• Title/Summary/Keyword: bipolar

Search Result 1,547, Processing Time 0.027 seconds

A Preliminary Study on the Development of Korean Medication Algorithm for Attention-Deficit Hyperactivity Disorder (한국형 주의력결핍 과잉행동장애 약물치료 알고리듬 개발을 위한 예비연구)

  • Park, Jae-Hong;Kim, Bung-Nyun;Kim, Jae-Won;Kim, Ji-Hoon;Son, Jung-Woo;Shin, Dong-Won;Shin, Yun-Mi;Yang, Su-Jin;Yoo, Hanik-K.;Yoo, Hee-Jeong;Lee, Soyoung Irene;Cheon, Keun-Ah;Hong, Hyun-Ju;Hwang, Jun-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
    • /
    • v.22 no.1
    • /
    • pp.25-37
    • /
    • 2011
  • Objectives:This study was conducted to develop a Korean algorithm of pharmacological and non-pharmacological treatment strategies in attention-deficit hyperactivity disorder (ADHD) and its specific comorbid disorders (e.g. tic disorder, depressive disorder, anxiety disorder, bipolar disorder, and oppositional defiant disorder/conduct disorder). Methods:Based on a literature review and expert consensus, both paper- and web-based survey tools were developed with respect to a comprehensive range of questions. Most options were scored using a 9-point scale for rating the appropriateness of medical decisions. For the other options, the surveyed experts were asked to provide answers (e.g., duration of treatment, aver-age dosage) or check boxes to indicate their preferred answers. The survey was performed on-line in a self-administered manner. Ultimately, 49 Korean child & adolescent psychiatrists, who had been considered experts in the treatment of ADHD, vol untarily completed the questionnaire. In analyzing the responses to items rated using the 9-point scale, consensus on each option was defined as a non-random distribution of scores as determined by a chi-square test. We assigned a categorical rank (first line/preferred choice, second line/alternate choice, third line/usually inappropriate) to each option based on the 95% confidence interval around the mean rating score. Results:Specific medication strategies for key clinical situations in ADHD and its comorbid disorders were indicated and described. We organized the suggested algorithms of ADHD treatment mainly on the basis of the opinions of the Korean experts. The suggested algorithm was constructed according to the templates of the Texas Child & Adolescent medication algorithm Project (CMAP). Conclusion:We have proposed a Korean treatment algorithm for ADHD, both with and without comorbid disorders through expert consensus and a broad literature review. As the tools available for ADHD treatment evolve, this algorithm could be reorganized and modified as required to suit updated scientific and clinical research findings.

Studies on the Electrocadiogram in Non-human Primates Reared in Korea (國內 飼育 원숭이의 心電圖에 관한 硏究)

  • 서진석;서지민;이버들;송근호;이수진;김덕환;현병화;신남식
    • Journal of Veterinary Clinics
    • /
    • v.19 no.2
    • /
    • pp.132-138
    • /
    • 2002
  • Non-human primates are widely used for experimental animal and raised as companion animal in Korea. To establish the electrocadiogram (ECG) of non-human primates that are domestically raised, the author measured bipolar limb leads and augmented unipolar limb leads, after tiletamine/zolazepam (TZ) injection as sedative agents. The amplitudes of P,Q, R,S and T wave and duration time of P wave, QRS complex, PR and QT interval in each lead of ECG were evaluated in 7 non-human primates at 15 minutes after TZ injection, respectively. The amplitude of P wave in I, II,III, aVR, aVL and aVF leads revealed 0.06$\pm$ 0.05,0.14$\pm$ 0.05, 0.1 $\pm$ 0.05,-0.11 $\pm$ 0.06,-0.04$\pm$ 0.04 and 0.12$\pm$ 0.05 mV respectively. The amplitude of Q wave revealed -0.16$\pm$ 0.15, -0.23$\pm$ 0.18, -0.17$\pm$ 0.13, 0.16$\pm$0.13, 0.04$\pm$ 0.09 and -0.2$\pm$0.13 mV, respectively. The amplitude of R wave revealed 0.56$\pm$0.56, 1.24$\pm$ 0.67, 0.92$\pm$0.33, -0.37$\pm$ 1.14, -0.22$\pm$ 0.47 and 1.12 $\pm$ 0.47 mV, respectively. The amplitude of S wave revealed -0.02$\pm$ 0.08, -0.04$\pm$0.06, -0.06$\pm$0.04, 0.02$\pm$0.04, 0.04$\pm$0.09 and -0.04 $\pm$ 0.06 mV, respectively. The amplitude of T wave revealed -0.01 $\pm$ 0.15,-0.02$\pm$ 0.13, 0.01 $\pm$ 0.08, 0.02$\pm$ 0.12, 0.01 $\pm$ 0.11 and -0.03$\pm$ 0.09 mV, respectively. The duration time of P wave revealed 0.05 $\pm$ 0.01, 0.04$\pm$ 0.01, 0.05$\pm$ 0.02, 0.05 $\pm$ 0.02, 0.04$\pm$ 0.01 and 0.04$\pm$ 0.01 sec, respectively. The duration time of QRS complex revealed 0.05 $\pm$ 0.02,0.05$\pm$ 0.01, 0.05 $\pm$ 0.01, 0.04$\pm$ 0.01, 0.05$\pm$ 0.01 and 0.05 $\pm$ 0.01 sec, respectively. The duration time of PR interval revealed 0.08$\pm$ 0.01, 0.07$\pm$0.01,0.08$\pm$ 0.03, 0.08$\pm$0.01, 0.08$\pm$ 0.01 and 0.08$\pm$0.01 sec, respectively. The duration time of QT interval revealed 0.23$\pm$ 0.06, 0.22$\pm$ 0.05, 0.23 $\pm$ 0.06, 0.23$\pm$ 0.06, 0.24$\pm$ 0.05 and 0.22$\pm$ 0.02 sec, respectively. No significant changes were observed in e amplitude of P and T waves. The amplitude of QRS complex in ketamine group was higher than that of TZ group. However, no significant changes were observed in both intra-group and inter-group. There were no significant changes in the duration time of P wave, QRS complex and PR interval obtained from both groups. Also, the duration time of QT interval in TZ group was significantly longer at 30 min.(P< 0.05) an that of 10 minutes after injection. However, significant difference was not found between two groups. The mean cardiac electric axis in ketamine group tended to decrease until 30 min. after injection and then gradually increase. However, mean cardiac electric axis of TZ group was increased until 30 min. after injection and then decreased. But significant differences were not observed between groups. These results suggest that the ECG pattern after TZ injection to non-human primates reared in korea was established. It was also considered that the injection of ketamine and TZ didn't significantly affect on ECG pattern of the non-human primates.

Effect of Coolant on PEMFC Performance in Low Humidification Condition (저가습 조건에서 냉각 유체의 고분자전해질 연료전지에 대한 영향)

  • Lee, Hung-Joo;Song, Hyun-Do;Kwon, Jun-Taek;Kim, Jun-Bom
    • Journal of the Korean Electrochemical Society
    • /
    • v.10 no.1
    • /
    • pp.25-30
    • /
    • 2007
  • Proton exchange membrane fuel cell(PEMFC) performance could be affected by various factors such as cell temperature, total pressure, partial pressure of reactants and relative humidity. Hydrogen ion is combined with water to form hydronium ion [$H_3O^+$] and pass through membrane resulting electricity generation. Cooling system is needed to remove heat and other uses on large scale fuel cell. In case that collant conductivity is increased, fuel cell performance could be decreased because produced electricity could be leaked through coolant. In this study, triple distilled water(TDW) and antifreeze solution containing ethylene glycol was used to observe resistance change. Resistance of TDW was taken 28 days to reach preset value, and effect on fuel cell operation was not observed. Resistance of antifreeze solution was not reached to preset value up to 48 days, but performance failure occurred presumably caused by bipolar plate junction resulting stoppage resistance experiment. Generally PEMFC humidification is performed near-saturated operating conditions at various temperatures and pressures, but non-humidifying condition could be applied in small scale fuel cell to improve efficiency and reduce system cost. However, it was difficult to operate large scale fuel cell without humidifying, especially higher than $50{\sim}60^{\circ}C$. In case of small flux such as 0.78 L/min, temperature difference between inlet and outlet was occurred larger than other cases resulting performance decrease. Non-humidifying performance experiments were done at various cell temperature. When both of anode and cathode humidification were removed, cell performance was strongly depended on cell operating temperature.

Effects of Traditional Acupuncture on Colonic Motility in the Rat with Colitis (결장염 유발 Rat의 결장운동성에 침술이 미치는 영향)

  • Kim, Hee-Young;Shim, In-Sop;Lee, Hye-Jung;Jeong, Seong-Mok;Kim, Sun-Young;Nam, Tchi-Chou
    • Journal of Veterinary Clinics
    • /
    • v.20 no.1
    • /
    • pp.22-25
    • /
    • 2003
  • The aims of this study were to investigate the efficacy of acupuncture on myoelectrical activity of inflamed or normal colon in the rat, and whether the effect of acupuncture on colonic motility was related to endogenous opioids. Twenty-two male Sprague-Dawley rats were divided into three groups. Experimental groups were normal group (n = 8), colitis group (n = 6) and naloxone group (n = 8). Stainless steel bipolar electrodes were implanted on the serosal layer of the proximal colon of rats. Colitis was induced 7 days after electrode implantation using trinitrobenzene sulphonic acid (TNBS) and ethanol. Electromyograms (EMG) were recorded by using polygraph 11 days after implantation of electrodes. In normal group, normal colonic motility was recorded for 60 min, and then traditional acupuncture at GV-1 was applied for 20 min and EMG was recorded for further 60 min in untreated rats. In colitis group, after recording of basal colonic motility for 60 min, 20 min of acupuncture treatment and further EMG recording was performed for 60 min in TNBS/ethanol treated rats. In naloxone group, following subcutaneous administration of naloxone (3 mg/kg), recording of EMG and acupuncture treatment were performed in TNBS/ethanol treated rats. In the normal group, acupuncture at GV-1 did not induce significant changes in colonic motility. TNBS/ethanol treatment had no significant effect on the frequency of colonic motility. And in colitis group, GV-1 acupuncture significantly decreased colonic motility (p < 0.01). In naloxone group, after injection of naloxone, acupuncture at GV-1 did not change colonic motility in TNBS/ethanol treated rats. On the inflamed colon, naloxone blocked the effect of acupuncture. The present results suggested that endogenous opioids released by acupuncture at GV-1 decrease the motility of inflamed colon in rats, but not normal colon.

Effect of Knee Joint Stimulation on the Activity of Phrenic Nerve and Inspiratory Nuron in the Cat (슬관절 자극이 횡격신경 및 흡식중추신경에 미치는 영향)

  • Cho, Dong-Ill;Han, Hee-Chul;Nahm, Sook-Hyun
    • Tuberculosis and Respiratory Diseases
    • /
    • v.40 no.6
    • /
    • pp.683-693
    • /
    • 1993
  • Background: During movement the major inputs to nervous system come from firstly the muscle and joint to maintain posture and motion and secondly the chemoreceptors and baroreceptors to adjust the cardiovascular and respiratory function. Their complex relationships are generally studied for many years but the direct relation between the joint and respiratory system is not studied thoroughly until now. So this experiment was performed to determine whether the natural movement of knee joint can cause the enhancement of respiratory function by observation of the changes of respiratory rate, phrenic nerve activity and inspiratory neuron activity during the stimulation of knee joint in cat anesthetized with $\alpha$-chloralose. Method: Twenty six male adult cats were used and the extracelluar recording using bipolar platinum electrode and carbon filament electrode was done to record the changes in the activities of phrenic nerve and inspiratory neuron movement of knee joint, injection of chemicals into the joint cavity and electrical stimulation of articular nerve were done. Results: The 60 Hz. could not but 120 Hz. flexion-extension movement of knee joint increased respiratory rate(R.R.), tidal neural activity(TNA) and minute neural activity(MNA). Intra-articular injection of lactate could not increase R.R. but significantly increase TNA and MNA which represented the enhanced respiratory function. Injection of potassium chloride showed similar effects with the case of lactate but the duration of effect was shorter. The electrical stimulation of medial articular nerve with IV strength which could activate only group I and II afferents showed increased TNA and MNA during stimulation but 20 V stimulation which could activate all the afferents increased all the respiratory parameters. The changes of inspiratory neuron activity by knee joint stimulation was similar to that of phrenic nerve. Conclusion: The respiratory center could be directly stimulated by the activation of group I and II articular afferents and it seemed that the magnitude of the respiratory center enhancement is proportional to the amount of sensory information from the knee joint. These facts might suggest that the respiratory function could be enhanced even by the normal movement of knee joint.

  • PDF

Suicide Method, the Recent Stressors, Psychiatric Diagnosis of Suicide Attempters and Suicide Completers (자살시도자와 자살 사망자의 자살 방법, 스트레스 요인 및 정신과적 진단)

  • Sea Hyun O;Jihye Ahn;Seo Jihyo;Hyerin Gu;Minjeong Kim;Hyeyeon Jang;Seog Ju Kim
    • Sleep Medicine and Psychophysiology
    • /
    • v.29 no.1
    • /
    • pp.15-20
    • /
    • 2022
  • Objectives: Suicide is the major public mental health concerns all over the world. The comparison of suicide attempters and suicide completers could be the fundamental evidence for the suicide prevention. The aim of this study is to explore the differences between suicide attempters and suicide completers in terms of the stressors, suicide methods, and psychiatric diagnosis. Methods: Two types of secondary data were collected for the analyses. Data of the suicide attempters (n = 680) were gathered by intensive reviewing the medical records of Samsung Medical Center, Seoul, Republic of Korea. Data of suicide completers (n = 11,722) were collected by the psychological autopsy data which were gathered by Korean Foundation for Suicide Prevention. Suicidal methods, psychiatric disorders and stressors before suicidal attempt were compared between suicide attempter and completers. Results: Suicide completers were older and male predominant compared to suicidal attempt. Hanging or gas intoxication were more commonly used in the suicide completion, while wrist cutting or drug intoxication were more common in suicide attempters. All types of stressors were found to be high in suicide completers than suicide attempters. However, the proportion of economic and physical stress were greater in suicide completers, while the proportion of family stress were greater in suicide attempters. According to the recorded diagnoses, the rates of depressive disorders, sleep-wake disorders, substance-related disorders were higher in suicide completers, while the rates of anxiety disorders and trauma- and stressor-related disorders, bipolar and related disorders and somatic symptom disorders were higher in suicide attempters. However, after controlling the gender and age, there were no significant differences in diagnosis between suicide attempters and suicide completers. Conclusion: These findings implicate that suicide attempters and completers differed in suicide methods and type of stress. The results suggests that economic stressors, physical illness might raise the risk of suicide completion.

Consumer Responses to Retailer's Location-based Mobile Shopping Service : Focusing on PAD Emotional State Model and Information Relevance (유통업체의 위치기반 모바일 쇼핑서비스 제공에 대한 소비자 반응 : PAD 감정모델과 정보의 상황관련성을 중심으로)

  • Lee, Hyun-Hwa;Moon, Hee-Kang
    • Journal of Distribution Research
    • /
    • v.17 no.2
    • /
    • pp.63-92
    • /
    • 2012
  • This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective responses. Information relevancy was integrated into pleasure-arousal-dominance (PAD) emotional state model in the present study as a conceptual framework. The results of an online survey of 335 mobile phone users in the U.S. indicated the positive effects of arousal and information relevancy on pleasure. In addition, there was a significant relationship between pleasure and intention to use a LBMSS. However, the relationship between dominance and pleasure was not statistically significant. The results of the present study provides insight to retailers and marketers as to what factors they need to consider to implement location-based mobile shopping services to improve their business performance. Extended Abstract : Location aware technology has expanded the marketer's reach by reducing space and time between a consumer's receipt of advertising and purchase, offering real-time information and coupons to consumers in purchasing situations (Dickenger and Kleijnen, 2008; Malhotra and Malhotra, 2009). LBMSS increases the relevancy of SMS marketing by linking advertisements to a user's location (Bamba and Barnes, 2007; Malhotra and Malhotra, 2009). This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective response. The purpose of the study was to examine the relationship among information relevancy and affective variables and their effects on intention to use LBMSS. Thus, information relevancy was integrated into pleasure-arousal-dominance (PAD) model and generated the following hypotheses. Hypothesis 1. There will be a positive influence of arousal concerning LBMSS on pleasure in regard to LBMSS. Hypothesis 2. There will be a positive influence of dominance in LBMSS on pleasure in regard to LBMSS. Hypothesis 3. There will be a positive influence of information relevancy on pleasure in regard to LBMSS. Hypothesis 4. There will be a positive influence of pleasure about LBMSS on intention to use LBMSS. E-mail invitations were sent out to a randomly selected sample of three thousand consumers who are older than 18 years old and mobile phone owners, acquired from an independent marketing research company. An online survey technique was employed utilizing Dillman's (2000) online survey method and follow-ups. A total of 335 valid responses were used for the data analysis in the present study. Before the respondents answer any of the questions, they were told to read a document describing LBMSS. The document included definitions and examples of LBMSS provided by various service providers. After that, they were exposed to a scenario describing the participant as taking a saturday shopping trip to a mall and then receiving a short message from the mall. The short message included new product information and coupons for same day use at participating stores. They then completed a questionnaire containing various questions. To assess arousal, dominance, and pleasure, we adapted and modified scales used in the previous studies in the context of location-based mobile shopping service, each of the five items from Mehrabian and Russell (1974). A total of 15 items were measured on a seven-point bipolar scale. To measure information relevancy, four items were borrowed from Mason et al. (1995). Intention to use LBMSS was captured using two items developed by Blackwell, and Miniard (1995) and one items developed by the authors. Data analyses were conducted using SPSS 19.0 and LISREL 8.72. A total of usable 335 data were obtained after deleting the incomplete responses, which results in a response rate of 11.20%. A little over half of the respondents were male (53.9%) and approximately 60% of respondents were married (57.4%). The mean age of the sample was 29.44 years with a range from 19 to 60 years. In terms of the ethnicity there were European Americans (54.5%), Hispanic American (5.3%), African-American (3.6%), and Asian American (2.9%), respectively. The respondents were highly educated; close to 62.5% of participants in the study reported holding a college degree or its equivalent and 14.5% of the participants had graduate degree. The sample represents all income categories: less than $24,999 (10.8%), $25,000-$49,999 (28.34%), $50,000-$74,999 (13.8%), and $75,000 or more (10.23%). The respondents of the study indicated that they were employed in many occupations. Responses came from all 42 states in the U.S. To identify the dimensions of research constructs, Exploratory Factor Analysis (EFA) using a varimax rotation was conducted. As indicated in table 1, these dimensions: arousal, dominance, relevancy, pleasure, and intention to use, suggested by the EFA, explained 82.29% of the total variance with factor loadings ranged from .74 to .89. As a next step, CFA was conducted to validate the dimensions that were identified from the exploratory factor analysis and to further refine the scale. Table 1 exhibits the results of measurement model analysis and revealed a chi-square of 202.13 with degree-of-freedom of 89 (p =.002), GFI of .93, AGFI = .89, CFI of .99, NFI of .98, which indicates of the evidence of a good model fit to the data (Bagozzi and Yi, 1998; Hair et al., 1998). As table 1 shows, reliability was estimated with Cronbach's alpha and composite reliability (CR) for all multi-item scales. All the values met evidence of satisfactory reliability in multi-item measure for alpha (>.91) and CR (>.80). In addition, we tested the convergent validity of the measure using average variance extracted (AVE) by following recommendations from Fornell and Larcker (1981). The AVE values for the model constructs ranged from .74 through .85, which are higher than the threshold suggested by Fornell and Larcker (1981). To examine discriminant validity of the measure, we again followed the recommendations from Fornell and Larcker (1981). The shared variances between constructs were smaller than the AVE of the research constructs and confirm discriminant validity of the measure. The causal model testing was conducted using LISREL 8.72 with a maximum-likelihood estimation method. Table 2 shows the results of the hypotheses testing. The results for the conceptual model revealed good overall fit for the proposed model. Chi-square was 342.00 (df = 92, p =.000), NFI was .97, NNFI was .97, GFI was .89, AGFI was .83, and RMSEA was .08. All paths in the proposed model received significant statistical support except H2. The paths from arousal to pleasure (H1: ${\ss}$=.70; t = 11.44), from information relevancy to intention to use (H3 ${\ss}$ =.12; t = 2.36), from information relevancy to pleasure (H4 ${\ss}$ =.15; t = 2.86), and pleasure to intention to use (H5: ${\ss}$=.54; t = 9.05) were significant. However, the path from dominance to pleasure was not supported. This study investigated consumer intention to use a location-based mobile shopping service (LBMSS) that integrates cognitive and affective responses. Information relevancy was integrated into pleasure-arousal-dominance (PAD) emotional state model as a conceptual framework. The results of the present study support previous studies indicating that emotional responses as well as cognitive responses have a strong impact on accepting new technology. The findings of this study suggest potential marketing strategies to mobile service developers and retailers who are considering the implementation of LBMSS. It would be rewarding to develop location-based mobile services that integrate information relevancy and which cause positive emotional responses.

  • PDF