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Open Clinical Trial of Morning Light Therapy in Sleep Disturbance of Alcohol Dependent Patients (알코올의존 환자에서의 수면장애에 대한 아침 광치료의 임상시도)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Jeon, Seung-Kyu;Kim, Byoung-Kyu;Kwon, Sung-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.196-204
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    • 2003
  • Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

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Factorial Validity of the Korean Version of the Illness Intrusive Rating Scale among Psychiatric Outpatients Mainly Diagnosed with Anxiety or Depressive Disorders (불안 및 우울장애를 주요 진단으로 하는 정신건강의학과 외래환자 대상 한국판 질병침습도 평가척도의 요인 타당도 연구)

  • Cho, Yubin;Kim, Daeho;Kim, Eunkyung;Jo, Hwa Yeon;Yun, Mirim;Lee, Hoseon
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.77-84
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    • 2019
  • Objectives : The Illness Intrusiveness Rating Scale (IIRS) is a well-validated self-report instrument for assessing negative impact of chronic illness and/or adverse effects of its treatment on everyday life domains. Although extensive literature probed its psychometric properties in medical illness, little attention was paid for its validity for psychiatric population. This study aimed to test factorial structure of the Korean Version of the IIRS (IIRS-K) in a consecutive sample of psychiatric outpatients. Methods : Data set of 307 first-visit patients of psychiatric clinic at Guri Hanyang univ. Hospital were used. Exploratory and confirmatory factor analysis, internal consistency were tested in IIRS-K. We also checked Spearman's correlation analysis between IIRS-K, Zung's self-report anxiety scale and Zung's self-report depression scale. Results : 76.9% of the patients were with anxiety disorder and depressive disorder. The principal component factor analysis of the IIRS-K extracted three-factor structure accounted for 63.2% of total variance that was contextually similar to the original English version. This three-factor solution showed the best fit when tested confirmatory factor analysis compared to the original IIRS, two-factor model of IIRS-K suggested from medical outpatients, and one-factor solution. The IIRS-K also showed good internal consistency (Cronbach's α=0.90) and good convergent validity with anxiety and depression scales. Conclusions : The IIRS-K showed the three-factor structure that was similar but not identical to original version. Overall, this study proved factorial validity of the IIRS-K and it can be used for Korean clinical population.

Cognitive and Psychological Characteristics of Psychiatric Patients with Military Service Eligibility Issues (군 복무 적합성 판정을 위해 내원한 환자들의 인지적 및 심리적 특성)

  • Nam, Jisoo;Choi, Junho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.119-129
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    • 2019
  • Objectives : The purpose of this study was to examine cognitive and psychological characteristics of patients who visited psychiatric outpatient clinic with military service suitability issues. Methods : Since January, 2017 to September, 2018, patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. And each of participants tested with K-WAIS-IV, K-SCL-95 by clinical psychologist. The data were analyzed using SPSS 18.0. Results : The results indicated 24.6% of the patients have significantly low level of intellectual functioning. and 10.8% of the patients have borderline level of intellectual functioning, and 26.3% of them were below average. The results of psychological characteristics showed patients have cautious and potentially dangerous level of depression, anxiety, agoraphobia, and suicidal idea. And PTSD subscale's mean score was above problematic level. Next, we divided patients into two groups based on question of whether the patient is eligible to serve in the military service or not arises from recruitment process or army training center. But two group didn't differ significantly. And for further analyses, we also divided patients into two groups based on if they got single psychiatric diagnosis or more than one psychiatric diagnosis. Conclusions : The results indicated that group which has coexisting psychiatric disorders were more depressed, had higher level of anger and aggression, and had more serious levels of suicidal ideas than single psychiatric diagnosis group. The implications and limitations were discussed along with some suggestions for the future studies.

A Study on Results of Rehabilitation Therapy of Patients with Head Injury (두부손상 환자의 재활치료 결과에 관한 연구)

  • Kim, Su-Min;Lim, Hye-Hyeon
    • Journal of Korean Physical Therapy Science
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    • v.1 no.1
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    • pp.135-144
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    • 1994
  • The authors studied therapeutic effects and related clinical data retrospectively on a series of 48 consecutive patients with head injury who were referred to physical therapy and occupational therapy, Kosin University Medical Center during 1 year, from March, 1993. through March, 1994. The conclusions were as follows : 1. Average age of the subject patients was 50.6 years, their age remped from 14 to 72 years, and the incidence between male and femele was 1:1.1. 2. In respect to the educational level high school graduates showed the highest incidence 18 (39.1 %) of 46 cases, and in respect to economy level, middle class revealed the highest incidence, 31(64.6 %) in 48 cases. 3. The HBP was the most common cause of spontaneity injury, disclosing 19 cases in 35 patients(54.3%), whereas the main cause of traumatic injury was a traffic accident, 7 cases ( 53.8 %) in 13 patients. 4. As for the region of injury in the cases of spontaneity ICH was 14 persons (40%). In the cases of trauma, hematoma was seen in 6 cases(42.2 %) in 48 total cases ICH was seen in 17 cases (35.4 %) to be the most common region. 5. Among 35 persons, spontaneity CBR was the highest region of injury, 13 cases(37.1 %) ; the side of paralysis in extremities the right side showed higher incidence, 18 cas (1.4 %) as compared to the left, 16 cases(45.7%). In the case of traumatic injury, CBR was the highest region of injury, 4(30.8% )in 13 cases and as for the paralysis side, right side showed higher incidence 7 cases(53.8%) as compared to the left side 5 cases(38.5%). 6. In respect to recurrence, HBP was seen in 5 cases to be the most common cause, and as for the region of injury, CBR was the highest. 7. A period of rehabilitation therapy in the cases of physical therapy the highest term was 1-2 month, 14 persons(29.2%). As for occupational therapy within 2 week-term was the highest, 24 persons(50%). 8. Physical strenth grade M.T in the cases of the upper extrimities before therapy, the low mark(grade 0) was 30 cases(62.5%), compared to the high mark(above grade 3)seen in 1 case(2.1%), And after therapy, the lowest mark(grade 0)was seen in 5 cases(10.4%) where as the high mark(above grade 3)was seen in 29 cases(60.4%). In the case of the lower extremities before therapy, the mark(below grade 1)was 37 cases(77.1 %), while the high mark(above grade 3)was seen n 4 cases(8.4%). And after therapy the low mark(below grade 1)was seen in 5 cases (10.4 %) and the high mark (above grade 3)was seen in 29 cases(60.4 %). 9. Before therapy conigtive function-level evaluation utilized R.L.A.L, the low mark(below level 3)was seen in 9 cases(18.8%), while the high mark(above level 7)was seen in 18 cases(37.5%). And after therapy the low mark (below level 3)was 4 cases(8.3%) and high mark(above level 7)was seen in 38 cases(79%). 10. After rehabilitation therapy, patients who were able to walk independently were 29 persons(60.4%), among which 16 cases(55.2%) depended on cane. The ratio between the cases who were able to walk and unable to walk was 1.5:1.

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Material Characteristics and Deterioration Assessment of the Stone Buddhas and Shrine in Unjusa Temple, Hwasun, Korea (화순 운주사 석조불감의 재질특성과 풍화훼손도 평가)

  • Park, Sung-Mi;Lee, Myeong-Seong;Choi, Seok-Won;Lee, Chan-Hee
    • Journal of Conservation Science
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    • v.24
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    • pp.23-36
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    • 2008
  • The stone Buddhas and Shrine of Unjusa temple (Korea Treasure No. 797) in Hwasun formed in Koryo Dynasty are unique style which the Buddha faces each other the back parts of south and north within the stone Shrine. The stone Buddhas and Shrine are highly evaluated in historical, artistic and academic respects. But, the stone properties have been exposed in the open system various aspects of degradations weathered for a long time without specific protective facilities. The rock materials of the stone Buddhas and Shrine are about 47 blocks, and total press load is about 56.6 metric ton. The host rocks composed mainly of white grey hyaline lithic tuff and rhyolitic tuff breccia. In addition, biotite granite used as part during the restoration works. The chemical index of alteration for host tuffaceous rocks and the replacement granites range from 52.1 to 59.4 and 50.0 to 51.0, respectively. Weathering types for the stone Buddhas and Shrine were largely divided with physical, chemical and biological weathering to make a synthetic deterioration map according to aspects of damage, and estimate share as compared with surface area. Whole deterioration degrees are represented that physical weathering appeared exfoliation. Chemical weathering is black coloration and biological weathering of grey lichen, which show each lighly deterioration degrees. According to deterioration degree by direction of stone Buddhas and Shrine, physical weathering mostly appeared by 39.1% on the sorthern part, and chemical weathering is 61.2% high share on the western part. Biological weathering showed 38.3% the largest distribution on the southern part. Therefore, it is necessary to try hardening for the parts with serious cracks or exfoliations, remove secondary contaminants and organisms through regular cleaning. Also necessary to make a plan to remove moisture of the ground which causes weathering, and estimate that need established and scientific processing through clinical demonstration of conservation plan that chooses suitable treatment.

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Studies on Lipids in Fresh-Water Fishes 6. Comparison of Lipid Components between Wild and Cultured Snakehead, Channa argus (담수어의 지질에 관한 연구 6. 천연 및 양식 가물치의 지질성분 비교)

  • CHOI Jin-Ho;BAE Tae-Jin;BYUN Dae-Seo;YOON Tai-Heon
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.4
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    • pp.309-315
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    • 1985
  • This study was designed to compare the lipid components between wild and cultured snakehead, Channa argus. The lipid components of cultured snakehead were analyzed and compared with that of wild snakehead. In both edible portion and viscera, the lipid content in cultured, snakehead was higher than that in wild one. In the fatty acid composition of neutral lipid in edible portion, percentages of $C_{14:0},\;C_{16:0},\;C_{18:1},\;C_{20:5},\;C_{22:5}\;and\;C_{22:6}$ in cultured snakehead were higher than those in wild one, while percentages of $C_{18:0},\;C_{16:1},\;C_{18:2},\;C_{18:3},\;C_{20:4}\;and\;C_{22:4}$ lower. In the case of phospholipid in edible portion, percentages of $C_{16:0},\;C_{18:1}\;and\;C_{22:6}$ in cultured snakehead were higher than those in wild one, while percentages of $C_{16:1},\;C_{18:2},\;C_{18:3},\;C_{20:4},\;C_{22:4}\;and\;C_{22:5}$ lower. The unsaturation (TUFA/TSFA) and w3 highly unsaturated fatty acid content (w3 HUFA) of neutral lipid in cultured snakehead were higher than those in wild one, while those of phospholipid lower. The essential fatty acid contents (TEFA) of both neutral and phospholipids in wild snakehead were higher than those in cultured one. In the ratio (A/B) of fatty- acid content (A) in cultured snakehead to that (B) in diet, the A/B ratios of $C_{18:2\;w6},\;C_{18:3\;w3},\;C_{20:5\;w3}\;and\;C_{22:6\;w3}$ were 0.3 to 2.5 times, and it is considered to be related to the biosynthesis of polyenoic acids and growth rate of cultured snakehead.

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Clinical effects of combination anorganic bovine-derived hydroxyapatite matrix(ABM)/cell binding peptide (P-15) in periodontal intrabony defects (치주 골내낭에서 anorganic bovine-derived hydroxyapatite matrix(ABM)/cell binding peptide(P-15)의 임상적효과)

  • Won, Mi-Sook;Paik, Jeong-Won;Kim, Chang-Sung;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan;Choi, Seong-Ho
    • Journal of Periodontal and Implant Science
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    • v.32 no.3
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    • pp.565-576
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    • 2002
  • The ultimate goal of periodontal therapy is the regeneration of periodontal tissue which has been lost due to destructive periodontal disease. To achieve periodontal regeneration, various kinds of methods have been investigated and developed, including guided tissue regeneration and bone graft. Bone graft can be catagorized into autografts, allografts, xenografts, bone substitutes. And materials of all types have different biological activity and the capacity for periodontal regeneration, but ideal graft material has not been developed that fits all the requirement of ideal bone graft material. Intensive research is underway to identity, purify, synthesize a variety biologic modulators that may enhance wound healing and regeneration of lost tissues in periodontal therapy. The present study evaluates the effects of ABM/P-15 on the periodontal regeneration in intrabony defects of human. We used thirty four 2-wall or 3-wall osseous defects in premolars and molars of chronic peridontitis patient that have more than 5mm pockets and more than 3mm in intrabony defect. 12 negative control group underwent flap procedure only, 11 positive control group received DFDBA graft with flap procedure, and 11 experimental group received ABM/P-15 graft with flap procedure. The changes of probing pocket depth, loss of attachment and bone probing depth following 6months after treatment revealed the following results: 1. The changes of probing pocket depth showed a statistically significant decrease between after scaling and 6months after treatment in negative control(2.0${\pm}$0.9mm), positive control(3.0${\pm}$0.9mm), and experimental group (3.4${\pm}$1.5mm) (P<0.01). Significantly more reduction was seen in experimental group compared to negative control group (P<0.05). 2. The changes of loss of attachment showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.0${\pm}$0.6mm), and experimental group (2.2${\pm}$l.0mm) except negative control group(0.1${\pm}$0.7mm) (P<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group(P<0.05). 3. The changes of bone probing depth showed a statistically significant decrease between after scaling and 6months after treatment in positive control(2.7${\pm}$l.0mm), and experimental group (3.4${\pm}$1.3mm) except negative control(0.l${\pm}$0.9mm) (9<0.01). Significantly more reduction was seen in both experimental and positive control group compared to negative control group (P<0.05). The results suggest that the use of ABM/P-15 in the treatment of periodontal intrabony defects can reduce loss of attachment and bone probing depth more than flap operation only. It suggests that ABM/P-15 may be an effective bone graft material for the regeneration of periodontal tissue in intrabony defects.

The neuroprotective effect of mycophenolic acid via anti-apoptosis in perinatal hypoxic-ischemic brain injury (주산기 저산소성 허혈성 뇌손상에서 항세포자멸사를 통한 mycophenolic acid의 신경보호 효과)

  • Kim, Ji Young;Yang, Seung Ho;Cha, Sun Hwa;Kim, Ji Yeun;Jang, Young Chae;Park, Kwan Kyu;Kim, Jin Kyung;Chung, Hai Lee;Seo, Eok Su;Kim, Woo Taek
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.686-693
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    • 2007
  • Purpose : Mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil (MMF), is a potent inhibitor of inosine-monophosphate dehydrogenase (IMPDH), a new immunosuppressive drug used. It was reported that MPA protected neurons after excitotoxic injury, induced apoptosis in microglial cells. However, the effects of MPA on hypoxic-ischemic (HI) brain injury has not been yet evaluated. Therefore, we examined whether MPA could be neuroprotective in perinatal HI brain injury using Rice-Vannucci model (in vivo) and in rat brain cortical cell culture induced by hypoxia (in vitro). Methods : Cortical cells were cultured using a 18-day-pregnant Sprague-Dawley (SD) rats and incubated in 1% $O_2$ incubator for hypoxia. MPA ($10{\mu}g/mL$) before or after a HI insult was treated. Seven-day-old SD rat pups were subjected to left carotid occlusion followed by 2 hours of hypoxic exposure (8% $O_2$). MPA (10 mg/kg) before or after a HI insult were administrated intraperitoneally. Apoptosis was measured using western blot and real-time PCR for Bcl-2, Bax, caspase-3. Results : H&E stain revealed increased brain volume in the MPA-treated group in vivo animal model of neonatal HI brain injury. Western blot and real-time PCR showed the expression of caspase-3 and Bax/Bcl-2 were decreased in the MPA-treated group In in vitro and in vivo model of perinatal HI brain injury, Conclusion : These results may suggest that the administration of MPA before HI insult could significantly protect against perinatal HI brain injury via anti-apoptotic mechanisms, which offers the possibility of MPA application for the treatment of neonatal HI encephalopathy.

Comparison of the seroconversion rate after primary hepatitis B vaccination and after revaccination of non-responders in full-term infants according to mother's HBsAg seropositivity (산모의 HBsAg 보유 여부에 따른 만삭아의 B형간염 기본접종 및 무반응자에서 재접종 후 항체 양전율에 대한 연구)

  • Kang, Jang Hee;Moon, Jae Won;Kong, Seung Hyun;Hwang, Kwang Su;Mok, Ji Sun;Lee, Hyeon Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1165-1171
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    • 2008
  • Purpose : This study aimed to identify the true extent of non-responsiveness in full-term infants born from HBsAg-negative or HBsAg-positive mothers and vaccinated against hepatitis B virus (HBV) at 0, 1, and 6 months of age and to evaluate the effect of revaccination among non-responders. Methods : The study included 716 full-term infants born in 2004-2007. Of 716, 662 infants (A group) were born to HBsAg-negative mothers and 54 infants (B group: 50, except HBsAg-positive infants) were born to HBsAg-positive mothers. All infants were administered DNA recombinant vaccines at 0, 1, and 6 months of age. B group infants received hepatitis B immunoglobulin at birth. Anti-HBs titers were tested at 7-12 and 9-15 months in A and B groups, respectively. Three revaccination doses were administered to non-responders whose anti-HBs titers were under 10 mIU/ml; revaccinated infants were retested at 1-3 months after last vaccination. The association between HBeAg seropositivity of mother and the failure of HBV immunoprophylaxis was evaluated. Results : The seroconversion rates after primary hepatitis B vaccination were higher in A group (94.1%) than in B group (78%, P<0.001). The seroconversion rates were high in revaccinated infants (A group non-responders: 96.9%, B group non-responders: 87.5%). The failure of HBV immunoprophylaxis was significantly associated with maternal HBeAg seropositivity (P<0.001). Conclusion : The seroconversion rates after primary hepatitis B vaccination were low in B group infants. Revaccination of non-responders in B group was very effective. Therefore, anti-HBs testing and revaccination of B group is very important. Revaccination of non-responders in A group was also very effective. Thus, testing the immune status of infants born to HBsAg-negative mothers even after primary hepatitis B vaccination should be considered. However, to realize this, further studies on the cost-effectiveness of anti-HBs testing in healthy full-term infants are necessary.

Late aortic root dilatation and aortic regurgitation in repaired tetralogy of fallot (팔로 4징의 완전 교정술 후 장기 추적 관찰상 나타나는 대동맥근의 확장과 대동맥판 폐쇄부전)

  • Kim, Jeong Eun;Hur, Kyong;Kwon, Hae Sik;Yoo, Byung Won;Choi, Jae Young;Sul, Jun Hee
    • Clinical and Experimental Pediatrics
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    • v.50 no.10
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    • pp.976-981
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    • 2007
  • Purpose : Aortic valve or aortic root (AoRo) replacement is occasionally required because of AoRo dilatation and aortic regurgitation (AR) in repaired tetralogy of Fallot (TOF). We evaluated AoRo size and possible factors associated with its hemodynamic nature in patients with repaired TOF. Methods : We investigated 130 repaired TOF patients more than 15 years of age who followed-up by echocardiography from January 2002 to December 2003. Of 130 patients, we identified 17 patients with AoRo dilatation, which was defined as ratio of expected AoRo size by standard nomogram (AoRo ratio) >1.5 (dilator group), and 113 TOF controls, with AoRo ratio <1.5 (non-dilator group). Results : Mean indexed AoRo size ($mm/m^2$) in the first echo was $24{\pm}3.2$ in the dilator group and $18{\pm}3.4$ in the non-dilator group (P<0.0001). AoRo rate of change (mm/year) from the first to latest echo study was $1.6{\pm}3.8$ in dilator group and $0.05{\pm}1.6$ in the non dilator group (P=0.0021). Patients from the dilator group showed a higher prevalence of pulmonary atresia (P=0.031) and a history of aortopulmonary shunt before repair (P=0.048), moderate to severe AR (P=0.0065), and increased left ventricular end-diastolic dimensions (P=0.003). Conclusions : A subset of patients late after TOF repair may show progressive dilatation of AoRo. To identify and prevent long-term sequelae in this patient group, regular follow-up and speculation about AoRo after TOF repair is recommended.