groups adjusting for age and sex as covariates. Results The patients with BD-I showed significant hypogyria in the left pars opercularis (uncorrected-p = 0.049), the left rostral anterior cingulate gyrus (uncorrected-p = 0.012), the left caudal anterior cingulate gyrus (uncorrected-p = 0.033). However, these findings were not significant after applying the multiple comparison correction. Severity or duration of illness were not significantly correlated with LGI in the patients with BD-I. Conclusions Our results of lower LGI in the anterior cingulate cortex and the ventrolateral prefrontal cortex in the BD-I group implicate that altered cortical gyrification in neural circuits involved in emotion-processing may contribute to pathophysiology of BD-I.

• 생물정신의학
• /
• 제23권4호
• /
• pp.199-204
• /
• 2016

Objectives Although forgetfulness is a common complaint among menopausal depressed women, there is still a debate about the relationship between memory impairment and menopause. The aim of this study is to examine whether menopause is related to cognitive decline among women with depressive disorders. We hypothesized that postmenopausal depressed women show generally poorer performance than premenopausal depressed women on various cognitive function tests. Methods With a retrospective chart review, we identified a total of 87 female patients (45 premenopausal patients and 42 postmenopausal patients) who were hospitalized with depressive disorders from 2000 to 2016. Demographic and clinical variables and cognitive test results were compared between two groups. Results Education year is longer in premenopausal group than postmenopausal group whereas clinical characteristics (illness duration, recurrence, and symptom severity) and mean Intelligence Quotient (IQ) were similar between two groups. The postmenopausal group took longer time for Bender-Gestalt Test (BGT) recall, Trail Making Test (TMT)-A, and TMT-B than the premenopausal group. After controlling for age and education, significant difference was remained for BGT recall (p = 0.029). Conclusions Postmenopausal state may be related with decline of visuospatial memory function, in particular, among depressed female patients. Other areas of cognitive function including complex attention, verbal memory, auditory memory, and working memory might be interpreted while considering age and education level.

• 한국임상약학회지
• /
• 제27권2호
• /
• pp.77-82
• /
• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• 한국의료질향상학회지
• /
• 제6권1_2호
• /
• pp.80-91
• /
• 1999

Background : With the CQI concepts, which emphasize doing the right things right the first time, we tried to enhance the timely completion of medical records by changing the review process from retrospective method to concurrent one. Methods : Against the current retrospective QA activity, Medical record administrator did the concurrent QA of the inpatient medical records with the deficiency sheets. One general surgery ward was chosen as a trial one. The deficiency rate of the medical records of the discharged patients was compared before and after the enforcement of the system. Job analysis of the medical record departments was done about four tertiary care hospitals located in Seoul to estimate the cost and the time consumed by current system. Results : There was a little improvement in the completion rate of the medical records after the trial. The new system was effective. And job analysis showed that much money and time were wasted by current retrospective feedback system. Conclusion : Though the result was not so satisfactory, it should be considered that this test was a voluntary one and the interns and residents were not forced to complete the medical records during this trial period. If there be any strong motivation to complete the medical record in time, this system is sure to be succeed. As the DRG system requires the concurrent review of the medical records to confirm severity of the patient's illness and to assure the timely discharge, it is desirable to enforce this method with the DRG system together. DRG coding and reducing deficiency rate of the medical records can be accomplished simultaneously.

• Pediatric Infection and Vaccine
• /
• 제11권1호
• /
• pp.121-125
• /
• 2004

신생아 수두는 모체가 감염된 시기에 따라 그 증상과 예후가 달리 나타날 수 있으며, 출생 후 감염된 경우는 태반을 통해 모체로부터 태아에게 항체가 전달되지 못하기 때문에 합병증의 발생 가능성이 높고, 예후가 좋지 않아 적절한 치료와 추적관찰이 필요하다. 저자는 합병증의 동반없이 acyclovir를 사용하여 치료한 불현성 감염 엄마로부터 감염된 신생아 수두 1례를 경험하였기에 보고하는 바이다.

• 한국학교보건학회지
• /
• 제9권2호
• /
• pp.185-195
• /
• 1996

This study attempts to discover ways to prevent and cope with stress m primary school students, Specific, ally, we wish to investigate the sources of stress and to identify the variance and frequency of coping methods which have been used by the subjects. After examining the school children's list of items about stress and coping strategies by on open structure method, subjects ranked the seventy of stressor's and frequency of a coping strategies by closed structure method. A survey was done of 720 students who were from the 4th to 6th grade in 4 primary schools in the Chonbuk area from April 1st to May 30th, 1995. The major results obtained from this study were the following. 1. The sources of stress bad were classified in 57 items Among the 57 items, 'were school records' 'illness of parents' 'death of family members' 'meetings with trouble makers' ranked high ranking in the stress ratings. 2. Severity of stress. the mean total stress scores were 186.4 with 285 as the highest score. 3. The kinds of coping with stress using were classified in 35 items, Among the 35 items, 'wandering and walking alone' 'mood getting out of the in any way' 'trying to forget the stressor' 'were among the highest scored. 4. Frequency of coping with stress: mean total stress coping scores were 67.9 with 140 as the highest score. 5. Difference m stress and coping strategies between sex, age, living district and religion groups were examined. 1) Significant variables influencing stress scoring were sex (t=-2,29, p<.001) and grade (F=6.33, p<.001). 2) Significant variables influencing stress coping practice were residence (t=1.94, p<.05), sex (t=-3.17, p<.002) and religion (F=5,95, p<.0001).

• 생물정신의학
• /
• 제25권2호
• /
• pp.31-37
• /
• 2018

Objectives The aim of this study was to evaluate the psychopathological features such as depression and anxiety in schizophrenics with obsessive-compulsive symptoms (OCS) as well as the severity of OCS according to duration of schizophrenia. Methods We randomly selected sixty four inpatients with schizophrenia. We classified the patients into two groups (OCS group, non-OCS group) according to the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Clinical and demographic features were evaluated. To assess OCS, Y-BOCS were performed. The Korean version of the Positive and Negative Syndrome Scale(K-PANSS), the Brief Psychiatric Rating Scale (BPRS), the Korean version of the Calgary Depression Scale for Schizophrenia (K-CDSS), the Beck Anxiety Inventory (BAI) and the Satisfaction With Life Scale (SWLS) were conducted. Independent t-test and chi-square test were conducted to compare the two groups. Pearson correlation analysis was performed to examine the relationship between the duration of schizophrenia and the Y-BOCS score. Results The Y-BOCS, K-CDSS, and BAI scores were higher in the OCS group. There was a significant correlation between the duration of schizophrenia and the Y-BOCS score. Conclusions Anxiety and depression symptoms were severe in the OCS group. In addition, the results of this study indicate that the longer duration of schizophrenia, the more severe the OCS. Therefore, the evaluation of OCS in schizophrenics should be accompanied by treatment intervention.

• Clinical and Experimental Pediatrics
• /
• 제58권10호
• /
• pp.380-385
• /
• 2015

Purpose: Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. Methods: The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ${\leq}18years$ presenting with croup or epiglottitis. Results: We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were $2.2{\pm}2.0$ and $5.6{\pm}5.8years$, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05). Conclusion: Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

• Journal of Korean Neurosurgical Society
• /
• 제57권1호
• /
• pp.19-22
• /
• 2015

Objective : Posttraumatic cerebral infarction (CI) is a well-known complication of traumatic brain injury (TBI). However, the causation and apportionment of trauma in patients with CI after TBI is not easy. There is a scoring method, so-called trauma apportionment score (TAS) for CI, consisted with the age, the interval, and the severity of the TBI. We evaluated the reliability of this score. Methods : We selected two typical cases of traumatic CI. We also selected consecutive 50 patients due to spontaneous CI. We calculated TAS in both patients with traumatic and spontaneous CI. To enhance the reliability, we revised TAS (rTAS) adding three more items, such as systemic illness, bad health habits, and doctor's opinion. We also calculated rTAS in the same patients. Results : Even in 50 patients with spontaneous CI, the TAS was 4 in 44 patients, and 5 in 6 patients. TAS could not assess the apportionment of trauma efficiently. We recalculated the rTAS in the same patients. The rTAS was not more than 11 in more than 70% of the spontaneous CI. Compared to TAS, rTAS definitely enhanced the discriminating ability. However, there were still significant overlapping areas. Conclusion : TAS alone is insufficient to differentiate the cause or apportionment of trauma in some obscure cases of CI. Although the rTAS may enhance the reliability, it also should be used with cautions.

• 한방안이비인후피부과학회지
• /
• 제30권2호
• /
• pp.51-85
• /
• 2017

Objectives : This study aimed to investigate the awareness improvement of atopic dermatitis(AD) for AD children's parents and to evaluate the mental health condition of AD children and QoL of their parents. Methods : We conducted elementary school visit education(the first education) and recruited children and parents who wanted to participate the hospital visit education(the Second education). In the first education, we lectured about AD, performed survey about QoL and awareness about AD and obtained 48 valid results. In the second education, we performed an education for AD again, skin condition evaluation, mental health analysis survey and obtained 29 valid results. We compared the AD and non-AD groups of each education in the first and second education. We assessed atopic awareness, FDLQI, DFI, CDI, BAI, and KISE scores by gender, age, duration of disease, onset, and severity of AD. Results : Despite children with AD, the survey showed their parents lacked knowledge about AD. However, they acquired the necessary knowledge in AD education. There was a significant difference in the total score of Atopic awareness between the AD group in the first education and the AD group in the second education. (p=0.042) In addition, the CDI and BAI scores of all patients were divided by the duration of disease, and it was estimated that depression and anxiety disorders may be aggravated by longer term illness. Conclusions and Discussions : This study confirmed duration of AD affects AD children's mental health, and verified positive changes in atopic awareness after AD education.