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내과에 입원하여 정신과에 자문의뢰된 우울증 환자의 임상양상
한상익,이정표,유태열 大韓神經精神醫學會 1985 신경정신의학 Vol.24 No.3
In an attempt to establish some guidelines for psychiatric consultants who work in a general hospital setting who frequently are encountered with depressed medical inpatients, authors evaluated a few outstanding clinical characteristics of them. We discussed why these patients seek help at the internal medicine instend of seeking more than adequate help at the psychiatric service. We also tried to visualize who they are. Authors tried to suggest some specific future guidelines for those who work with this kind of patients. The subjects were consisted of 51 medical inpatients who were admitted at the Kang-Nam St. Mary’s Hospital from Apr. 1, 1983 to Jul. 31, 1984, who were seen on psychiatric consultation and were apparently suffering from clinical depression. Their clinical characteristics were compared with randomly selected 48 psychiatric inpatients with depression who were hospitalized at the same hospital for the same period. The conclusions were as follows: 1. For their age distribution, medical inpatients with depression group with age over 60(23.5%) were two times greater than psychiatric inpatients with depression group for the same age bracket (10.4%). This result shows current trend that senile depressed patients tend to seek medical help rather than to seek psychiatric help. 2. For their medical diagnostic distribution, medical inpatients with depression frequently received one of the gastrointestinal disorder diagnoses(26.6%) at the internal medicine. After psychiatric consultation, “medical diagnoses” decreased from 77.7% to 63.3% and diagnoses of “depression” increased from 6.4% to 27.6% for the medical inpatients. 3. For the depressed female medical inpatients who were seen on psychiatric consultation, marital problems were the most frequently observed psychiatric problems which needed psychiatric attention. This finding appears to reflect women’s trend to express their emotional conflicts in a more subtle and vague physical symptoms of depressive equivalents rather than outright depressed affect itself. 4. Most of the chronic dysthymic disorder patients with multiple physical complaints (62.7%) usually seek medical help rather than psychiatric help. Whe compared with this, patients who suffer from depressed affect itself rather than physical symptoms of depression came directly to psychiatric service. 5. Regarding their physical symptoms, both of the depressed medical inpatients and depressed psychiatric inpatients frequently complained of gastrointestinal symptoms, 39.9% and 41.9% respectively. For their frequency and number of physical symptoms, depressed medical inpatients complained more of them (3.76±1.70) than those of depressed psychiatric inpatients (1.73±1.94). 6. While they were admitted at the internal medicine, depressed medical inpatients frequently recieved antianxiety drugs (80.4%). However, very few of them (9.8%) recieved less than therapeutic dose of antidepressants before psychiatric consultation. After psychiatric consultation, 74.4% of the recieved antidepressant medication and 45.2% of them were followed-up by psychiatric consultants. Psychiatric diagnosis of “depression” was officially adopted on discharge summary for 44.0% of them. 7. Eventually, 80.0% of the depressed medical inpatients who were recommended transfer for psychiatric treatment were transferred to the psychiatric service for proper psychiatric treatment. However, their duration of hosptalization (23.8±14.41 days) was shorter than that of depressed psychiatric inpatients (31.21±21.91 days). These transferred depressed patients who originally seek medical help tends to discharge early as soon as their physical symptoms clear up and before gaining any insight. Those who were recommended out patient clinic followup only 14.3% of them were adequately followed up at outpatient clinic. 8. Findings of this study suggest that most of these patients could be more adequately managed by establishing a psychiatric liasion service at the gastroenterology section of internal medicine in the future.
The Distribution of Fetal Nuchal Translucency Thickness in Normal Korean Fetuses
Han Jung Yul,Kim Moon Young,Choi Kyu Hong,류현미,Chung Jin Hoon,Yang Jae Hyug,Song Mi Jin,Cho Jeong Yeon,Lee Young Ho,Park So Yeon,Choi June Seek,Kim Joo Oh,Shin Joong Sik,Ahn HyunKyong,Lim Ha Jung,Moon 대한의학회 2004 Journal of Korean medical science Vol.19 No.1
The aim of present study was to establish normative data for the distribution of nuchal translucency (NT) thickness in normal Korean fetuses. The data were collected from pregnant women with singleton pregnancies in whom fetal ultrasound was performed and the fetal NT thickness was measured between 11 and 14 weeks of gestation. Among them, a total of 2,577 fetuses with a known normal outcome were included in this study. The distribution of multiple of median (MoM) values of the NT thickness with crown-rump length (CRL) in 10-mm intervals and the 95th percentile of MoM were calculated with the linear regression method. The present study showed that NT measurements increase with increasing CRL and a false positive rate increases with increasing gestational age. Therefore, a fixed cut-off point through the first tri-mester was not appropriate and each NT measurement should be examined accord-ing to the gestational age. The present study offers normative data of the fetal NT thickness in a Korean population, which can be used as reference for screening chro-mosomal aberrations or other congenital abnormalities in the first trimester.
( Su Jung Lee ),( Kyung Tae Noh ),( Tae Heung Kang ),( Hee Dong Han ),( Sung Jae Shin ),( Byoung Yul Soh ),( Jung Hee Park ),( Yong Kyoo Shin ),( Han Wool Kim ),( Cheol Heui Yun ),( Won Sun Park ),( I 생화학분자생물학회 2014 BMB Reports Vol.47 No.2
In this study, we show that Mycobacterium avium subsp. paratuberculosis MAP1305 induces the maturation of bone marrow-derived dendritic cells (BMDCs), a representative antigen presenting cell (APC). MAP1305 protein induces DC maturation and the production of pro-inflammatory cytokines (Interleukin (IL)-6), tumor necrosis factor (TNF)-α, and IL-1β) through Toll like receptor-4 (TLR-4) signaling by directly binding with TLR4. MAP1305 activates the phosphorylation of MAPKs, such as ERK, p38MAPK, and JNK, which is essential for DC maturation. Furthermore, MAP1305-treated DCs transform naive T cells to polarized CD4+ and CD8+ T cells, thus indicating a key role for this protein in the Th1 polarization of the resulting immune response. Taken together, M. avium subsp. Paratuber-culosis MAP1305 is important for the regulation of innate immune response through DC-mediated proliferation of CD4+ and CD8+ T cells. [BMB Reports 2014; 47(2): 115-120]
Suk-Yul Jung,Mi-Jung Ahn,Joo-Yeon Oh,Hae-Seon Nam,Sung-Tae Hong,Yeon-Han Yun,Min Seo 대한기생충학열대의학회 2015 The Korean Journal of Parasitology Vol.53 No.2
At present, more than 500,000 foreigner workers, most of them from Asian countries with high parasitic infection rates, are working in Korea. Since investigation into the prevalence of parasitic infections in foreigner workers has not yet been conducted in Korea, the present study was performed to determine the parasitic infection status of foreigner workers living in Cheonan City, Chungcheongnam-do (Chungnam Province) and to plan, on that basis, effective control measures. From October to December 2013, the parasitic infection status of 231 foreigner workers employed at selected Cheonan-si small businesses was investigated by both stool examination and ELISA. A total of 60 individuals (26.0%) were found to be infected with parasites. The stool examination detected 14 positive cases (6.1%), and ELISA revealed 50 positive people (21.6%), for at least a kind of parasitic disease. The most common infection was cysticercosis (8.7%), followed by toxocariasis (7.8%) and clonorchiasis (7.4%). Since it was proved that parasitic infections were prevalent among foreigner workers living in Cheonan City, more comprehensive study is urgently needed in order to understand the nationwide status of parasitic infections in foreigner workers.
덱스트로메토판과 클로르페니라민 과용으로 인한 세로토닌 증후군 2례
정광율 ( Kwang Yul Jung ),윤성현 ( Sung Hyun Yun ),정현민 ( Hyun Min Jung ),김지혜 ( Ji Hye Kim ),한승백 ( Seung Baik Han ),김준식 ( Jun Sig Kim ),백진휘 ( Jin Hui Paik ) 대한임상독성학회 2013 대한임상독성학회지 Vol.11 No.1
Dextromethorphan and chlorpeniramine are common ingredients of over-the-counter (OTC) cough pills. They are known to be safe when used alone, however, combination with other serotonergic drugs or use of an overdose can cause serotonergic toxicity. We report on a 43-year-old male and a 57-year-old female who ingested an overdose of antitussive drugs containing dextromethorphan and chlorpeniramine. They commonly presented with altered mentality and hyperreflexia on both upper and lower extremities. After conservative therapies, they were discharged with alert mentality. These cases are meaningful in that there are few cases of serotonin syndrome with an overdose of a combination of dextromethorphan and chlorpeniramine. Careful use with medication counseling for OTC cough pills is needed in order to prevent overdose of these ingredients.