OBJECTIVES: Sleep problems has been consistently reported as a suicidal risk factor in adults and, recently, also in adolescents. In this study, dividing study subjects by the previous suicidal behaviors (suicidal vs non-suicidal), we compared the group differences of suicidal risk factors, and examined the possibility of sleep as a suicidal risk factor. METHODS: Study subjects were 561 (271 boys and 290 girls) from a community sample of high school students. Suicidal Risk Behavior Checklist, Center for Epidemiological Study-Depression (CES-D), Symptom Checklist-90-Revision (SCL-90-R) Anxiety and Aggression subscale, Pittsburg Sleep Quality Index (PSQI) were done. RESULTS: Forty six students (8.1%) reported previous actual self-harm behavior as a suicidal attempt, 181 students (32.4%) reported having suicidal thought only. Three hundred thirty four students (59.5%) reported no previous suicidal behavior (thought and attempt, both). Suicidal behavior group showed higher score on risk behaviors such as school violence, substance use and internet addiction. CES-D, SCL-90-R, PSQI showed significant group difference. Logistic regression analysis showed suicidal risk were significantly associated with depression, stress in suicidal risk factors and sleep latency, daytime dysfunction in PSQI. Analysis of variance (ANOVA) shows the most prolonged sleep latency and increased index of all PSQI components except sleep efficiency in suicidal attempt group. CONCLUSIONS: Sleep Problems had a strong association with the suicidal risk behavior in adolescents. Sleep problems, especially, prolonged sleep latency, daytime dysfunction might be important markers for suicidal behavior. Screening for sleep problems in adolescents are encouraged for the parents, school teachers, and related medical physicians.
Adolescent ; Adult ; Aggression ; Anxiety ; Checklist ; Depression ; Humans ; Internet ; Logistic Models ; Mass Screening ; Parents ; Risk Factors ; Risk-Taking ; Suicide ; Violence

We report a case of a 44 year old femele with unilateral aldosterone-proudcing adrenal adenoma characterized by hypertension, plasma aldosterone excess, and low plasma renin, commonly but not invariably with hypokalemia. She also had asymmetric septal hypertrophy of left ventricle established with two-dimensional echocardiography. The electrocardiogram showed inverted T wave and prominent U wave with high QRS voltage on precordial leads. In the case of this patient, we are not sure whether asymmetric septal hypertrophy was caused by secondary hypertension and chronic aldosterone excess of primary aldosteronism, or hypertrophic cardiomyopathy per se, so further long=term follow-up is required to determine it. Following the successful unilateral adrenalectomy, however, the systemic pressure fell down to the normal level and electrolyte abnormalities were corrected immediaterly within a few days and the modest regression in septal hypertrophy was noted in one year, suggesting that the promary aldosteronism contributes to the development or porgression of asymmetric septal hepertrophy.
Adenoma ; Adrenalectomy ; Adult ; Aldosterone ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypertrophy ; Hypokalemia ; Plasma ; Renin

Although ventricular pacing alone initially had deemed adequate for most clinical situations, some patients did not do well after ventricular pacing was initiated, and developed various symptoms attributed to this mode of pacing. The pacemaker syndrome is complex of clinical signs and symptoms related to the adverse hemodynamic and electrophysiologic consequences of ventricular pacing in the absence of other causes. Neurologic symptoms or those congestive heart failure predominated. We recently experienced a case of pacemaker syndrome in a 44-year-old female who had suffered sick sinus syndrome and was implanted with dual chamber pacing system being programmed to VVI pacing. She complained of chest discomfort, dyspnea, and near-fainting in a day after being programmed to VVI. Blood pressure was decreased to 9/60mmHg. Electrocardiography showed toPwave onT wave, representing retrograde ventriculoatrial conduction. The symptoms and signs were disappeared immediately after the pacing system was programmed to DDD pacing.
Adult ; Blood Pressure ; Dichlorodiphenyldichloroethane ; Dyspnea ; Electrocardiography ; Female ; Heart Failure ; Hemodynamics ; Humans ; Neurologic Manifestations ; Sick Sinus Syndrome ; Thorax

PURPOSE: In this study, we examined the difference in the treatment efficacy depending on the sympathetic activity in men with lower urinary tract symptoms (LUTS). METHODS: In the current single-center, retrospective study, we evaluated a total of 66 male patients aged 40-70 years of age, presenting with LUTS, whose International Prostate Symptom Score (IPSS) exceeded 8 points. They had a past 3-month history of taking alfuzosin XL, and their heart rate variability (HRV) was measured before and after the treatment. In addition, we also recruited 39 healthy volunteers who visited a health promotion center for a regular medical check-up. They were aged between 40 and 70 years and had an IPSS of <8 points. We divided the patients with LUTS into two groups: the groups A and B, based on a low frequency/high frequency (LF/HF) ratio of 1.7, which was the mean value of the LF/HF ratio in the healthy volunteers. After a 3-month treatment with alfuzosin XL, we compared treatment outcomes, based on the IPSS and peak urine flow rate, between the two groups. RESULTS: A 3-month treatment with alfuzosin XL, comprising the measurement of the HRV, was performed for the 23 patients of the group A (23/38) and 17 of the group B (17/28). After a 3-month treatment with alfuzosin XL, total IPSS and IPSS questionnaire 2 and 5 were significantly lower in the group A as compared with the group B. But this was not seen in the group B. Furthermore, there were no significant differences in other parameters, such as maximal flow rate and IPSS storage subscore, between the two groups. CONCLUSIONS: Our results indicate that the treatment efficacy was lower in patients with sympathetic hyperactivity as compared with those with sympathetic hypoactivity. Thus, our results will provide a basis for further studies to clarify causes of LUTS in a clinical setting.
Autonomic Nervous System ; Health Promotion ; Healthy Volunteers ; Heart Rate ; Humans ; Lower Urinary Tract Symptoms* ; Male ; Prostate ; Retrospective Studies ; Treatment Outcome*

OBJECTIVES: The objective of this study was to examine the and gender difference between metabolic syndrome and clinical psychiatric characteristics. METHODS: This study was conducted in local habitants who visited one community health service from July to August 2014. 318 local habitants who have not been diagnosed with psychiatric disorders were evaluated using Center for Epidemiological Studies-Depression Scale (CES-D), Reynold Suicidal Ideation Questionnaire (SIQ, Reynolds), Rosenberg Self-Esteem Scale (SES), Korean version of WHO Quality of Life Scale-Abbreviated Version (WHOQOL-BREF), and EuroQol-5 Dimension (EQ-5D). Differences in demographic characteristics of both gender were analyzed. RESULTS: In women, the group with metabolic syndrome showed significantly lower alcohol drinking frequency (p<0.001), educational level (p<0.001) compared to the group without syndrome. Women with metabolic syndrome had lower scores for physical health (p=0.002), environment (p=0.007) on WHOQOL-BREF than those without the syndrome. However, CES-D, EQ-5D, SIQ, Reynolds, and SES show no differences. Among men, no difference was observed in all scales. In addition, in women, logistic regression analysis showed that after adjusting for confounders, metabolic syndrome group had lower score for physical health (p=0.009), environment (p=0.042) on WHOQOL-BREF than the group without syndrome. CONCLUSION: Our study showed an association of metabolic syndrome with poor physical health, environment in women.
Adult* ; Alcohol Drinking ; Community Health Services* ; Depression ; Female ; Humans ; Logistic Models ; Male ; Mental Health* ; Quality of Life ; Suicidal Ideation ; Weights and Measures

For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, 360degrees. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of 360degrees directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.
Humans ; Radiotherapy, Intensity-Modulated

We report two cases of adrenal abscesses that occurred following a Histoacryl(R) (N-butyl-2-cyanocrylate) injection for variceal bleeding. Patients had been diagnosed with alcoholic liver cirrhosis and gastric varices bleeding and received a Histoacryl(R) injection for the variceal bleeding. Patients had fever and abdominal tenderness and were diagnosed with an adrenal abscess at 2 months following the Histoacryl(R) injection. One patient received open drainage and the other underwent percutaneous drainage. When a patient has previously been injected with Histoacryl(R) for the treatment of variceal bleeding and presents with fever, an evaluation for an unusual complication such as adrenal abscess is recommended.
Abscess ; Drainage ; Enbucrilate ; Esophageal and Gastric Varices ; Fever ; Hemorrhage ; Humans ; Liver Cirrhosis, Alcoholic

OBJECTIVES: Nursing is a job with high stress. This study investigated the relationship between temperament and character traits, heart rate variability, and the severity of occupational stress in new nursing employees. METHODS: Ninety-seven nurses newly employed in a Seoul Medical Center from April 2014 to September 2015 were included to the study. Before beginning employment, all subjects were asked to complete a sociodemographic questionnaire and Temperament and Character Inventory (TCI). After they were employed for a month, we administered a heart rate variability test and Korean Occupational Stress Scale (KOSS). RESULTS: Harm avoidance (r=0.334, p=0.001), self-transcendence (r=0.224, p=0.028) and KOSS scores were positively correlated. Self-directedness (r=-0.278, p=0.006) and cooperativeness (r=-0.263, p=0.009) were negatively correlated with KOSS scores. In multiple regression analyses, harm avoidance and cooperativeness were risk factors for severe occupational stress. Physical parameters of total power (r=0.303, p=0.003), very low frequency (VLF ; r=0.318, p=0.002), and standard deviation of the NN interval (r=0.220, p=0.030) were significantly associated with higher KOSS scores. In multiple regression analysis, VLF was significant correlated with KOSS scores. CONCLUSION: Individual factors, such as personality trait or autonomic function, may affect the occupational stress vulnerability on this study. Harm avoidance, cooperativeness in TCI parameters are associated with severity of the occupational stress.
Employment ; Heart Rate* ; Heart* ; Nursing* ; Risk Factors ; Seoul ; Temperament*

BACKGROUND AND OBJECTIVES: Aims of the study were to determine if the somatosensory input influences on vertical perception by comparing the results with the head or body tilted (15Degree to the right and to the left, and to examine the influence of tactile sensation in the perception of verticality in head lateral positions. MATERIALS AND METHOD: We tested 34 normal subjects in their ability to set a straight line to the perceived gravitational vertical. Measurements were taken in static conditions, sitting upright, head tilted (15Degree, body tilted (15Degree, and head lateral positions (90Degree on the right/left sides with or without physical support under the head. RESULTS: The normal range of the subjective visual vertical (SVV) was 0.65Degree/-.23Degreein upright position. The normal ranges of SVV in head-tilts 15Degreeto the left/right sides were -0.47Degree/-.76Degreeand 1.88Degree/-.94Degree which were significantly different from those in upright position (E-effect). But the normal ranges of SVV in body-tilts 15Degreeto the left/right were not different from those in upright position. And the normal ranges of SVV in head lateral positions maintained actively and passively were not different each other, but significantly larger than that in upright position (A-effect). CONCLUSION: Our results support that neck somatosensory input plays a part in the perception of verticality. In contrast, tactile sensation of the head had no effect on the settings of a visual line to visual vertical in head lateral positions.
Head ; Neck ; Otolithic Membrane ; Reference Values ; Sensation

BACKGROUND AND OBJECTIVES: Nasal airflow is asymmetrical and is subjected to spontaneous reciprocal changes which are referred to as the nasal cycle. Limited information is available about how they are affected by allergens. The purpose of this study was to evaluate effects of allergen provocation on the nasal cycle. SUBJECTS AND METHOD: This study was performed in 11 patients with allergic rhinitis and 6 healthy controls. Acoustic rhinometry was used to test subjects before and after the allergen provocation. The subjects underwent acoustic rhinometry in 15 minutes interval for evaluation of nasal cycle and 3 minutes interval for immediate response. RESULTS: With the allergic subjects, 10 of the 11 subjects (90.9%) showed nasal cycle and they still had nasal cycle after the allergen provocation. In the study on the changes of the immediate responses, recovery time was on the average of 33.0 minutes and reduction rate of non-patent side was higher than that of patient side. And the period of nasal cycle was on the average of 173 minutes before the allergen provocation and the average 159 minutes after the allergen provocation; there were no statistical differences. The amplitude of each nasal cycle increased after allergen provocation and the difference had statistical meaning. CONCLUSION: Overall duration and reciprocity of nasal cycle were not changed after the allergen provocation and the amplitude of nasal cycle was increased significantly after the allergen provocation.
Allergens ; Humans ; Nasal Provocation Tests ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinometry, Acoustic