• Title/Summary/Keyword: psychiatric disease

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Surgical Treatment of Sucidal Laceration in the Wrist (수근부 자해열상의 수술적 치료)

  • Lee, Young-Keun;Park, Chan-Il;Lee, Jun-Mo
    • Archives of Reconstructive Microsurgery
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    • v.21 no.1
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    • pp.41-49
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    • 2012
  • Purpose: To report clinical appearances and the outcomes of patients treated for wrist laceration with suicidal intent. Materials and Methods: Between March 2005 and February 2008, patients with wrist laceration were treated at our center. Among them, 14 patients with suicidal intent were reviewed retrospectively. They were 8 females and 6 males with a mean age of 33 years at the time of treatment. The side of injured wrist, injured structures, suicidal instrument, the time of injury, a suicidal motive, drug or alcohol abuse or not, indication of combined psychiatric disease, the duration of postoperative treatment, and the results of treatment were analyzed. Results: The injured wrist was the left one in 13 cases (93%), and knife wounds in 11 cases (79%) was the most frequent mechanism of injury. An average of 4.6 structures were injured including 3.5 tendons, 0.57 nerves and 0.5 arteries. The most frequently injured structures were the palmaris longus (71%), FCU (50%), FCR (43%), FDS 3 (36%), FDS 2, median nerve, and ulnar artery (each 29%). Simultaneous injury of both median and ulnar nerves occurred in 3 cases (21%), and simultaneous injury of both radial and ulnar artery occurred in 1 case (7%). The injury time was the night in 12 cases (86%), and the most frequent suicidal motive was human relations such as lover or spouse in 12 cases (86%). In 9 cases (64%), the injured were in a drunken state, 3 cases (21%) had been treated for a psychiatric disease at the time of the injury. The durations of postoperative treatment were an average of 5 days of admission and 1 day follow up. Only 1 case results could be evaluated. Conclusions: Patient's poor compliance in wrist laceration with suicidal intent should be expected and these characteristics may affect the management plan.

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Risk Factors for Depression and Anxiety among Breast Cancer Survivors in Their 40s (40대 유방암 생존자의 우울·불안 위험요인)

  • Hwang, Sook Yeon
    • The Journal of the Korea Contents Association
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    • v.15 no.2
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    • pp.313-323
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    • 2015
  • This study was performed to examine the prevalence of and risk factors for depression and anxiety among breast cancer survivors in their 40s. Completed questionnaires were collected from 609 breast cancer survivors in their 40s who agreed to participate the study. The mean scores of CES-D and GAD-7 were 16.35(SD=9.24) and 4.25(SD=4.17), respectively. Nearly 47.7% of the participants had depression and 10.3% had anxiety. The mean score of pain severity was 1.91(SD=1.60) and 10.9% of the participants reported more than moderate pain. The final model in the hierarchical regression analysis showed that pain interference, unemployment, the type of live-in partner, and past psychiatric disease were the significant risk factors for depression, and pain interference, unemployment and past psychiatric disease for anxiety. These results show the prevalence of depression and anxiety among breast cancer survivors in their 40s is high and suggest appropriate psychosocial intervention should be provided for high risk groups based on those risk factors.

The Safety Guidelines for use of Ma-huang in Obesity Treatment (비만처방에서의 안전한 마황사용 지침)

  • Song, Mi-Young;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine for Obesity Research
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    • v.6 no.2
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    • pp.17-27
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    • 2006
  • Objectives : Ma-huang (Ephedra sinica) is frequently prescribed for obesity management in oriental medicine. The main component is ephedrine alkaloids which can have serious adverse side effects such as heart attack, stroke, sudden death. There are no scientific guidelines for Ma-huang usage in the safe treatment of obesity in oriental medicine. We reviewed published studies on its safety to make evidence based guidelines. Methods : We searched electronic databases up to May 2006. We limited evidence to controlled trials for efficacy or safety, case reports for safety, and studies for Ma-huang contents analysis. Results and Conclusions : In clinical trials for weight loss, Ma-huang and ephedrine promote modest short-term weight loss but have no serious adverse effects, have only a few adverse effects associated with increased risk of psychiatric, autonomic, gastrointestinal symptoms and heart palpitations. In case reports, there have been serious adverse effects including stroke, heart attack, and death using typical doses of ephedrine or no associated illness. There are factors related to serious adverse effects, such as overuse, lack of standardization, individual sensitivity, and interactions with other drugs. Studies relating to these factors should be analyzed for safe use of Ma-huang and ephedrine. After analyzing related studies, we suggest guidelines for Ma-huang usage. We propose that the dosage should be within 4.5-7.5g per day for up to 6 months for generally healthy individual. It's use is contraindicated in individuals with heart disease, thyroid disease, diabetes mellitus, hypertension, psychiatric disorders, glaucoma, urination disorders, enlarged prostate, persons using MAOIs, methyldopa and sympathomimetic agents.

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Controversies in Management of Functional Dysphonia (기능성 음성 장애 치료의 고려사항)

  • Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.86-89
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    • 2014
  • Functional dysphonia (FD) is a voice disorder in the absence of structural or neurologic laryngeal pathology. FD is not a single disease but a disease entity. Therefore several voice disorders, which have completely different pathogenesis, are included in this category. The first step of treatment of FD is differentiating patient's voice symptoms from other organic voice disorders and other functional voice problems. Several different treatment modalities are included in the managements of FD. Voice therapy is in charge of the main role in treatment of FD. Medical treatment is also necessary when patient has general problems which would affect voice production. Vocal folds mucosal lesions can cause FD even the lesion is minor. In this case proper surgical intervention helps to improve the symptom of FD. Psychiatric consultation should be considered when the patient has psychological problems.

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Community Pharmacists' Perception of Barriers to Pharmacy Work (약국업무시 고충에 관한 개국약국 약사의 인식에 관한 연구)

  • Kim, Hyun-Ah
    • Korean Journal of Clinical Pharmacy
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    • v.19 no.1
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    • pp.37-42
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    • 2009
  • The purpose of this study was to evaluate barriers to pharmacists' routine work in community setting. A survey was given to 281 pharmacists who enrolled in 16-week clinical pharmacy educating program in continuous education center for advanced pharmacy at Seoul National University. Three main questions that pharmacists were asked to answer were: (1) difficulties on dispensing prescription, (2) difficulties on communicating with doctors, (3) most difficult disease on patients counseling. The response rates for the survey were more than 60 % for each three questions (62.63 %, 63.7 %, and 64.41 %, respectively). The top three barriers to dispensing prescription were lack of professional knowledge about medications, prescription error and its solving ability and patient counseling. The top three barriers to communicating with doctors were lacking of opportunity to discuss about patients' medication due to unavailability of doctors, doctors' attitude using authoritative manner, and a pharmacist's lack of knowledge. The top 4 most difficult diseases on patients counseling were cardiovascular disorders, dermatologic disorders, endocrinologic disorders, and psychiatric disorders.

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Attempted Suicides in South Korea : A Multi-Center Analysis of Causes, Methods, and Psychiatric Diagnoses of Suicidal Attempters in 2013 (응급실 방문 자살기도자들의 기도 원인, 방법, 정신과적 진단에 대한 다기관 분석)

  • Kim, Hyeyoung;Kim, Bora;Kang, Seung-Gul;Kim, Moon-Doo;Kim, Min-Hyuk;Kim, Soo In;Kim, Jae Min;Moon, Eunsoo;Ahn, Joon-Ho;Lee, Kyung-Uk;Lee, Sang-Hyuk;Lee, Seung Jae;Jeong, Seong Hoon;Chung, Young-Chul;Jung, Hee Yeon;Ju, Gawon;Cha, Boseok;Ha, Tae Hyon;Ahn, Yong-Min
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.187-194
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    • 2015
  • Objectives To examine direct causes of attempted suicides, methods adopted to commit suicide, and psychiatric diagnoses among suicide attempters in South Korea. Methods A total of 1359 suicide attempters who had visited emergency department of 17 medical centers due to suicide attempt from May 2013 to Nov 2013 were interviewed using semi-structured questionnaires. Results Psychiatric symptoms were the most common cause of suicide attempts (62.2%), followed by interpersonal relationships (24.4%). Women attempted suicide more often for interpersonal reasons, whereas men were more likely to do so for financial and job-related reasons. Half of participants (55.8%) attempted suicide by drug intoxication, which was more prevalent among females and those who had previous history of psychiatric disease or previous suicide attempt. Men were more likely to use more lethal methods such as pesticide poisoning and gas inhalation than women. Pesticide poisoning was also prevalent among the elderly group and the rural population. Near ninety-five percent (94.5%) of participants received a psychiatric diagnosis : the most frequent diagnosis was depressive disorder. Conclusions This is the first nationwide study of cases of attempted suicide. When stratified by age groups, gender, urbanicity, living alone or not, presence of physical illness, previous psychiatric history, and previous suicide attempt, there were significant differences with respect to causes, methods of attempted suicides and psychiatric diagnoses of suicide attempters.

MicroRNAs in Human Diseases: From Cancer to Cardiovascular Disease

  • Ha, Tai-You
    • IMMUNE NETWORK
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    • v.11 no.3
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    • pp.135-154
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    • 2011
  • The great discovery of microRNAs (miRNAs) has revolutionized current cell biology and medical science. miRNAs are small conserved non-coding RNA molecules that post-transcriptionally regulate gene expression by targeting the 3' untranslated region of specific messenger RNAs for degradation or translational repression. New members of the miRNA family are being discovered on a daily basis and emerging evidence has demonstrated that miRNAs play a major role in a wide range of developmental process including cell proliferation, cell cycle, cell differentiation, metabolism, apoptosis, developmental timing, neuronal cell fate, neuronal gene expression, brain morphogenesis, muscle differentiation and stem cell division. Moreover, a large number of studies have reported links between alterations of miRNA homeostasis and pathological conditions such as cancer, psychiatric and neurological diseases, cardiovascular disease, and autoimmune disease. Interestingly, in addition, miRNA deficiencies or excesses have been correlated with a number of clinically important diseases ranging from cancer to myocardial infarction. miRNAs can repress the gene translation of hundreds of their targets and are therefore well-positioned to target a multitude of cellular mechanisms. As a consequence of extensive participation in normal functions, it is quite logical to ask the question if abnormalities in miRNAs should have importance in human diseases. Great discoveries and rapid progress in the past few years on miRNAs provide the hope that miRNAs will in the near future have a great potential in the diagnosis and treatment of many diseases. Currently, an explosive literature has focussed on the role of miRNA in human cancer and cardiovascular disease. In this review, I briefly summarize the explosive current studies about involvement of miRNA in various human cancers and cardiovascular disease.

An Unappreciated Correlation : Surgical Treatment of Lumbosacral Disc Disease and Erectile Dysfunction

  • Kulaksizoglu, Haluk;Kaptan, Hulagu
    • Journal of Korean Neurosurgical Society
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    • v.47 no.4
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    • pp.282-286
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    • 2010
  • Objective : The aim of the present study was to assess the effect of lumbar disc herniation surgery for low back pain on the erectile functioning. Methods : Thirty-eight patients, with age ranging from 22 to 56 years, who had presented with pain due to herniated lumbar discs were included in the study. International Index of Erectile Function (IIEF) Short Form questionnaire was used to evaluate the erectile functioning. Patient visits on the 1st week,1st month and 3rd month postoperatively were analyzed. Pain scores were also noted together with side effects and the complications of the surgery. Results : Of the 38 patients, 18 patients had reported erectile dysfunction; 10 patients mild and 8 patients moderate erectile dysfunction. Twenty patients did not report erectile problems. The herniation levels mostly were L5-S1 in 12 (31.6%). Overall, erectile dysfunction rates have improved in 31.7% of those previously with erectile dysfunction in a 3 month period after the surgery. Best results were obtained in those patients with mild erectile dysfunction preoperatively. Conclusion : Mild erectile dysfunction together with radiculopathy tends to improve after lumbosacral disc surgery. Moderate and severe erectile dysfunction may be related to a more severe nerve injury or to vascular and/or psychiatric factors. An evaluation of erectile functioning should routinely be performed in patients with lumbosacral disc disease both for data accumulation and for medico legal causes since the documentation of the correlation between erectile dysfunction and lumbosacral disc disease is still lacking.

Analysis of Three Years of Airmen Medical Certificate for Preparing Aviation-related Health Promotion Plan (항공종사자 건강증진활동계획에 반영되어야 할 근거자료: 3년간의 항공신체검사 결과 분석)

  • Han, Bok Soon;Kwon, Young Hwan;Shin, Yun Young
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.1
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    • pp.40-49
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    • 2020
  • In accordance with ICAO SARPs, the states should implement appropriate aviation-related health promotion for airmen subject to an aviation medical examination to reduce future medical risks to flight safety. We aimed to analyze the results of the aviation medical examination to use as objective evidence for establishing an aviationrelated health promotion plan. The results of the final issuance of airmen medical certificate from 2015~2017 were collected from the e-sky computer system. The 30 cases (0.3%) in 2015, 22 cases (0.2%) in 2016, 38 cases (0.3%) in 2017 were unfit for flight duty. The 34 unfit out of the total 90 cases were renewal physical examinations. The cardiovascular disease was most commonly in 11 cases, followed by 8 tumors, 4 psychiatric diseases, 3 ophthalmic diseases, 2 respiratory diseases, 2 neurologic diseases, 2 otolaryngological diseases, 1 endocrine disease and 1 digestive disease. The results of this study can be used as objective data in aviation-related health promotion plan. The health promotion activities based on objective data can contribute to improving aviation safety by improving the lifestyles of airmen.

Behavioral Variant Frontotemporal Dementia Phenocopy Syndrome (행동증상 아형 전측두엽 치매 표현형모사 증후군)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.3-11
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    • 2017
  • Objectives : The aim of this study was to draw attention toward so called 'behavioral variant frontotemporal dementia(bvFTD) phenocopy syndrome', which is difficult to discriminate with the primary psychiatric disorders, showing poor response to conventional therapeutic drugs, leading to higher risk to misdiagnoses and legal problems. Furthermore, the author insisted that our interest and study on them must be continued. Methods : English articles published during 2000 thru 2016 had been searched by internet with the combination of words such as 'frontotemporal', 'phenocopy' and 'behavioral', and reviewed. Besides, two clinical vignettes were described. Results : Precise diagnosis is important because patients' behavioral symptoms can influence on their families and community. However, disease-modifying treatment for bvFTD are not developed until now, and recent therapeutic drugs are only good for specific symptoms, while deterioration progresses in spite of proper psychiatric management. The possible bvFTD patients are not progressed into probable bvFTD clinically, showing no decline of cogntive and social function, no decrease of activity function, longer survival time, and normal neuroimaging for several years. Conclusions : Rather than expected, there are much more patients having clinical symptoms, course and diagnostic findings including neuroimaging, which are atypical to classical frontotemporal dementia and primary psychiatric disorders. If our knowledge and discriminating ability is improved, discovery rate of that cases will be increased. However, the identity of these atypical features are not clarified until now, it must be further actively investigated.