• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.116-125
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• 2020

Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.963-975
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• 1996

The purpose of this study was to call attention to the mental, physical and occupational hazards of the anticancer-drug-handling nurses by examining the possible urinary mutagenicity and measuring physical symptoms and stress level of the nurses exposed to anticancer drugs. The experimental group of the urinary mutagenicity assay was 14 nurses handling anticancer drugs at the medical wards of a hospital located in J city ; the control group was 12 psychiatric nurses of the same hospital. The test material was the nurses' 24hrs urine, which was concentrated by XAD-2 column chromatography. Tester strains were TA98(±S9 mix), TA100(±S9 mix), TA1535(±S9 mix) and TA1537(±S9 mix) ; Salmonella mammalian-microsomal test(Ames test) was employed for the urinary mutagenicity assay. The physical symptoms of which the nurses experienced were investigated through self-reports on open-questionnaires. The stress levels of the experimental group were measured by a stress measuring instrument developed by this author. Reliability of this instrument was found to be adequate (Cronbach's Alpha=0.9079). To ascertain the urinary mutagenicity of the experimental group, the mean and the standard deviation of the colonies of Tester strains appearing on the minimal plates were taken and compared differences between two groups. T-test was employed for the significance test of two groups. The physical symptoms were compared between the two groups through the analysis of the nurse' self-reports. The mean and standard deviation of the stress levels of the experimental group were also calculated and were examined through t-test. The results were summarized as follows : 1. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and the non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, two groups showed no difference in the non-activation method test, but the activation method revealed difference. 2. The physical symptoms were also much more frequently reported in the experimental group. 79.3% of the experimental group reported more than 1 kind of physical symptoms. On the other hand, 33.2% of the control group complained of 1 kind of physical symptom. The items with high symptom frequency were 'headache', 'itching sensation', 'corneal congestion', 'skin allergy' 3. The mean score of stress in the experimental group was 2.41(range 1-4). The experimental group showed the stress level above 2.0 in the 14 of 15 items in all. The highest stress level were recorded in the following items in the order quoted, 'I fear that anticancer drug may touch any part of body while handling it.', 'I feel concerned there is no protective countermeasure against anticancer drug handling.', 'I am afraid the anticancer drug handling may produce a fetal loss in the future'.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.489-494
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• 2014

Background: Psychiatric patients appear to be at lower risk of cancer. Some antipsychotic drugs might have inhibitory effects on tumor growth, including penfluridol, a strong agent. To test this, we conducted a study to determine whether penfluridol exerts cytotoxic effects on tumor cells and, if so, to explore its anti-tumor mechanisms. Methods: Growth inhibition of mouse cancer cell lines by penfluridol was determined using the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Cytotoxic activity was determined by clonogenic cell survival and trypan blue assays. Animal tumor models of these cancer cells were established and to evaluate penfluridol for its anti-tumor efficacy in vivo. Unesterified cholesterol in cancer cells was examined by filipin staining. Serum total cholesterol and tumor total cholesterol were detected using the cholesterol oxidase/p-aminophenazone (CHOD-PAP) method. Results: Penfluridol inhibited the proliferation of B16 melanoma (B16/F10), LL/2 lung carcinoma (LL/2), CT26 colon carcinoma (CT26) and 4T1 breast cancer (4T1) cells in vitro. In vivo penfluridol was particularly effective at inhibiting LL/2 lung tumor growth, and obviously prolonged the survival time of mice bearing LL/2 lung tumors implanted subcutaneously. Accumulated unesterified cholesterol was found in all of the cancer cells treated with penfluridol, and this effect was most evident in LL/2, 4T1 and CT26 cells. No significant difference in serum cholesterol levels was found between the normal saline-treated mice and the penfluridol-treated mice. However, a dose-dependent decrease of total cholesterol in tumor tissues was observed in penfluridol-treated mice, which was most evident in B16/F10-, LL/2-, and 4T1-tumor-bearing mice. Conclusion: Our results suggested that penfluridol is not only cytotoxic to cancer cells in vitro but can also inhibit tumor growth in vivo. Dysregulation of cholesterol homeostasis by penfluridol may be involved in its anti-tumor mechanisms.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.2
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• pp.83-93
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• 2017

This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.482-487
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• 2010

Attention Deficit-Hyperactivity Disorder(ADHD) is the most common psychiatric disorder in school-age children which is increasing gradually. It is hard for ADHD children to focus on particular stimulus for a long time. ADHD children are characterized by hyperactivity which shows in behaviors like, talking too much, getting up from their seats without permission, running around, keep on moving their arms and legs. ADHD children have problems with impulse controlling that they tend to fall and get into an accident very often. Thus dentist's attention and care must increase when dental treatment is performed with ADHD children since behavior control, oral hygiene problems, and trauma might be expected. By using sedative drugs and psychological behavior control, chief complaint was resolved in a 8-years-old female diagnosed for ADHD.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6711-6714
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• 2015

Background: Insomnia is a common condition in cancer patients. In spite of the high prevalence its associations have not been well studied. Existing data suggests that insomnia is related to depression and pain. However, the impact of ongoing chemotherapy on sleep is not investigated. Aim: To study the relationship between insomnia and chemotherapy after analysing confounding variables. Materials and Methods: Consecutive patients who visited New England Oncology Clinic in Tamworth were recruited. Insomnia was assessed with the Bergen insomnia scale. The Montgomery Asberg Depression rating scale was used to measure depression. Pain was assessed with the Brief Pain inventory. Chronic medical conditions, type of cancer, side effects to chemotherapy, role of steroids and other drugs were studied as confounders. Results: A total of 56 patients participated in the study. Age ranged from 33 to 83 years (mean: 63.6, SD=10.97). There were 29 men and 27 women. 42 patients received at least one form of chemotherapy and 15 were receiving radiotherapy at the time of assessment. Mean insomnia score was significantly higher in those receiving chemotherapy than in those without chemotherapy (8.92 vs 17.2, two tailed p=0.005, 95% CI=2.63-13.71). There was no significant variation in insomnia scores in terms of chronic medical condition, type of cancer, psychiatric history, use of steroids or adverse effects of chemotherapy. However, total insomnia score was correlated with depression rating score (Pearson correlation, r=0.39, p=0.003) and magnitude of pain (r=0.37, p=0.006). On regression analysis only pain was found to be predictive of insomnia. Conclusions: Insomnia in patients with cancer is found to be associated with concurrent chemotherapy and correlated with degree of depression and pain. Identifying factors related to insomnia in cancer population has implications in its management and patient education.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.400-411
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• 2002

This study was performed to identify the drug use and reuse relating characteristics and reuse relating factors in illegal drug users. Subjects consisted of 88 illegal drug users. Some of them were confined in a mental hospital or National Forensic Psychiatric Hospital located in Chung-nam province, others on attending a drug abuse prevention program in Seoul Probational Institute. Data were collected during the period from February 1, 2002 to February 25, 2002, and analyzed by SAS program. version 6.12. for Wilcoxon rank sum test, Pearson Correlation, Multiple regression. Results were as follows; 1. Drug use characteristics were as follows. $19.3\%$ was has drug family history and $20.7\%$ was has alcohol family history. Main drug was Phillopon$44.3\%$, inhalants $35.2\%$, LSD et al $22.7\%$. Drug use rate of months was everyday $31.2\%$, every other day $24.4\%$. 2. $100\%$ has experienced abstinence and reuse. Abstinence period was less than 12 months in $49.4\%$ and reuse period was less than 6 months in $58.6\%$. 3. Drug use and reuse characteristics related to general characteristics was identified as below. Abstinence period of male was longer than that of female. Person who have drug family history experienced more drugs and person who have family alcohol history started earlier. 4. Reuse periods was correlated with abstinence periods, age. And abstinence period was correlated with age and outcome that following reuse. 5. The multiple regression was used to identify the relating factors that influence reuse period and abstinence period. At the state of controlling abstinence period. inhalants users have 10.07 days shorter reuse period than others. And abstinence period had lengthened age, bad health status, early initiate age, and long reuse period.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.437-441
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• 2010

Toxic epidermal necrolysis (TEN) and Stevens Johnson syndrome (SJS) are rare, life-threatening mucocutaneous -diseases, usually attributable to drugs and infections. Corticosteroids have been used in the management of TEN for the last 30 years. This remains controversial and is still much debated. TEN can occur despite administration of high doses of systemic corticosteroids. The psychiatric side effects of corticosteroids can include headache, insomnia, depression, and mood disorders with or without psychotic episodes. Steroid-induced psychosis is dealt with by tapering or discontinuing the steroid; antipsychotics are also sometimes used. We report a case of an 11-year-old boy who was admitted with TEN. He had also been diagnosed as having nephrotic syndrome in the past. Remission was achieved through induction therapy and by maintaining the use of steroids. After a full-dose intravenous dexamethasone for TEN, he showed psychotic symptoms. We diagnosed him as having steroid-induced psychosis. We tapered the steroid use and initiated an atypical antipsychotic medication, olazapine and intravenous immunoglobulin (IV-IG). His symptoms dramatically improved and he was discharged.

• Korean Journal of Biological Psychiatry
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• v.27 no.2
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• pp.42-57
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• 2020

Electroconvulsive therapy (ECT) is indicated for various mental disorders (e.g., major depressive disorder, schizophrenia, and bipolar disorder) and the behavioral and psychological symptoms of dementia in elderly patients. Furthermore, ECT is a useful first-line treatment in emergency and crisis situations such as suicide risk, violent behavior, catatonia, and food refusal, which are more frequent in elderly patients. ECT is also effective in the treatment of the motor symptoms of neurological disorders, such as Parkinson's disease and Huntington's disease. Due to the high risk of various physical diseases, the comorbid physical conditions of elderly patients should be individually controlled to optimize ECT treatment. Compared to young adults, in elderly patients the seizure threshold is higher, the seizure duration is shorter, and the anesthetic dose is lower. On the contrary, the response rate in the elderly is both faster and higher. Considering potential cognitive decline and the prevention of further deterioration of cognitive function in elderly patients, in the absence of significant comorbidities, twice weekly sessions and right unilateral electrode placement with a lower seizure threshold and less cognitive effect are preferred to bilateral electrode placement, which has a high risk of adverse cognitive effects. After an acute course of ECT, continuation and maintenance of ECT, combined with prescription of therapeutic drugs, may prevent possible relapse or recurrence of mental disorders. In conclusion, ECT can be used to treat mental disorders in elderly adults, with safety and effectiveness comparable to that in young adults.

• Journal of Oriental Neuropsychiatry
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• v.33 no.2
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• pp.123-131
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• 2022

Objectives: The purpose of this study was to investigate the experience and perception of using Korean medicine treatments for patients with mental disorders. Methods: The method of a qualitative analysis was used, and semi-structured interviews were conducted. The researchers developed the survey questionnaires with consultation from psychiatrists from various university hospitals. Before conducting interviews, an IRB was approved KHSIRB-21-131 (RA), and the Hankook Research Company managed the interviews. The question composition comprised 11 questions based on symptoms and treatment situations accompanying treatment due to mental distress, perception of Korean medicine, awareness of treatment costs, and awareness of treatment costs. Results: A total of six patients were interviewed. Each interviewee took 90 minutes to answer questions. Through the analysis of the data, the patients comprised four categories: characteristics, awareness of Korean medicine, awareness of Western treatment, and daily life due to mental disorder. The experience and perception of patients using Korean medicine showed positive attitudes. There was an opinion among patients that Korean medicine treatment was less dependent on drugs, and had fewer side effects, than Western medicine. Some patients said that Korean medical treatment is expensive and burdensome medical expenses. Some patients were not aware of the application of insurance to mitigate medical expenses. Conclusions: Based on the findings of the study, it is urgent to expand the application of insurance benefits to Korean medicine.