• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.207-212
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• 2021

Anti-N-methyl-D-aspartate receptor (Anti-NMDAR) encephalitis is a neuroinflammatory disease mediated by autoantibodies to NMDAR. In the initial clinical stages of anti-NMDAR encephalitis, psychiatric symptoms like delusions, perceptual disturbances, and disorganized speech or behaviors are pronounced even without obvious neurological symptoms. Early treatments like immunotherapy and/or tumor removal are central to good clinical outcomes. Hence, it is important to diagnose early anti-NMDAR encephalitis, distinguishing it from mental disorder. In the present case study, the authors described psychiatric symptoms assessed with Positive and Negative Syndrome Scale (PANSS) of Ms. A, a 26-year-old woman, in the early phase of anti-NMDAR encephalitis. We will discuss the characteristic psychopathology of anti-NMDAR encephalitis toward prompt diagnosis and treatment. Ms. A showed a higher negative subscale score than positive one on the PANSS. Compared with mental disorder, negative symptoms and cognitive impairment would be more prominent in the early stage of anti-NMDAR encephalitis. Rituximab and teratoma removal were effective, and quetiapine showed good tolerability. It is recommended to evaluate anti-NMDAR encephalitis when negative symptoms, cognitive impairment, catatonia, changes in consciousness level, and neurological symptoms are observed, especially in young women.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.546-555
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• 2014

Objectives: Recently, many studies have reported beneficial effects from the application of laser and light-emitting diode (LED) therapy for cerebral nervous disease. Transcranial laser therapy and LED therapy may be an effective method to treat diseases of the cerebral nervous system. This study aims to discuss the possibility of laser and LED therapy for cerebral nervous disease by reviewing literature about its effectiveness. Methods: We searched papers using PubMed, Science Direct, CINAHL, KTKP, Oasis and NDSL, using the keywords "Laser therapy, low-level", "Transcranial laser", "Transcranial light emitting diode" and "stroke", "traumatic brain injury", "dementia", "anxiety", "cognitive", "emotional effects", "psychiatric disorder", "multiple sclerosis", "Parkinson's disease". The search range included randomized controlled trials (RCTs) and clinical case series. Reviews and animal experiments were not included. Studies not matched with inclusion criteria were excluded. Results: A total 1,119 studies were found. 1,100 were excluded from scanning titles and abstracts and finally 9 articles were selected. Among the 9 articles, 5 were RCTs, one was a controlled study, and the other 3 were case reports. They reported that transcranial laser therapy and LED treatment had beneficial effects from photobiomodulation to the cerebral nervous system. Clinical evaluation factors showed favorable trends. Conclusions: Transcranial laser therapy and LED therapy seem to be effective to the cerebral nervous system and they may be a favorable choice for cerebral nervous disease.

• Journal of Oriental Neuropsychiatry
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• v.21 no.2
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• pp.157-169
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• 2010

Objectives : The aim of this study was to investigate the characteristics of Hwa-Byung(HB) patients, draw the clinical key issue of HB, and provide the data as the basis for development of Clinical Guideline of HB. Methods : The study participants included 151 subjects who thought they have HB in 9 site. For all patients, we used HB epidemiologic study protocol, which include the Korean version of the Structured Clinical Interview for the DSM-IV Diagnosis (SCID-1), diagnostic criteria of HB, symptoms check list, pattern identification tool, psychiastric psychological questionaires, and Framingham coronary risk score(FRS). Results : 1. For all participants, 62 % of subjects were diagnosed with HB. These patients had comorbid DSM-IV diagnoses with depression (65%) and anxiety (27%). But 22% of these patients had only HB. 2. HB patients had various physical symptoms when visiting, were diagnosed as various disease, and undergone medical treatments in the past. Among the diagonsed illness, Gastronitestinal diseases (51.6%), psychiatric disorders(40.9%), endocrine diseases(39.8%) were being the most frequent. The frequent physical symptoms of HB patients reported were chest discomfort, head ache, pallpitation, frequent sigh, amnesia, shoulder pain, dry mouth, eye fatigue etc. 3. HB patients had high scores in psychologic questionares, CES-D, STAI, and STAXI. It means that HB patients might be low-level emotional stability. 4. Participant had negative opinion about the treatment of HB that it would be difficult or impossible (65.7%), but they neglect the need of medical treatment. Conclusions : This result shows that HB is comorbid with various psychiatric disease, but it has different physio-psychological symptoms from others and there were only HB patients. so we identify HB is independent disease. Moreover, there were the wrong perception of HB which blocking treatments. These problems support that the neccesity of development of Clinical Guideline of HB.

• Anxiety and mood
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• v.10 no.1
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• pp.11-16
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• 2014

Objective : Despite the high prevalence and clinical importance of panic disorder, studies on the clinical characteristics and course of panic disorder are relatively rare. This study is a multi-center, and retrospective study to examine the clinical characteristics and course of Korean panic disorder patients who visit university hospital. Methods : The study subjects were panic disorder patients who had visited the psychiatric outpatient clinics of 8 university hospitals in South Korea from January to December in 2008. Finally, 238 panic patients were included in this study. Their medical charts were retrospectively reviewed and reassessed by experienced psychiatrists to examine their clinical characteristics, demographic data and clinical course in repose to pharmacotherapy. Results : Among the 238 patients (121 males vs. 117 females), the mean age of disease onset was $41.3{\pm}12.7$ years and female patients showed 5 years older age of disease onset, compared with male patients. The mean score of PSR scale was $4.5{\pm}1.0$ at the first visit, reflecting a 'marked' level of severity of illness and impairment in functioning. Only 110 patients (46.4%) completed the whole follow up visits, whereas 128 patients (53.6%) dropped out during the treatment. After $17.7{\pm}0.5$ months of mean follow up period, the mean score of PSR scale at the last visit was reduced into $2.1{\pm}0.9$, reflecting a 'residual' severity of illness and impairment in functioning. The cumulative recovery rate was 62.1% in the completer group, whereas that of the drop-out group was 47.7%. Conclusions : The mean age of disease onset in Korean panic disorder patients who had visited university hospital was about 10 years older than that of Western panic disorder patients in previous studies, and the Korean panic disorder patients who had visited university hospital showed a relatively higher cumulative recovery rate. These differences might result from an ethnic difference in clinical characteristics and course in response to pharmacotherapy of panic disorder.

• Journal of Community Nutrition
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• v.1 no.1
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• pp.33-38
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• 1999

Since binge eating is known to be related to increased risk of body weight fluctuations, it may be associated with increased health risks. This study was conducted to investigate the risks of binge eating on the cardiovascular system of female university students in Korea. Sixty-five female university students who were interested in a weight control program were recruited from a university campus. After personal interviews were conducted using a semi-structured questionnaire, 36 individuals were classified as binge eaters and 29 as non-binge eaters according to modified criteria of the proposed DSM-IV by the American Psychiatric Association(APA). All subjects participate in anthropometric and clinical measurements to evaluate the level of obesity and cardiovascular risks. Binge eating subjects showed no significant differences in obesity index compared to non-binge eating subjects. However, they had a higher level of low-density lipoprotein (LDL) cholesterol and a higher atherogenic index. They also showed close correlations with general obesity and cardiovascular risk factors. Body mass index(BMI) was the main explanatory index related to cardiovascular risk factors according to the stepwise regression analysis. Furthermore, obese binge subjects had higher levels than non-obese binge subjects or non-binge subjects for total cholesterol, LDL-cholesterol, triacylglycerols, atherogenic index, and systolic blood pressure. The findings strongly suggest that obese young women having binge eating episodes might display a greater risk for cardiovascular disease tan that shown for obese non-binge eating women.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.723-731
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• 2016

Background: Cancer is a major public health problem in many parts of the world. Gastrointestinal (GI) cancers are responsible for 20% of all cancer-related deaths. In Turkey, stomach cancers account for 8.9%, colon cancer for 6.9%, and pancreatic cancer for 5.9%. This study examined the anxiety-depression levels and the quality of life of patients with GI cancer. Materials and Methods: This descriptive study was carried out on 335 adult patients who had gastrointestinal cancer and who were hospitalized in medical oncology clinics. Data were collected by using hospital anxiety and depression scale, EORTC QLQ C-30 and a patient information form. Results: Patients who were male and secondary school graduates/graduates/postgraduates experienced more functional difficulties. Patients with poor economic status experienced more symptoms. Patient general wellbeing decreased with increase disease duration. The level of functional difficulties decreased with an increasing number of hospital stays. Anxiety scores increased with decreasing age. Both anxiety and depression scores increased with increasing disease duration. Patients who were female, single/widowed/divorced, and literate/elementary school graduates had higher anxiety and depression scores. Life quality decreased with increasing anxiety and depression. Conclusions: Patients should be supported to prevent anxiety and depression, and should be followed up with this in mind.

• Sleep Medicine and Psychophysiology
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• v.1 no.1
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• pp.3-8
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• 1994

With the recent development of sleep medicine, insomnia has been perceived as a disease from a simple symptom. As there are various causes in a disease, proper treatment according to each cause is necessary for a more effective treatment In general, insomnia is classified into five categrories of physical, physiological, psychological, psychiatric and pharmacological aspects. However, such categorizations are often insufficient in treating insomnia. Furthermore understanding of the developmental mechanisms of insomnia is required. The function of sleep is developed and maintained through the balance of the reciprocal forces of sleep and arousal. These forces are contantly regulated by what is called a circadian rhythm. Sleep is induced by this rhythm which is affected by factors such as awakening time in the morning, amount of intellectual function, amount and time length of physical exercise and sunlight Insomnia could develop when this rhythm is delayed and leads to a "forbidden zone" which is a very difficult period for inducing sleep about two to four hours before the routine bedtime. Whereas sleep gradually develops in line with the circardian rhythm, arousal can occur very abruptly by any cause triggered by emotional discomfort or anxiety. Such characteristic and emotional factors as perfectionism, separation anxiety, secondary gain, insecurity, and negative cognition may provoke the inner anxiety and fear for insomnia, which can lead acute insomnia to a chronic one. As chronic insomnia is developed by multiple causes and factors, integrated approaches through analysis of above mentioned factors will be more effective in the treatment of insomnia than a simple administration of hypnotics.

• Korean journal of aerospace and environmental medicine
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• v.30 no.1
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• pp.34-39
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• 2020

The medical fitness of pilots is part of the civil aviation safety scenery. This study aimed to analyze the health problems occurring among Korean commercial pilots. Three data sources were used to identify the health problems: 7,574 aviation medical examination data, 5,400 sick leaves and 39 cases of a decrease in medical fitness during flight duty period and layover of Korean commercial pilots who have been working for K airline from Jan. 1, 2016 to Dec. 31, 2018. This study was retrospectively analyzed using SPSS 22 statistical program. Waiver of medical certificates was an average 11.9% of total issuance for 3 years, with a denial of 0.1%. The leading cause of denial of medical certificates was predominantly of cardiovascular cause (55.6%). Mild respiratory and digestive disease accounted for 82% of total sick prevalence and 68% of total sick days. The psychiatric and cardiovascular disease were ranked high according to the number of days lost per case. The most common cause of decrease in medical fitness during flight duty period was acute abdominal pain (36.4%) and musculoskeletal disorder (40%) when staying abroad. Aeromedical emphasis on minimizing cardiovascular risk remains appropriate. Major pilot health problems identified in this study should be considered in establishing pilot health promotion programs for aviation safety.

• Journal of Preventive Medicine and Public Health
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• v.49 no.2
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• pp.134-138
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• 2016

Objectives: Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer's disease (AD) have been inconsistent. We investigated whether the month or season of birth are associated with AD. Methods: A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719) and up to four age- sex- and region of residence-matched controls (n=282 862) residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression. Results: Month of birth was not associated with AD (p=0.09). No strong associations were observed with season (p=0.13), although in comparison to winter births (December-February) summer births (June-August) were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05). However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively). Conclusions: Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal) risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.2
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• pp.121-127
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• 2015

Purpose: To evaluate clinical and laboratory profile of Wilson's disease (WD) in children. Methods: This cross sectional study was conducted at Bangabandhu Sheikh Mujib Medical University Hospital. Bangladesh, over a period of 3 years. One hundred consecutive children of WD between 3 to 18 years of age were evaluated. Results: Mean age was $8.5{\pm}1.5years$. Male female ratio was 2:1. Ninety-one percent of patients were Muslim and 9% Hindu. A total of 53% cases of hepatic WD presented between 5 to 10 years of age and most of the neurologic WD manifested in 10-15 years age group. Sixty-nine children presented only with hepatic manifestations, 6 only with neurological manifestations, 14 with both hepatic and neurological manifestation, 10 children was asymptomatic and 1 patient presented with psychiatric features. WD presented as chronic liver disease (CLD) in 42%, CLD with portal hypertension in 34%, acute hepatitis in 20% and fulminant hepatic failure in 4% cases. Stigmata of CLD were found in 18% patients. Keiser-Fleischser ring was found in 76% total patients. Elevated serum transaminase was found in 85% cases, prolonged prothrombin time in 59% cases and hypoalbuminaemia in 53% cases. A total of 73% patients had low serum ceruloplasmin, basal urinary copper of >$100{\mu}g/day$ was found in 81% cases and urinary copper following penicillamine challenge of >$1,200{\mu}g/day$ was found in 92% cases. Conclusion: Majority of studied WD children presented with hepatic manifestation of which 76% presented with CLD. Any child presented with jaundice after the age of 3 years should be investigated for WD.