In the year two thousand and following years, there will be tremendous changes in the field of psychiatry. At this critical period, we should rethink the identity of psychiatry. The characteristics and problems of psychiatry in the near future include a) 'mindless' psychiatry confined into the brain cell, b) a continuous evolution of non-psychiatric practitioners, medical or nonmedical, c) the atrophy of psychiatric practice due to economic pressure by society, and d) psychiatric policy of functional diagnostic criteria and guidelines in practice. The above situations can result in a) the more superficial and easy going attitude of psychiatry in practice, b) superficial understanding of patients and inadequate treatment outccome, c) patients' frustration and seeking help from alternative or quasi-practitioners, and tele-psychiatry or cyber space. Psychiatrists' recognition of a crisis, active coping with the problems and harmonized and integrated education were suggested for the better contribution.
Atrophy ; Brain ; Critical Period (Psychology) ; Education ; Frustration ; Humans

Health belief is an important factor influencing the performance of health behaviors. Young adulthood is a critical period to establish health beliefs and behaviors for a healthy life. As health professionals, nurses can help young people establish more positive health beliefs and carry out health behaviors more effectively. But before attempting to help them, it is necessary to identify their health beliefs and behaviors. The purpose of this study was to identify the health beliefs and health behaviors of university students in Korea. Subjects for this study were 2000 students from 10 universities, but data from only 1605 subjects was included in the analysis. Data were collected from May 5th, 1998 to June 21th, 1998. Instruments used in this study were two tools to measure 'health beliefs' and 'performance of health behaviors' that had been developed and used in previous research. Cronbach's alphas were .8737 for the tool for health beliefs and .8385 for the tool for health behaviors. The results of this study are as follows. (1) Average score of the subjects was 117.68 for health belief and 95.15 for performance of health behaviors. (2) There was a significant correlation between the health belief and the performance of health behaviors(r= .419). (3) School year, major, health status, and experience of disease in the students were important factors in the explanation of health belief(28.8%). (4) Health belief, major, health status, school year, sex, age, experience of disease in family members were important factors in the explanation of the performance of health behaviors (21.2%).
Critical Period (Psychology) ; Health Behavior* ; Health Occupations ; Humans ; Korea*

PURPOSE: Allergic diseases are triggered by Th2-mediated immune reactions to allergens and orchestrated by various immunological factors, including immune cells and cytokines. Although many reports have suggested that childhood is the critical period in the onset of allergic diseases and aging leads to alter the susceptibility of an individual to allergic diseases, age-related changes in various immunological factors in healthy individuals as well as their difference between healthy and allergic children have not yet been established. METHODS: We investigated the ratio of Th1/Th2 cells and the levels of 22 allergy-related cytokines across all age groups in individuals who were classified as clinically non-atopic and healthy. We also examined their differences between healthy and allergic children to evaluate immunological changes induced by the development of allergic diseases during childhood. RESULTS: The Th1/Th2 ratio rose gradually during the growth period including childhood, reaching peak values in the twenties-thirties age group. Th1/Th2 ratios were significantly lower in allergic children than in healthy controls, whereas 14 of 22 cytokines were significantly higher in allergic children than in healthy controls. On the other hand, there were no differences in Th1/Th2 ratios and cytokines between healthy and allergic adolescents. CONCLUSIONS: In this study, age-related changes in Th1/Th2 ratios were found in normal controls across all age groups, and decreases in Th1/Th2 ratio were observed with increasing of 14 cytokines in allergic children. The results of this study may be helpful as reference values for both monitoring immunological changes according to aging in healthy individuals and distinguishing between normal and allergic subjects in terms of immune cells and soluble factors.
Adolescent ; Aging ; Allergens ; Child ; Critical Period (Psychology) ; Cytokines ; Hand ; Humans ; Hypersensitivity ; Immunologic Factors* ; Reference Values

IVRO is a popular procedure to setback prognathic mandible. But guided functional physiotherapy after IVRO is the most important factor to get successful result, because there have been some concerns over an openbite tendency following this procedure. The purpose of this study is to evaluate the early adaptability to fuctional phsiotherapy and early openbite tendency associated with the kinds of surgery performed. The study was performed in fifty patients who had received bilateral IVRO from 1993 to 1994. After two weeks of maxillomandibular fixation(MMF), active physiotherapy was carried out according to Park's protocol and detail of openbite tendency was checked. We recorded the number of days for physiotherapy to analzye the adaptability in early physiotherapy until there was no more openbite tendency. The following results were obtained. 1. The adaptability in early physiotherapy to prevent openbite tendency following IVRO was more favorable in two-jaw surgery group than one-jaw surgery group.(p<0.005) 2. The adaptability in early physiotherapy was more favorable in lesser mandibular setback group than larger setback group, but there was no statistical significance. (p<0.05). 3. The adaptability in early physiotherapy was more favorable in posterior impaction group than non-posterior impaction group, but there was no statistical significance.(p<0.05). 4. The cases which MMF was applied again because of the strong openbite tendency were more plentiful in one-jaw surgery group than in two-jaw surgery group. 5. First two or three days after releasing of maxillomandibular fixation might be the critical period to prevent anterior openbite tendency, and if the partient shows strong openbite tendency during this period, 4-5 days of reapplication of MMF was enough to prevent openbite tendency .
Critical Period (Psychology) ; Humans ; Jaw Fixation Techniques ; Mandible ; Open Bite* ; Prognathism*

PURPOSE: To investigate about the influence of acquired strabismus, its angle and stereopsis on visual evoked potential (VEP). METHODS: This study included 30 accommodative esotropes and 30 intermittent exotropes aged 5 to 10, who had not undergone strabismus surgery. Partially accommodative esotropes were excluded. Angle of deviation, stereopsis, and refractve error were measured in all subjects. The values of VEP to monocular and binocular pattern stimulation were recorded. Statistical significances were tested by t-test and Kruskall-Wallis test. RESULTS: In intermittent exotropes, the P100 amplitude of deviating eye was smaller than that of normal eye in the test with 8 X 8 and 16 X 16 check size (p<0.05). There was no significant difference in accommodative esotropes. The P100 latency of binocular VEP using 16 X 16 check size was significantly short in intermittent exotropes, comparing to the normal eye. Angle of deviation and stereopsis did not influence on VEP. CONCLUSIONS: Acquired strabismus occurring beyond the end of the visual critical period can influence on VEP, but angle of deviation and stereopsis could not.
Critical Period (Psychology) ; Depth Perception ; Esotropia* ; Evoked Potentials, Visual ; Exotropia* ; Strabismus ; Telescopes

We compared preoperative binocularity and binocular visual field with postoperative ones in heterotropic patients without any treatment during the critical period for the development of binocular visual function. Nineteen patients were enrolled: seven of them had esotropia and twelve patients had exotropia. All of them showed suppression of deviating eye. The mean preoperative extent of binocular visual field measured by Goldmann perimeter was 112.1 degrees(+/-20.3) in esotropia, 114.4 degrees(+/-9.5) in exotropia. In postoperative Bagolini test, six of esotropic patients (85.7%) and twelve exotropic patients (100%) showed fusion. In Titmus test, one case of esotropic patient (14.3%) showed stereopsis of 100 arc of second while seven cases of exotropic patients(58.3%) showed stereopsis of 100 arc of second or more. Mean postoperative extent of binocular visual field was 113degree(+/-13.5) in esotropia and 112.9degree(+/-7.4) in exotropia. There was no significant difference between pre- and post operative extent of binocular visual field. Conclusively, we suggest the binocularity could be improved by the surgical alignment in adults with long-standing strabismus. We could not observe, however, any significant difference between pre- and postoperative extent of binocular visual field.
Adult ; Critical Period (Psychology) ; Depth Perception ; Esotropia ; Exotropia ; Humans ; Strabismus* ; Telescopes* ; Visual Fields*

OBJECTIVE: Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. METHODS: For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. RESULTS: Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). CONCLUSION: This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods.
Critical Period (Psychology) ; Hospitals, Psychiatric ; Humans ; Japan ; Logistic Models ; Medication Adherence* ; Outpatients* ; Recurrence ; Schizophrenia*

Eye alignment is related with binocular connection in the visual cortex during critical period between postnatal 3 and 5 months. Authers examined horizontal pursuit and latent fixation nystagmus using electronystagmogram(ENG)in 6 year old female patient, who was diagnosed a congenital esotropia showing V patten esodeviation, both inferior oblique overaction, dissociated vertical deviation and head turn. In the pursuit examination, symmetric pursuit was observed under binocular viewing. However asymmetric pursuit was observed with smooth pursuit toward temporo-nasal direction and irregular saccade toward naso-temporal direction under monocular viewing. We could observe jerky nystagmus with decelerating velocity under monocular viewig, direction of which was toward fixating eye and degree of which was increased in abduction and decreased in adduction. The direction of pursuit asymmetry and nystagmus were instantaneously reversed when changing occluding eye. The results of ENG were not changed after successful strabismus surgery. We report a typical case of congenital esotropia as one of oculomotor disorders showing asymmetric pursuit and latent fixation nystagmus, which findings were proved by ENG.
Child ; Critical Period (Psychology) ; Esotropia* ; Female ; Head ; Humans ; Pursuit, Smooth ; Saccades ; Strabismus ; Telescopes ; Visual Cortex

The "Barker hypothesis" postulates that a number of organ structures and associated functions undergo programming during embryonic and fetal life, which determines the set pont of physiological and metabolic responses that carry into adulthood. Hence, stimulus or insult at a critical period of embryonic and fetal development, can result in developmental adaptations that produce permanent structural physiological, and metabolic changes, thereby predisposing an individual to cardiovascular, metabolic and endocrine disease in adult life. This article will provide an evidence linking these disease to fetal undernutrition and an overview of previous studies in this area, the current advances in understanding the mechanism and the role of the placenta in fetal programming.
Adult ; Critical Period (Psychology) ; Embryonic and Fetal Development ; Endocrine System Diseases ; Fetal Development* ; Humans ; Malnutrition ; Placenta

PURPOSE: To investigate the change of the Beta adrenergic system in the rat visual cortex and superior colliculus after visual deprivation during a critical period of postnatal development. METHODS: The changes of beta 1 and beta 2 adrenergic receptor mRNA were investigated by using northern blot analysis in the rat visual cortex and superior colliculus. The right eyelid of visually deprived rat was sutured at the 10th postnatal days. After visual deprivation for 4 weeks, the rat were sacrificed and the visual cortex and superior colliculus tissues were removed for analysis. RESULTS: Beta 1 and beta 2 adrenergic receptor mRNA expression was decreased in the contralateral visual cortex to the deprived eye. In the superior colliculus, beta 2 adrenergic receptor mRNA expression increased in both sides, but a much greater increase was shown in the ipsilateral superior colliculus than the contralateral side. CONCLUSIONS: These results suggests that visual deprivation during a critical period of postnatal development influences the beta adrenergic system in the rat visual cortex and superior colliculus.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Eyelids ; Rats* ; Receptors, Adrenergic ; RNA, Messenger* ; Superior Colliculi* ; Visual Cortex*