Shim, In Hee;Bahk, Won-Myong;Woo, Young Sup;Yoon, Bo-Hyun
Clinical Psychopharmacology and Neuroscience
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v.16
no.4
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pp.376-382
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2018
We reviewed clinical studies investigating the pharmacological treatment of major depressive episodes (MDEs) with mixed features diagnosed according to the dimensional criteria (more than two or three [hypo]manic symptoms+principle depressive symptoms). We systematically reviewed published randomized controlled trials on the pharmacological treatment of MDEs with mixed features associated with mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). We searched the PubMed, Cochrane Library, and ClinicalTrials.gov databases through December 2017 with the following key word combinations linked with the word OR: (a) mixed or mixed state, mixed features, DMX, mixed depression; (b) depressive, major depressive, MDE, MDD, bipolar, bipolar depression; and (c) antidepressant, antipsychotic, mood stabilizer, anticonvulsant, treatment, medication, algorithm, guideline, pharmacological. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We found few randomized trials on pharmacological treatments for MDEs with mixed features. Of the 36 articles assessed for eligibility, 11 investigated MDEs with mixed features in mood disorders: six assessed the efficacy of antipsychotic drugs (lurasidone and ziprasidone) in the acute phase of MDD with mixed features, although four of these were post hoc analyses based on large randomized controlled trials. Four studies compared antipsychotic drugs (olanzapine, lurasidone, and ziprasidone) with placebo, and one study assessed the efficacy of combination therapy (olanzapine+fluoxetine) in the acute phase of BD with mixed features. Pharmacological treatments for MDEs with mixed features have focused on antipsychotics, although evidence of their efficacy is lacking. Additional well-designed clinical trials are needed.
Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social skills and communication with repetitive behaviors. Etiology is still unclear although it is thought to develop with interaction of genes and environmental factors. Oxytocin has extensive effects on intrauterine brain development. Vitamin D, affects neural development and differentiation and contributes to the regulation of around 900 genes including oxytocin receptor gene. In the present study, the contribution of D vitamin receptor and oxytocin receptor gene polymorphisms in the development of ASD in Turkish community was investigated. To our knowledge, this is the first study examining these two associated genes together in the literature. Methods: Eighty-five patients diagnosed with ASD according to DSM-5 who were referred to outpatient clinics of Child and Adolescent Psychiatry of Başkent University and Mersin University and 52 healthy, age and gender-matched controls were included in the present study. Vitamin D receptor gene rs731236 (Taq1), rs2228570 (Fok1), rs1544410 (Bsm1), rs7975232 (Apa1) polymorphisms and oxytocin receptor gene rs1042778 and rs2268493 polymorphisms were investigated using real time polymerase chain reaction method. Results: No significant difference between groups in terms of distribution of genotype and alleles in each of polymorphisms for these genes could be found. Conclusion: Knowledge of genes and polymorphisms associated with the development of ASD may be beneficial for early diagnosis and future treatment. Further studies with larger populations are required to demonstrate molecular pathways which may play part in the development of ASD in Turkey.
Purpose: Reminiscence therapy is a widely used intervention for older adults and those with dementia. However, the attributes of the concept of reminiscence is not clearly proposed. The aim of this study was to clarify the concept of reminiscence in Korean older adults with dementia. Methods: The study applied the concept analysis method of Walker and Avant. The literature review included the previous studies of reminiscence from philosophy, literature, art, neuroscience, medicine, psychology, sociology, and nursing. Results: A total of 43 Korean or international papers were analyzed in this study. Attributes of reminiscence in Korean older adults with dementia were regeneration of memories, internal and external communications, expression of suppressed emotions, and recognition of ego identity. The suppressed emotions and ego identity may result from Korean cultural characteristics based on the suppressed environments of many wars and dictatorships in the past. The consequences of reminiscence in Korean older adults with dementia are cognitive enhancement, relief of depression, and improvements of social interactions, ego integrity, and quality of life. Conclusion: The results of this study suggest that the historical and cultural characteristics should be considered to develop effective nursing interventions including reminiscence for Korean older adults with dementia.
Journal of The Korean Society of Integrative Medicine
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v.7
no.3
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pp.51-59
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2019
Purpose : To evaluate the effect of comprehensive art therapy on physical function and activities of daily living in children with cerebral palsy (CP). Methods : Ten ambulant children with diplegic (n=8) or hemiplegic (n=2) CP participated in this study. All were randomly assigned to either the art therapy group (n=5) or the control group (n=5). Both groups received physical therapy based on neurodevelopmental techniques for 20 minutes a day, 1 day a week, for a period of 12 weeks. Children in the art therapy group received additional comprehensive art therapy for 70 minutes once a week for 3 months. Tests for various measurements-Motricity Index (MI) for strength, Trunk Control Test (TCT) for trunk ability, Gross Motor Function Measure (GMFM) and Gross Motor Function Classification System (GMFCS) for gross motor function, Denver Developmental Screening Test-II (DDST-II) for developmental milestones, Functional Independence Measure of Children (WeeFIM) for abilities to complete daily activities, Leg and Hand Ability Test (LHAT) for limb function-were performed before and after treatments. Results : The upper extremity and whole extremity strengths of MI, self-care and total scores of WeeFIM, and leg and arm functions of LHAT improved significantly only for individuals in the art therapy group after the art therapy (p<.05). The value of MI after treatment was at the upper extremity and whole extremity strengths the leg function of LHAT was also significantly improved compared to the control group (p<.05). Conclusion : This study revealed that comprehensive art therapy along with physiotherapy was effective in increasing upper extremity strength and leg ability in children with CP. This suggests that comprehensive art therapy may be a useful adjunctive therapy for children with CP.
Sohn, Seil;Chung, Chun Kee;Han, Kyung Do;Jung, Jin Hyung;Hyeun, Joung Ho;Kim, Jinhee;Chang, Ung-Kyu;Sohn, Moon Jun;Kim, Sung Hwan
Journal of Korean Neurosurgical Society
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v.62
no.1
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pp.46-52
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2019
Objective : The aim of this nationwide study was to analyze the current state of patients with newly diagnosed metastatic spine tumors according to surgical methods. Methods : Data was extracted from the Korean Health Insurance Review and Assessment Service database. Surgery was categorized into three methods : fusion, decompression, and vertebroplasty. Data included patient age, sex, health insurance type, and co-morbidities. Survival rates of metastatic spine tumor patients according to each surgical method were evaluated. Results : Among 1677 patients who had an operation, 823 patients were treated by fusion, 141 patients underwent decompression, and 713 patients were treated by vertebroplasty. The three most prevalent primary tumor sites were the lung, breast, and liver & biliary. On the other hand, the three most prevalent primary tumor sites of patients who underwent surgery were the lung, liver & biliary, and the prostate. The median survival periods for each surgical method in the metastatic spine tumor patients were 228 days for those who underwent surgery, 249 days for decompression, and 154 days for vertebroplasty. Age, sex, and comorbidities significantly affected survival rate. Conclusion : For every primary tumor site, decompression was the least common surgical method during the study period. Although the three surgical methods did not significantly affect the survival period, patients with a poor prognosis tended to undergo vertebroplasty.
As the use of cosmetics has greatly increased in a daily life, safety issues with cosmetic ingredients have drawn an attention. Drometrizole [2-(2'-hydroxy-5'-methylphenyl)benzotriazole] is categorized as a sunscreen ingredient and is used in cosmetics and non-cosmetics as a UV light absorber. No significant toxicity has been observed in acute oral, inhalation, or dermal toxicity studies. In a 13-week oral toxicity study in beagle dogs, No observed adverse effect level (NOAEL) was determined as 31.75 mg/kg bw/day in males and 34.6 mg/kg bw/day in females, based on increased serum alanine aminotransferase activity. Although drometrizole was negative for skin sensitization in two Magnusson-Kligman maximization tests in guinea pigs, there were two case reports of consumers presenting with allergic contact dermatitis. Drometrizole showed no teratogenicity in reproductive and developmental toxicity studies in which rats and mice were treated for 6 to 15 days of the gestation period. Ames tests showed that drometrizole was not mutagenic. A long-term carcinogenicity study using mice and rats showed no significant carcinogenic effect. A nail product containing 0.03% drometrizole was nonirritating, non-sensitizing and non-photosensitizing in a test with 147 human subjects. For risk assessment, the NOAEL chosen was 31.75 mg/kg bw/day in a 13-week oral toxicity study. Systemic exposure dosages were 0.27228 mg/kg bw/day and 1.90598 mg/kg bw/day for 1% and 7% drometrizole in cosmetics, respectively. Risk characterization studies demonstrated that when cosmetic products contain 1.0% of drometrizole, the margin of safety was greater than 100. Based on the risk assessment data, the MFDS revised the regulatory concentration of drometrizole from 7% to 1% in 2015. Under current regulation, drometrizole is considered to be safe for use in cosmetics. If new toxicological data are obtained in the future, the risk assessment should be carried out to update the appropriate guidelines.
Objectives: Despite the accumulating evidence of the effectiveness of positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) syndrome, adherence to PAP therapy is not high. Several factors reportedly affect PAP adherence; however, it remains unclear whether patients' symptoms were detrimental to adherence rate. This study is aimed at investigating the relationship between insomnia symptoms and adherence. Methods: Retrospective analyses were performed in 359 patients with OSA (mean age $58.4{\pm}13.2$ years; females, n=80). Logistic regression analyses were performed between PAP adherence with clinical factors and questionnaires, such as Epworth Sleepiness Scale, Insomnia Severity Index, and Beck Depression Inventory (BDI). Results: PAP adherence was defined as the use of PAP for ${\geq}4h$ per night on 70% of nights during 30 consecutive days. The median follow-up time was 55 days (interquartile range, 30-119 days), and 54.3% showed poor adherence. Non-adherent patients showed more severe sleep onset insomnia, higher BDI, and higher nadir oxygen saturation ($SaO_2$). Patients with good adherence had higher apnea-hypopnea index, oxygen desaturation index, and respiratory arousal to total arousal ratio. Sleep onset insomnia [odds ratio (OR)=1.792, p=0.012], BDI (OR = 1.055, p=0.026), and nadir $SaO_2$ (OR=1.043, p=0.040) were independently associated with PAP non-adherence. Conclusions: Not the severity of insomnia but sleep onset insomnia was associated with PAP adherence, as well as depressive mood. It suggests that different interventions for reducing insomnia and depressive mood are needed to increase PAP adherence in patients with OSA.
Multiple system atrophy (MSA) is a neurodegenerative disease characterized by presence of α-synuclein-positive inclusions in the cytoplasm of oligodendrocytes. These glial cytoplasmic inclusions (GCIs) are considered an integral part of the pathogenesis of MSA, leading to demyelination and neuronal demise. What is most puzzling in the research fields of GCIs is the origin of α-synuclein aggregates in GCIs, since adult oligodendrocytes do not express high levels of α-synuclein. The most recent leading hypothesis is that GCIs form via transfer and accumulation of α-synuclein from neurons to oligodendrocytes. However, studies regarding this subject are limited due to the absence of proper human cell models, to demonstrate the entry and accumulation of neuronal α-synuclein in human oligodendrocytes. Here, we generated mature human oligodendrocytes that can take up neuronderived α-synuclein and form GCI-like inclusions. Mature human oligodendrocytes are derived from neural stem cells via "oligosphere" formation and then into oligodendrocytes, treating the cells with the proper differentiation factors at each step. In the final cell preparations, oligodendrocytes consist of the majority population, while some astrocytes and unidentified stem cell-like cells were present as well. When these cells were exposed to α-synuclein proteins secreted from neuron-like human neuroblastoma cells, oligodendrocytes developed perinuclear inclusion bodies with α-synuclein immunoreactivity, resembling GCIs, while the stem cell-like cells showed α-synuclein-positive, scattered puncta in the cytoplasm. In conclusion, we have established a human oligodendrocyte model for the study of GCI formation, and the characterization and use of this model might pave the way for understanding the pathogenesis of MSA.
Journal of the Architectural Institute of Korea Planning & Design
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v.34
no.12
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pp.85-94
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2018
The purpose of this paper was to propose a model that recognizes potential users' emotional response toward design by classifying Electroencephalography(EEG). Studies in neuroscience and psychology have made an effort to recognize subjects' emotional response by analyzing EEG data. And this approach has been adopted in design since it is critical to monitor users' subjective response in the preface of design. Moreover, the building design process cannot be reversed after construction, recognizing clients' affection toward design alternatives plays important role. An experiment was conducted to record subjects' EEG data while they view their most/least liked images of small-house designs selected by them among the eight given images. After the recording, a subjective questionnaire, PANAS, was distributed to the subjects in order to describe their own affection score in quantitative way. Google TensorFlow was used to build and train the model. Dataset for model training and testing consist of feature columns for recorded EEG data and labels for the questionnaire results. After training and testing, the measured accuracy of the model was 0.975 which was higher than the other machine learning based classification methods. The proposed model may suggest one quantitative way of evaluating design alternatives. In addition, this method may support designer while designing the facilities for people like disabled or children who are not able to express their own feelings toward alternatives.
Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDWshift) and free days (SDFshift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJLshift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDWD was shortest (4.68 hr) and SDFE was longest (8.93 hr) in the EG. SJLD was longest in the EG (3.77 hr), and SJLN was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.
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