1.Communicating about the Middle East respiratory syndrome outbreak to the international community and in-country foreigners, Republic of Korea, 2015
Minwon Lee ; Jooyoung Sohn ; Kidong Park
Western Pacific Surveillance and Response 2016;7(1):28-30
During the Middle East respiratory syndrome (MERS) outbreak in 2015, the Ministry of Health and Welfare (MOHW) of the Republic of Korea provided outbreak information targeting international visitors and foreign residents through multiple channels. The MOHW created a MERS portal website in Korean and English on 10 June 2015; in addition, the existing MOHW website provided English-language press releases beginning 28 May. A toll-free telephone hotline also started service in English on 12 June; it expanded to include 18 other foreign languages on 15 June. This report describes the usage of these multi-language communication channels during this MERS outbreak.
2.A Qualitative Study of Psychological State of Suicide Victims through Suicide Notes.
Keunsoo HAM ; Chuyeon PYO ; Jongpil PARK ; Jooyoung NA ; Seong Ho YOO ; Ena LEE
Korean Journal of Legal Medicine 2014;38(4):155-166
Suicide notes are essential for investigating the psychological state of suicide victims and establishing suicide prevention programs. Since only a few studies have attempted to identify the causes of suicidal behavior through suicide notes, it would be worth examining suicide notes. Quantitative research on suicide has offered a limited understanding of suicide. Results showed that the suicide victims had used the suicide note as a tool for their last communication. Further, in addition to neutral contents such as directions for funeral, the note often contained information about precipitating events that caused the suicidal ideation. Writing a suicide note seemed to help the victims consider concrete plans for suicide. This study proved that qualitative research on suicide notes would be helpful for researchers to understand suicide victims in depth, which cannot be achieved by quantitative methods alone. Based on these results, several suggestions for suicide prevention programs were discussed.
Qualitative Research
;
Suicidal Ideation
;
Suicide*
;
Writing
3.Visual Searching Pattern of Patients with Schizophrenia in the Idea-of-Reference-Provoking Situation.
Seungjin CHOI ; Jooyoung OH ; Il Ho PARK ; Jae Jin KIM
Journal of Korean Neuropsychiatric Association 2014;53(4):195-205
OBJECTIVES: Patients with schizophrenia often present the idea of reference in social situations ; however, the number of research studies examining the nature of the idea of reference and the visual searching pattern in social situations is limited. The aim of this study was to investigate behavioral and visual searching characteristics of patients with schizophrenia in social situations in which the idea of reference can be provoked. METHODS: Eighteen subjects with schizophrenia (eight males) and 18 healthy volunteers (seven males) performed the idea-of-reference-provoking task, which was composed of movie clips with scenes of two women sitting on a bench 1 m away. The participants' reactions were rated using questionnaires for self-reference, malevolent intentions, and anxiety. Visual scan path was monitored during performance of the task. RESULTS: There were significant group differences in the reactions on self-reference, malevolent intentions, and anxiety. The visual searching pattern in patients with schizophrenia was to avoid looking at the women's body area in every movie clip. However, there was no significant difference in the face area in both groups. CONCLUSION: A distinct visual strategy in schizophrenia may affect the self-referential bias and paranoid response. The absence of difference in attention to a core information region (face) may suggest the possibility of inferential errors as well as the cause of self-referential bias and paranoid responses.
Anxiety
;
Bias (Epidemiology)
;
Female
;
Healthy Volunteers
;
Humans
;
Intention
;
Surveys and Questionnaires
;
Schizophrenia*
4.The Relationship between Delirium and Statin Use According to Disease Severity in Patients in the Intensive Care Unit
Jun Yong AN ; Jin Young PARK ; Jaehwa CHO ; Hesun Erin KIM ; Jaesub PARK ; Jooyoung OH
Clinical Psychopharmacology and Neuroscience 2023;21(1):179-187
Objective:
The aim of this study was to investigate the association between the use of statins and the occurrence of delirium in a large cohort of patients in the intensive care unit (ICU), considering disease severity and statin properties.
Methods:
We obtained clinical and demographical information from 3,604 patients admitted to the ICU from January 2013 to April 2020. This included information on daily statin use and delirium state, as assessed by the Confusion Assessment Method for ICU. We used inverse probability of treatment weighting and categorized the patients into four groups based on the Acute Physiology and Chronic Health Evaluation II score (group 1: 0−10 - mild; group 2: 11−20 -mild to moderate; group 3: 21−30 - moderate to severe; group 4: > 30 - severe). We analyzed the association between the use of statin and the occurrence of delirium in each group, while taking into account the properties of statins.
Results:
Comparisons between statin and non-statin patient groups revealed that only in group 2, patients who were administered statin showed significantly higher occurrence of delirium (p = 0.004, odds ratio [OR] = 1.58) compared to the patients who did not receive statin. Regardless of whether statins were lipophilic (p = 0.036, OR = 1.47) or hydrophilic (p = 0.032, OR = 1.84), the occurrence of delirium was higher only in patients from group 2.
Conclusion
The use of statins may be associated with the increases in the risk of delirium occurrence in patients with mild to moderate disease severity, irrespective of statin properties.
5.Quality of Early Depression Management and Long-Term Medical Use: Aspect of Quality Indicatorsfor Outpatients with Depression
Hyun Ho LIM ; Jae Kwang LEE ; Sunyoung PARK ; Jhin Goo CHANG ; Jooyoung OH ; Jaesub PARK ; Jungeun SONG
Mood and Emotion 2023;21(3):95-103
Background:
Depression is a global mental health concern that negatively affects individuals’ health and increases medical costs. This study aimed to assess whether early depression management is cost-beneficial and effective from the perspective of quality indicators.
Methods:
Data of patients newly diagnosed with depressive disorder between 2012 and 2014 as well as follow-up data until 2020 were extracted from the National Health Insurance Service database. Hospitalization, emergency room visits, and annual medical expenses were set as dependent variables to estimate the effect of depression and information on medical expenditures. Six quality indicators developed by the Health Insurance Review and Assessment Service comprised independent variables.
Results:
In total, 465,766 patients were included in this study. Patients who met the quality indicators were more likely to be hospitalized with a psychiatric diagnosis. Furthermore, patients who met the quality indicator of revisiting within 3 weeks of their first visit had greater psychiatric and overall expenses during the early treatment phase; however, the overall expenses gradually decreased over time.
Conclusion
High-quality initial treatment for depression can be cost-effective in the long term; however, further studies are needed to discern its immediate clinical effects.
6.Incidence and Procedure-Related Risk Factors of Delirium in Patients Admitted to an Intensive Care Unit
Jee Seon AHN ; Jooyoung OH ; Jaesub PARK ; Jae Jin KIM ; Jin Young PARK
Korean Journal of Psychosomatic Medicine 2019;27(1):35-41
OBJECTIVES: Although delirium is a common complication among patients hospitalized in intensive care units(ICUs), little is known about the roles that diagnostic and therapeutic procedures play in its development. This study investigates the procedure-related risk factors of delirium in ICU patients. METHODS: All the consecutive patients admitted to the ICU between June 2016 and May 2017 were routinely evaluated for delirium by psychiatrists. In total, 1156 patients met the inclusion criteria and were retrospectively analyzed. A multiple logistic regression analysis was conducted to investigate independent risk factors of delirium development while adjusting for other characteristics. RESULTS: The age, Acute Physiology and Chronic Health Evaluation (APACHE II) score, proportion of patients who had undergone an operation, and proportion of patients who were foley catheterized, mechanically ventilated, and physically restrained were higher in the delirium group. The multiple logistic regression analysis confirmed that the use of restraint was an independent risk factor of delirium (odds ratio : 10.006 ; 95% confidence interval : 6.120–16.360 ; p<0.001). The patient factors independently associated with delirium were an advanced age and a higher APACHE II score. The incidence of delirium was 15.3%. CONCLUSIONS: There is a high prevalence of delirium influenced by potentially harmful procedures in patients in ICU settings. The use of physical restraint had the strongest association with the development of delirium. These findings advocate the need to target procedure-related risk factors such as the use of restraints as preventive intervention measures for ICU delirium.
APACHE
;
Catheters
;
Critical Care
;
Delirium
;
Humans
;
Incidence
;
Intensive Care Units
;
Logistic Models
;
Prevalence
;
Psychiatry
;
Restraint, Physical
;
Retrospective Studies
;
Risk Factors
7.The Current Status of Death Certificate Written in an Academic Hospital and the Degree of Agreement in Interpretation: A Single Center Observational Study.
Daehyun BAEK ; Hanjin CHO ; Sungwoo MOON ; Jonghak PARK ; Juhyun SONG ; Jooyoung KIM ; Seoungho JEON ; Eusang AHN
Journal of the Korean Society of Emergency Medicine 2017;28(4):374-379
PURPOSE: This study aims to review the appropriateness of the issued death certificates and autopsy reports and to evaluate the improvement points of these documents in accordance with the guidelines of the Korean Medical Association and the National Statistical Office. Moreover, this study also examines why the guideline is necessary for the credibility of these documents. METHODS: The death certificates and autopsy reports written by a training hospital were analyzed for a 12-month period, between December 2014 and November 2015. The reference to analysis was the “guidelines to medical certificate 2015” written by the Korean Medical Association, “World Health Organization (WHO) death certificate principle”, and “guideline leaflet,” as provided by the National Statistical Office. Two researchers analyzed the documents that were against the guidelines, and suggested improvement points. The analyzed variables were age, sex, issued date, direct cause of death, manner of death, location of death, and types of accident. The primary goal was to see the rate of issued documents written correctly according to the guidelines and to suggest possible improvement points. The secondary goal was to analyze the reason for accordance and discordance between researchers. RESULTS: There were a total of 603 death certificates and autopsy reports issued during the research period; 562 (93.2%) and 41 (6.8%) cases, respectively. As for the manner of death, 521 cases were “death from disease,” 64 were “external causes,” and 18 were “others or unknown” (86.4%, 10.6%, and 3.0%, respectively). As for the issued department, internal medicine and emergency medicine issued 301 (49.9%) and 126 (20.9%) documents, respectively. Of these, 139 (23.1%) cases were regarded to be in accordance with the guidelines, while 304 (50.4%) were considered to be discordant cases. Among the discordant cases, there were 177 (29.4%) cases that were the mode of death directly written to cause of death. As for the records of “period of occurrence to death” were recorded only 70 (11.7%) cases (including “unknown” 65 cases) and the others were blank. The Kappa number of analysis regarding the evaluation correspondence of the two researchers was 0.44 (95% confidence interval, 0.38 to 0.51). CONCLUSION: The most frequent error was ‘the condition of death to direct cause of death’ with the ratio of 29.4%. This may have been because the rate of concordance between the researchers based on the guidelines was not high enough. There is a need to provide specific guidelines for each case, and also promote and educate regarding significant errors.
Autopsy
;
Cause of Death
;
Death Certificates*
;
Emergency Medicine
;
Internal Medicine
;
Medical Errors
;
Observational Study*
8.Current State of Abdominal Computed Tomography Performed in Emergency Department of a Tertiary University Hospital and Development of a Preliminary Interpretation Checklist.
Junyoung SUH ; Juhyun SONG ; Sungwoo MOON ; Hanjin CHO ; Jonghak PARK ; Jooyoung KIM ; Seoungho JEON ; Jaehyung CHA
Journal of the Korean Society of Emergency Medicine 2016;27(4):336-344
PURPOSE: Abdominal computed tomography (CT) is a widely recognized method to diagnose patients with acute abdominal pain in the emergency departments (EDs). We aimed to investigate the current state and interpretations of abdominal CT performed in the ED of a tertiary university hospital. METHODS: This was a retrospective study based on an abdominal CT database and medical records of patients over 15 years of age, who had visited our ED between January 1 and December 31, 2013. The data collected included CT types, final interpretations, characteristics of the patients, and location of pain at the time of CT. RESULTS: A total of 1,978 abdominal CTs were performed among 1,923 patients during the research period. The most frequent organs involved in the major diagnosis were those in the urinary system, followed by the appendix, liver, large intestine, and gallbladder. The most frequently interpreted diagnoses in these organs were in the order of urinary stone, appendicitis, liver cirrhosis, infectious colitis, and acute cholecystitis. The most frequent location of pain was the right lower quadrant (429 cases, 21.7%), and the most frequently performed CT types were contrast-enhanced abdominal and pelvic CT (1,260 cases, 63.7%). CONCLUSION: Various interpretations were derived based on the abdominal CTs, ranging from critical to mild diseases and from common to rare diseases. Based on this study, we have developed a preliminary interpretation checklist for abdominal CTs.
Abdominal Pain
;
Appendicitis
;
Appendix
;
Checklist*
;
Cholecystitis, Acute
;
Colitis
;
Diagnosis
;
Emergencies*
;
Emergency Service, Hospital*
;
Gallbladder
;
Humans
;
Intestine, Large
;
Liver
;
Liver Cirrhosis
;
Medical Records
;
Methods
;
Rare Diseases
;
Retrospective Studies
;
Tomography, X-Ray Computed
;
Urinary Calculi
9.The Utility of Pleural Fluid Cell IFN-gamma Production Assay in the Diagnosis of Tuberculous Pleurisy.
Jae Seuk PARK ; Youn Seup KIM ; Young Koo JEE ; Kye Young LEE ; Jooyoung CHOI ; Sungae CHO ; Sang Nae CHO
Tuberculosis and Respiratory Diseases 2005;59(2):186-192
BACKGROUND: Diagnosis of tuberculous pleurisy is sometimes difficult using conventional diagnostic methods. We have investigated the utility of pleural fluid cell IFN-gamma production assay in the diagnosis of tuberculous pleurisy. METHODS: We prospectively performed pleural fluid cell IFN-gamma production assay in 39 patients with tuberculous pleural effusions (TPE) and in 26 patients with nontuberculous pleural effusions (NTPE) (13 malignant pleural effusions and 13 parapneumonic effusions). Pleural fluid cells were cultured in DMEM media and stimulated with purified protein derivatives (PPD), and phytohemagglutinin (PHA) for 24 hr. The amount of IFN-gamma released in the culture supernatant was quantitated by IFN-gamma ELISA assay. We have also measured adenosine deaminase (ADA) activities and IFN-gamma concentrations in the pleural fluid. RESULTS: 1) The pleural fluid levels of ADA activity and IFN-gamma concentrations were significantly higher in TPE than NTPE (p<0.01). 2) IFN-gamma production in TPE cells stimulated by PPD (755,266+/-886,636 pg/ml) was significantly higher than NTPE cells (3,509+/-6,980 pg/ml) (p<0.01). By considering the fact that IFN-gamma concentrations over 10,000 pg/ml is a criteria for the diagnosis of TBE, sensitivity and specificity of the test were 97.4 and 92.3%, respectively. 3) The ratios of IFN-gamma production by the stimulation with PPD and PHA (PPD/PHA) were significantly higher in TPE cells (59+/-85) than NTPE cells (5+/-18)(p<0.01). Considering the criteria for the diagnosis of TBE as PPD/PHA ratio over 5, sensitivity and specificity of the test were 76.9 and 92.3%, respectively. CONCLUSION: Pleural fluid cell IFN-gamma production assay may be useful for the diagnosis of tuberculous pleurisy.
Adenosine Deaminase
;
Diagnosis*
;
Enzyme-Linked Immunosorbent Assay
;
Humans
;
Pleural Effusion
;
Pleural Effusion, Malignant
;
Pleurisy
;
Prospective Studies
;
Tuberculosis
;
Tuberculosis, Pleural*
10.A Study on Clinical Variables Contributing to Differentiation of Delirium and Non-Delirium Patients in the ICU
Chanyoung KO ; Jae Jin KIM ; Dongrae CHO ; Jooyoung OH ; Jin Young PARK
Korean Journal of Psychosomatic Medicine 2019;27(2):101-110
OBJECTIVES:
It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium.
METHODS:
Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium.
RESULTS:
There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity.
CONCLUSIONS
The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.