Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.33
no.3
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pp.73-81
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2022
Since dissociative identity disorder (DID) has symptoms similar to schizophrenia, such as auditory hallucinations and delusional thoughts of being controlled, there are difficulties in its differential diagnosis. A 16-year-old adolescent male patient who was previously diagnosed with schizophrenia from a different hospital was admitted to our inpatient psychiatric unit for the evaluation of auditory hallucinations and suicide attempts. Through psychiatric evaluations, it was determined that the patient suffered from identity alternation, dissociation, and amnesia. As for the diagnostic evaluations, the following measures were implemented: a psychiatric interview regarding the diagnostic criteria, mental status examination, laboratory tests, brain imaging studies, electroencephalography, and full psychological test for adolescents, and the self-reported measure of the Adolescent Dissociative Experiences Scale. The patient was diagnosed with DID, and the following treatments were administered: pharmacotherapy, ego state therapy, psychoeducation regarding emotions, trauma-focused psychotherapy including stabilization, and family therapy. Following treatment, in the internal dimensions, the patient was able to recognize the nine alternate identities in charge of his emotions, which established a basis for the potential integration of identities. In the external dimensions, he showed improvements in the aspects of family conflicts and issue of school refusal. This is the first reported case of DID in an adolescent in Korea; it emphasizes the consideration of DID in the differential diagnosis of other mental illnesses such as schizophrenia, bipolar disorder, and posttraumatic stress disorder and expands the treatment opportunities for DID by sharing the procedures of ego state therapy.
Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.
Objectives: The workplace is an ideal place for encouraging health-promoting behaviors. Therefore, the aim of the present study was to determine the effect of an empowerment program on the health-promoting behaviors of women workers. Methods: This randomized clinical trial was conducted with 80 women workers employed at a food packaging facility in 2020. The subjects were selected using convenience sampling and were classified into intervention and control groups using block randomization. An empowerment program for women workers was conducted across 6 sessions based on an empowerment model. Data collection tools included a demographic questionnaire and the Health Promoting Lifestyle Profile-II, which participants completed both before the program and 8 weeks after the last session. Data analysis was performed in SPSS version 16 using descriptive analysis and inferential statistics. Results: There were no significant differences between the 2 groups in various health-promoting behaviors before the program. However, the intervention group's scores for nutrition (34.92±1.09 vs. 27.87±4.23), physical activity (24.40±2.94 vs. 17.40±5.03), stress management (26.35±2.60 vs. 23.05±4.27), spiritual growth (34.02±3.00 vs. 30.22±5.40), interpersonal relationships (30.82±2.38 vs. 27.60±4.61), and health responsibility (31.60±2.71 vs. 28.22±4.59) were significantly higher than the control group's 8 weeks after the program had ended. Moreover, there was a significant difference in the total score of health-promoting behaviors for the intervention group compared to the control group (179.00±9.22 vs. 151.42±20.25, p=0.001). Conclusions: An empowerment program for women workers led to significant improvements in the health-promoting behaviors of the participants. Similar programs can ultimately improve women's health in the workplace.
The Journal of the Convergence on Culture Technology
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v.8
no.5
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pp.685-690
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2022
Recent research on soft adhesives has sought to understand in depth how their chemical or mechanical structures interact strongly with living tissues. The aim is to optimally address the unmet needs of patients with acute or chronic diseases. Synergy adhesion, which includes both electrostatic (hydrogen bonds) and mechanical interactions (capillary stress), appears to be effective in overcoming challenges related to long-term unstable bonds to wet surfaces. Here, we report electrostatic and mechanically synergistic mechanisms of adhesion without chemical residues. To infer the mechanism, a thermodynamic model based on custom combination adhesives has been proposed. The model supported experimental results that thermodynamically controlled swelling of hydrogels embedded in elastomeric structures improves biofluidic insensitive on-site adhesion to wet surfaces and improves detachment without chemical residues in the direction of peeling.
Background: Ketamine is widely used in infants and young children for procedural sedation and anesthesia. The aim of this study was to evaluate the efficacy and safety of low dose oral ketamine to control pain and distress in children during intravenous (IV) cannulation. Methods: This is a prospective, randomized, double-blind study, including children aged between 3 and 6 years requiring a non-emergent IV-line placement. Children were randomly assigned to two groups, treated either with oral ketamine or a placebo. All patients were monitored for vital signs. Pain was assessed using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and Wong-Baker Faces Pain Rating Scale (WBFS) scales and sedation using a 5-point sedation score. The facility of IV-line placement was measured by a 3-point scale. Adverse effects were recorded after 1 and 24 hours. Results: A total of 79 and 81 children were entered in the ketamine and placebo groups, respectively. The heart and respiratory rates increased significantly in the placebo group. The median CHEOPS 4 (95% confidence interval [CI]: 3, 4, P < 0.001) and WBFS 6 (95% CI: 4, 6, P < 0.001) scores decreased statistically in the ketamine group. IV-line placement was 50% easier in the ketamine group (95% CI: 37%, 63%, P < 0.001). No serious adverse effects were observed in all cases. Conclusions: Low dose oral ketamine effectively decreased the pain and distress during IV cannulation in children without any significant adverse reactions.
Journal of The Korean Society of Integrative Medicine
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v.10
no.3
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pp.257-266
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2022
Purpose : This systematic review examined evidence published 2000-2021 for occupational therapy interventions for adult Attention Deficit Hyperactivity Disorder (adult ADHD). Methods : In order to find out the studies on the effect occupational therapy intervention on individuals with adult ADHD, studies published from 2000 to February 2022 were searched on Google Academic Search. The keywords used were "adult ADHD" AND "Occupational therapy". A total of 785 studies were searched, and from these, 3 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 1 Quasi-experimental design study(one group pre-post test) and 2 randomized controlled trials design studies. The included studies were analyzed in PICO(patients, intervention, comparison, outcomes). Results : As a result of analysing the subjects of the included studies, subjects diagnosed with adult ADHD or classified as high-risk group in Adult ADHD Self-Report Scale test, the number of subjects was 97, and the average age was about 33 years old. Occupational therapy intervention methods for adult ADHD include Tailored Intervention, Computerized Cognitive Training, and Cognitive-Functional Intervention. The Adult ADHD Self-Report Scale was the most used to check the symptoms of ADHD, and the COPM was used the most to measure the effects of occupational therapy interventions. The dependent variables of occupational therapy intervention were occupational performance, quality of life, executive function (behavioral regulation, metacognition), self-regulation function, stress management, and sustained attention. The effect of the intervention was statistically significant in 78.5% of the total. Conclusion : It is expected that the results of this study can be used as basic data for evidence-based practice for occupational therapists to apply adult ADHD interventions. In the field of occupational therapy in Korea, research on various interventions that can improve the occupational performance of adults ADHD should be conducted.
Unlike the conventional triaxial test cells for cylindrical specimens, which impose uniform lateral confining pressures, the GREAT (Geo-Reservoir Experimental Analogue Technology) cell can exert differential radial stresses using eight independently-controlled pairs of lateral loading elements and thereby generate horizontal stress fields with various magnitudes and orientations. In the preceding companion paper, GREAT cell tests were numerically simulated under different mechanical loading conditions and the validity of the numerical model was investigated by comparing experimental and numerical results for circumferential strain. In the present study, we simulated GREAT cell tests for an artificial sample containing a fracture under both mechanical loading and fluid flow conditions. The numerical simulation was carried out by varying the mechanical properties of the fracture surface, which were unknown. The numerical responses (circumferential strains) of the sample were compared with experimental data and a good match was found between the numerical and experimental results under certain mechanical conditions of the fracture surface. Additionally, the effect of fluid flow conditions on the mechanical behavior of the sample was investigated and discussed.
The comparative study using the lab-scale experiment and the discrete element analysis is attempted to analyze the cross-anisotropic elasticity of granular soils. The lab-scale experiment consists of the small stress-controlled triaxial cyclic tests and the bender element tests. In the discrete element analysis the simulations of lab-scale cyclic tests are conducted in the various directions. Good agreement between the experimental data and the simulation on the elastic properties in the axial and shear directions confirms the usefulness of the discrete element method. The comparative analysis of the difference in the experimental data and the simulation of radial cyclic tests shows that the discrete element method can successfully be used to check the reasonable magnitude of each measurement in the experiments.
Objective: The purpose of this study is to present basic data for appropriate therapeutic intervention by confirming changes in the autonomic nervous system and pain by applying high-frequency deep diathermy to the lower abdomen in patients with primary dysmenorrhea. Design: A randomized controlled clinical trial. Methods: Thirty-eight women aged 18-50 years who complained of regular menstrual cycles (24-32 days) and primary dysmenorrhea symptoms were randomly assigned to a high-frequency therapy group (5, 7, or 9 mins) and a superficial heat therapy group (20 min). High frequency treatment group: The subject was in a supine position, and radio frequency was applied to the lower abdomen below the umbilicus. The radio frequency therapy device used in this study uses a 300 kHz capacitive electrode and a 500 kHz resistive electric transfer to deliver deep heat. Superficial heat treatment Group: Subjects applied a hot pack to the lower abdomen for 20 minutes while lying on their back. Evaluations were made of Heart rate variability and Visual Analogue Scale. Results: In subjects with menstrual pain, there was a significant difference in pain between the high-frequency therapy group and the superficial heat therapy group (p=0.026). However, there was no significant difference between the autonomic nervous system and the stress resistance (p>0.05). Conclusions: As a result of this study, high-frequencytreatment using radiofrequency was effective in relieving pain because it can penetrate deeper tissues than conventional hot packs using superficial heat. In particular, it was found that the optimum effect was obtained when high frequency was applied forfive-seven minutes.
In order to solve the serious traffic congestion in seoul metropolitan city, large-scale underground space development such as underpasses, deep underground roads, and GTX (Great Train eXpress) is being carried out. In order to minimize the impact of the adjacent seoul metro line A pier foundation and stability due to the construction of the underground road in Seoul, earth retaining structures were reinforced and the foundation was reinforced as well. In this study, three-dimensional finite element mehtod analysis was performed to evaluate the effect on adjacent construction and to review the stability of the underpass excavation work. The reinforcement effect was quantitatively analyzed through numerical analysis. As a result of the analysis, compared to the result of performing the existing reinforcement when overlapping CIP and ground reinforcement grouting were performed, the displacement of the earth retaining structures was reduced by more than 50%, and stress of the foundation piles were also reduced by more than 45%. Based on the analysis of the numerical analysis results, it was confirmed that the displacement of the walls of earth retaining structures during adjacent construction should be strictly controlled.
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