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To evaluate the associations between cyberbullying behaviors and problematic internetuse, and to compare psychopathologic symptoms in victims, perpetrators, and victims-perpetrators of cyberbullying to those in youths who were not involvedin cyberbullying. A total of 4531 youths (11-14 years of age) were recruited from elementary and middle schools. Among 4531 youths, 9.7% were involved in cyberbullying; 3.3% were only victims; 3.4% were only perpetrators; and 3.0% were victims-perpetrators. Cyberbullying behaviors were associated with problematicinternet use as well as various psychopathologic symptoms. Depressive symptomswere associated with cyberbullying victimization, and rule-breaking behaviorsand aggressive behaviors have relevance to cyberbullying perpetration. Greater attention needs to be paid to identify youths earlier who are involved in cyberbullying and prevent serious adverse consequences in them.
Resilience refers to a person’s ability to successfully adapt to acute stress, trauma or more chronic forms of adversity, maintaining psychological well-being. Recent years have seen a lot of research into the neurobiological factors and mechanism that characterize resilient individuals. It has shown that resilience is mediated by adaptive changes in several neural circuits involving numerous neurotransmitter and molecular pathways. Much more study is required to achieve a deeper understanding the genetic, biological, and psychological underpinnings of resilience, as well as the interactions between these factors. 리질리언스는 삶의 역경을 극복하고 스트레스 이전의 적응수준으로 회복하게 하는 힘 또는 능력이다. 스트레스를 잘 극복하는 신체의 적응 반응으로서 리질리언스의 신경생물학적 기전을 밝히기 위해 최근 많은 연구들이 진행되었다. 그결과 다양한 신경전달물질계, 신경호르몬 인자들, 그리고 관련 신경 회로의 기능이 스트레스에 대한 취약성 또는 저항성과 관련된 여러 생물학적 반응의 조절에 관여함이 밝혀졌다. 향후 리질리언스의 유전적, 생물학적, 심리적 요소의 유기적상호 작용의 기전을 보다 명확히 이해하기 위해서는 다양한방법론을 적용한 통합적 연구의 수행이 필요하다.
Objective: Hyponatremia (serum sodium arbitrarily defined as less than 135 mmol/L) is an increasingly recognized adverse effect of antidepressants such as selective serotonin reuptake inhibitors (SSRIs). This study compared the prevalence of hyponatremia associated with the use of SSRIs to that associated with mirtazapine in patients with major depressive disorder (MDD). Methods: The retrospective study included inpatients with MDD who had been treated with an antidepressant over a period of at least 4 weeks. The medical records of 58 patients treated with a SSRI and those of 48 patients treated with mirtazapine were analyzed. Demographic variables and serum sodium levels (at baseline, week 2, week 4) were compared between SSRI users and mirtazapine users. Results: Four patients (6.9%) from the SSRI group (N = 58) exhibitedhyponatremia during the study period. At week 2, patients treated with a SSRI had lower serum sodium levels than the patients treated with mirtazapine, but at week 4, serum sodium levels did not differ significantly between the two groups. Elderly subjects (60 years and older) in the SSRI group exhibited lower serum sodium levels at weeks 2 and 4. Conclusions: The results indicate that among patients with MDD, SSRI treatment may be associated with decreased serum sodium levels, and that elderly patients are at greater risk for hyponatremia. Further prospective studies would help clarify the relative risks of hyponatremia among various antidepressants, including SSRIs and others. 본 연구에서는 주요 우울장애의 치료에 있어 SRI 군과 mirtazapine 군을 비교하여 약물 투여와 저나트륨혈증과의 연관성을 살펴보고자 하였다. 이를 위해 다양한 요인을 통제한 상황에서 SRI와 mirtazapine 사용간의 저나트륨혈증의 발생 및 혈중 나트륨 수치 변동에 미치는 영향을 비교하였다. 저나트륨혈증의 정의는 135 mol/L 미만으로 정의하고 연구기간 4주 동안 두 군에서 저나트륨혈증의 발생을 조사하였으며, 단변량 공분산분석을 통해 두 군에서 혈중 나트륨 수치가 약물 치료 전후에 차이가 있는지를 비교하였다. 두 군(SRI 군 58명, mirtazapine 군 48명)간의 성별, 나이, BMI, 약물 치료 개시 시점의 혈중 나트륨 수치는 통계적으로 유의한 차이가 없었다. 연구기간 동안 저나트륨혈증의 발생은 SRI 군에서 4명(6.9%) 관찰되었고, mirtazapine 군에서는 관찰되지 않았다. 공분산분석을 통해 혈중 나트륨 기저 수치를 고려한 투여 후 2주 시점의 혈중 나트륨 수치를 비교하였을 때 두 군에서 통계적으로 유의한 차이를 보였다. 또, 고연령(60세 이상), 여성인 경우에 SRI 군은 mirtazapine 군에 비해 투여 후 2주, 4주 시점에서 혈중 나트륨 수치의 감소 소견을 보였다. 고연령은 SRI 사용에 따른 저나트륨혈증의 발생에 위험 요인으로 조사되었다. 본 연구 결과, 주요 우울장애에서 SRI 사용은 mirtazapine에 비해 저나트륨혈증의 발생 및 혈중 나트륨 수치 저하에 유의한 영향을 주며 특히 고연령, 여성의 경우 위험 요인이 될 수 있는 것으로 조사되었다. 본 연구는 예비 연구로 대상자 수가 적고 후향적 의무 기록 조사로서의 여러 제한점을 가지며, 향후에는 다양한 기전의 약물, 좀 더 많은 수의 환자를 포함한 장기간의 대조 연구가 이루어져야 할 것이다.
Objectives: Weevaluated the overall efficacy of fluoxetine and explored factors associated with the response to fluoxetine treatment in child and adolescent outpatients with major depression. Methods: Child and adolescent outpatients with major depressive disorder who had been treated with fluoxetine for at least eight weeks were selected for a retrospective study. The medical records of the subjects (N = 82) were reviewed to determine the details of clinical variables and the efficacy and pharmacological variables of fluoxetine. At eight weeks, Clinical Global Impression (CGI) scores were used to divide the subjects into two groups, i.e., clinical responders and non-responders, and the two groups were compared. Results:Of the 82 patients, 64% (N = 53) responded to fluoxetine treatment. Responders tended to be younger during the treatment period and tended to have had a shorter duration of depressive episodes prior to starting treatment, a lower family loading for depressive illness, and less difficulty in school than non-responders. Other variables did not differ significantly between responders and non-responders. Conclusions: Fluoxetine is effective for the treatment of depressed children and adolescents. Younger age, shorter duration of depressive episodes prior to starting treatment, lower family loading for depressive illness, and less difficulty in school were good predictors of the response to fluoxetine treatment. 본 연구는 후향적 연구 방법을 통해 소아청소년 우울장애에서 fluoxetine 치료에 대한 효능을 조사하고, 그 결과를 통해 fluoxetine의 치료반응과 관련한 인자를 분석하고자 하였다. 주요 우울장애로 진단되어 fluoxetine을 최소 8주 이상 투여 받았던 소아 청소년 외래 환아 82명을 대상으로 의무 기록 검토를 통해 임상적 변인과 fluoxetine 치료 효능을 조사하였다. 대상군을 fluoxetine 투여 후 8주 시점에서의 CGI를 기준으로 반응군과 그렇지 않은 군으로 나누고, 두 군 간의 차이를 비교하였다. 총 대상군의 64.6%(N=53)에서 fluoxetine 치료에 효과가 있는 것으로 조사되었다. 반응군은 그렇지 않은 군에 비해 어린 연령이 많고, 치료 전 우울삽화의 기간이 짧았으며, 기분장애의 가족력과 학교생활의 어려움이 더 적었다. 그 외 다른 변인에서는 두 군 간의 통계적으로 유의한 차이는 없었다. 본 연구 결과 fluoxetine은 소아청소년 우울장애에 효과가 있으며, 어린 연령, 치료 전 우울삽화 기간이 짧고 기분장애의 가족력 및 학교 적응 문제가 없는 경우에 치료 반응이 좋은 것으로 조사되었다.
Objectives: The purpose of this case report is to describe the clinical effectiveness of Korean medicine, especially Jungcheonwhadam-tang and Bopyeoyangyeong-jun, in a patient with chronic thoracic empyema while receiving treatment for this condition. Methods: The patient who had been diagnosed with empyema complained of a cough, with sputum. The patient was diagnosed with pe-ong (肺癰) based on his symptoms and x-ray findings. He was treated with a range of Korean medicines, including a herbal decoction, acupuncture, moxibustion, and cupping. A visual analogue scale and percentage pain reduction scale were administered after treatment. Results: After 20 days of the treatment, the patient's cough decreased by 80%, and sputum decreased by 50%. Conclusion: According to this study, Korean medicine, including Jungcheonwhadam-tang and Bopyeoyangyeong-jun, is effective in the treatment of chronic thoracic empyema.
Multiple randomized, double-blind, placebo-controlled trials have explored the efficacy of pregabalin for the treatment of generalized anxiety disorder(GAD) and this novel drug was recently approved in Europe. Short-term efficacy of pregabalin as a treatment modality for GAD is well supported by the positive results of several placebo-controlled studies, and most studies confirmed that pregabalin is superior to placebo and comparable with lorazepam, alprazolam and venlafaxine for the treatment of patients with GAD. Especially, pregabalin has a rapid speed of onset combined with equal efficacy in treating both psychic and somatic symptoms of GAD. Additionally, pregabalin has demonstrated potential for the prevention of relapses of GAD. Efficacy in the elderly patients was also shown in a separate placebo-controlled study. Pregabalin has a favorable safety and tolerability profiles relative to benzodiazepines and has minimal potential for drug-drug interactions, abuse and dependence. In the future, research should target further elucidating the efficacy of pregabalin for GAD in relapse prevention, long-term treatment and special populations. Additional studies are needed to guide clinicians in practical issues of how best to use pregabalin as a newer option for the pharmacotherapy of GAD.
Objective : Being overweight or obesity impairs quality of life and often causes treatment noncompliance in patients with bipolar disorder. This preliminary study evaluated the prevalence of overweight and obesity in inpatients with bipolar mania. Methods : Inpatients with bipolar mania, who were treated with adequate medications at least 4 weeks were included in a retrospective study. The body weight of each patient was measured and the body mass index (BMI) was calculated. Results : Of the 80 patients, 16.4% (N=13) were overweight, and 35.0% (N=28) were obese at discharge. Female patients had higher prevalence rates of overweight and obesity. Being overweight or obesity was associated with the number of previous episodes of depression and combination treatment with atypical antipsychotics and mood stabilizers. Conclusions : Being overweight or obesity is highly prevalent in patients with bipolar mania. Clinicians should pay more attention to weight gain and obesity when prescribing combination therapies. More research is required to identify the impact of specific risk factors for overweight and obesity in patients with bipolar mania.
Purpose: This study compared the mental symptoms, especially symptoms of posttraumatic stress disorder (PTSD), of women who escaped prostitution, helping activists at shelters, and matched control subjects. Materials and Methods: We assessed 113 female ex-prostitutes who had been living at a shelter, 81 helping activists, and 65 control subjects using self-reporting questionnaires on demographic data, symptoms related to trauma and PTSD, stress-related reactions, and other mental health factors. Results: Female ex-prostitutes had significantly higher stress response, somatization, depression, fatigue, frustration, sleep, smoking and alcohol problems, and more frequent and serious PTSD symptoms than the other 2 groups. Helping activists also had significantly higher tension, sleep and smoking problems, and more frequent and serious PTSD symptoms than control subjects. Conclusion: These findings show that engagement in prostitution may increase the risks of exposure to violence, which may psychologically traumatize not only the prostitutes themselves but also the people who help them, and that the effects of the trauma last for a long time. Future research is needed to develop a method to assess specific factors that may contribute to vicarious trauma of prostitution, and protect field workers of prostitute victims from vicarious trauma.
Objectives: The purpose of this study is to report the clinical effectiveness of Korean medicine, especially Palmijihwang-hwan and Oryung-san, on an alcoholic liver disease patient with fatigue and dizziness. Methods: A patient was treated with Korean medicine, including herbal decoction, acupuncture, moxibustion, and cupping. Then, the patient was asked about his condition every day and underwent liver function tests three times. Results: After 13 days of treatment, fatigue decreased by 80%, and dizziness disappeared on the second day of hospitalization. It also recovered from indigestion and abdominal distension. Conclusions: According to this study, Korean medicine, including Palmijihwang-hwan and Oryung-san, is an effective treatment for symptoms associated with alcoholic liver disease.