OBJECTIVES: The patient with alcohol dependence needs continuing care in an outpatient treatment setting. This naturalistic retrospective study is the first report investigating the long-term follow-up rate and predictors of outcome in outpatient-based alcoholism treatment in Korea. METHODS: We conducted a chart review of patients, who visited a university-affiliated hospital alcohol clinic from 2005 to 2007. All patients diagnosed with alcohol dependence were enrolled. Patients were evaluated using a customized alcoholism evaluation package. Demographic factors, clinical data and self rating scales were included in the evaluation form. RESULTS: Of 109 patients, 27 (24.8%) adhered to our outpatient-based treatment for 30 months. The mean follow-up duration of participants was 11.1 months. A Kaplan-Meier survival analysis showed that comorbidity, initial treatment on admission, previous treatment history and family history made a significant difference to follow-up duration. Age, sex, alcohol history, motivation, AUDIT-K, BDI, BAI and RTCQ-TV were not significantly associated with follow-up duration. CONCLUSION: Comparing to outcomes of previous inpatient alcohol treatment in Korea, long term follow-up rate in outpatient treatment was superior, and abstinence/controlled drinking rate is not inferior. This finding suggests that outpatient based alcoholism treatment has sufficient efficacy.
Alcoholism ; Comorbidity ; Demography ; Drinking ; Follow-Up Studies ; Humans ; Inpatients ; Korea ; Motivation ; Outpatients ; Retrospective Studies ; Weights and Measures

Phenomenology was founded in the 19th century by Edmund Husserl. Apart from natural sciences and metaphysics, phenomenology is presented as a rigorous scientific discipline, which aims to provide an understanding of the subjective experiences of human beings. After the eras of descriptive and dynamic psychiatry, phenomenological methods were adopted by psychiatry, and phenomenological psychopathology suggested a new perspective for understanding the pathological experiences of psychiatric patients. However, after the development of psychopharmacology and the operational diagnostic system, the center of phenomenology in psychopathology was moved from comprehensive understanding to simple description. Thus, phenomenological psychopathology in its original meaning did not get remarkable repercussions, especially in the English-speaking world. In this article, some major concepts of phenomenology will be briefly presented and then phenomenological psychopathology in its original meaning will be introduced. Secondly, as an example of its application, symptoms of schizophrenia will be interpreted in terms of phenomenological psychopathology. Finally, the authors will present a neurobiological interpretation of the phenomenological psychopathology of schizophrenia and suggest a possible role of phenomenological psychopathology in mitigating the impasse in psychiatric genetics research.
Humans ; Metaphysics ; Natural Science Disciplines ; Neurobiology ; Psychopathology ; Psychopharmacology ; Schizophrenia

Functional magnetic resonance imaging(fMRI) is a promising new imaging technique for functional mapping of cerebral cortex activation ; adequate image post-processing software is not readily available, however, we recently developed such a system based on the use of a personal computer, and evaluated its usefulness. With the cooperation of ten normal volunteers, 24 motor and five visual fMRIs activated by hand movement and photic stimulation, respectively, were performed on a 1.5-T MR unit using the gradient-echo technique(TR/TE/flip angle : 80/60/40degrees, 64X128 matrix). Functional maps were created by image post-processing, which consisted of subtraction, noise elimination by a statistical method, and coloration and overlapping of the images in sequence. All functional maps were successfully obtained. Twenty-four motor activation signals were detected in the sulci around the precentral gyrus, and five visual activation signals in the occipital lobes around the calcarine fissure. The image post-processing system developed in this study was useful for obtaining functional maps of human cerebral cortex activation. In conjunction with this system, fMRI can be successfully performed using a widely available 1.5-T MR unit.
Brain* ; Cerebral Cortex ; Hand ; Healthy Volunteers ; Humans* ; Magnetic Resonance Imaging ; Microcomputers ; Noise ; Occipital Lobe ; Photic Stimulation

OBJECTIVES: Mental health and work efficiency are adversely affected by exposure to physical and chemical hazards in the workplace. This study is the first large scale evaluation of the relationship between physical and chemical hazard exposure in the workplace in relation to the mental health of Korean workers. METHODS: A national survey of a random sample of workers (n=10,043) was conducted between June and September 2006 in Korea. Physical and chemical hazards in the workplace were considered if exposure occurred over more than a quarter of the time spent at work. Mental health problems were defined as work-related depression, anxiety or insomnia. We analyzed whether physical and chemical hazards were independent risk factors for work-related mental health problems by multiple logistic regression analysis after adjusting for age, gender, employment type, education, occupation, duty schedule, work hours, smoking, and alcohol consumption. RESULTS: The mean age of surveyed workers was 42 years and 58% were male. A total of 7.8% of workers had work-related mental health problems. Exposure to high temperature, mist, fumes, dust, chemicals, and radiation were associated with an increased risk of work-related mental health problems. CONCLUSIONS: This study reaffirmed that physical and chemical hazard exposure in the workplace significantly elevates the risk of work-related mental health problems.
Anxiety ; Appointments and Schedules ; Depression ; Dust ; Employment ; Hot Temperature ; Humans ; Korea ; Logistic Models ; Male ; Mental Health ; Occupations ; Risk Factors ; Sleep Initiation and Maintenance Disorders ; Smoke ; Smoking ; Vibration

OBJECTIVES: Children with attention-deficit hyperactivity disorder (ADHD) often have difficulties in social behavior. The aim of this study was to evaluate the effectiveness of a short-term training program for improving social skills, selfperception and attention deficits. METHODS: The subjects were nine children diagnosed with ADHD with (or without) other mental disorders using the Diagnostic Interview Schedule for Children (DISC-ADHD) module. Children were given eight sessions of a social skills training program. Parents of children simultaneously participated in their own training which was designed to support their children's generalization of skills. Assessments included child, parent and teacher ratings of social skills, self-perception and attention deficit at baseline and post-treatment. RESULTS: Social skills training led to significant improvements in child-reported measures of self-esteem, in teacherreported measures of social skills, and in parent-reported measures of attention deficit. CONCLUSION: This study suggests that short-term social skills training programs for children with ADHD may improve their social skills, self-perception and attention deficits.
Appointments and Schedules ; Child ; Generalization (Psychology) ; Humans ; Mental Disorders ; Parents ; Self Concept ; Social Behavior

PURPOSE: Many authors have reported that obesity is a serious health problem in schoolage children and adolescents and recently obese children are increasing. Accurate diagnosis is needed to estimate the prevalence rate and trend of obesity. We studied body mass index(BMI) percentile for age and sex as a reliable and valid screening for adiposity. METHODS: We measured weight and height of 33,329 schoolage children to estimate obesity according to body mass index(weight in kilograms/height in meters2) and different standard weight. We also calculated BMI percentiles according to age and sex. We defined obesity for screening purposes as body mass index(BMI) equal to or in excess of the 95th percentile for age and sex. We also compared the prevalence of obesity according to a different standard weight. RESULTS: The mean value of body mass index(BMI) increases with age and tends to be slightly higher for male than female subjects. The 95th percentiles of body mass index(BMI) ranges from 18.9kg/m2 to 28.2kg/m2 for both males and females. No significant differences were apparent in the mean value of body mass index for each year. CONCLUSION: The percentile curves of body mass index(BMI) will help pediatricians to determine the relative ranking of patients compared with large sample of healthy schoolage children. Further studies are needed to define a useful criteria for defining obesity using body mass index(BMI) in childhood and adolescence. A longitudinal study and nationwide sampling will be required to overcome the limitation of this cross-sectional study.
Adiposity ; Adolescent ; Body Mass Index* ; Child* ; Cross-Sectional Studies ; Diagnosis ; Female ; Humans ; Male ; Mass Screening ; Obesity* ; Prevalence ; Seoul*

OBJECTIVES: The present study aimed at confirming whether the previously reported rabbit vasospasm models are suitable to investigate the mechanisms of vasospasm after subarachnoid hemorrhage(SAH) in human. MATERIALS AND METHODS: Twenty rabbits were divided into 3 groups. The first one was the control group receiving no operation, and the second was the sham operation group, which received injection of 0.5ml/kg normal saline into cisterna magna, and the third was the SAH group, which received injection of 0.5ml/kg autologous arterial blood into the cisterna magna. Vertebrobasilar angiographies were followed up in the 12 rabbits that survived on the 2nd, 9th, and 16th days following the operation(9 rabbits in the SAH group, and 3 rabbits in the sham operation group). Baseline angiograms were obtained two days before the operation. The diameters of basilar artery on each days following the operation were measured and expressed as the percentage reduction compared with the initial basilar artery diameter. In 3 rabbits of the control group, vertebrobasilar angiographies were followed up on the same days as in the operation groups. RESULTS: There was a statistically significant differences in the size of the basilar artery among groups at sixteen days after cisternal injection(p=0.0450). On the second and ninth day after the operations, there was only the trend of the vasospasm of basilar artery(p=0.0687 and p=0.0812). The patterns of vasospasms were quite variable among rabbits. CONCLUSIONS: This study showed that vasospasm developed with the injection of 0.5ml/kg autologous blood injection into the cisterna magna but the pattern of vasospasm did not follow those demonstrated in the previous reports of vasospasm in rabbit models. The mortality rate was lower than previously reported results of other experimental SAH models. These results suggested that studies of the rabbit model should be conducted individually. In order to improve the model for the application to human, the functional study of the spasmodic basilar artery after the injection of autologous blood into the cisterna magna seems mandatory in the rabbits.
Angiography ; Basilar Artery ; Cisterna Magna ; Humans ; Mortality ; Rabbits*

PURPOSE: The pathophysiologic mechanisms and risk factors of renal functional deterioration are still controversial. We analyzed the factors associated with renal failure in children with primary vesicoureteral reflux. METHODS: The medical records of 166 children who were diagnosed with primary vesicoureteral reflux from Jan. 1985 to Dec. 1996 in the Department of Pediatrics, Seoul National University Children's Hospital were reviewed retrospectively. The patients were divided into two groups according to renal function: patients with renal failure(RF group) and patients with normal renal function(NRF group). RESULTS: Eighteen(11%) were classified as RF group, and 16(89%) of them were male. Sixteen (89%) of RF group revealed decreased renal function at the time of diagnosis. There was no past history of documented urinary tract infection in 16(89%) of RF group. Patients of RF group had a higher grade of reflux as compared with those of NRF group. Proteinuria and hypertension were found in 16(89%) and 6(33%) of RF group, respectively, while no NRF patients had proteinuria or hypertension. Renal functional deterioration had progressed to end-stage renal disease in 6(33%) of RF group during a mean follow-up of 4.4+/-2.7(range 0.5-12) years. CONCLUSION: Reflux nephropathy and renal scar in children can be prevented, in some cases, by early diagnosis of vesicoureteral reflux and prophylaxis of urinary tract infection. Regular check up for proteinuria and hypertension is essential for early detection of renal dysfunction. However, in other patients, especially in male, renal dysfunction can develop independently on urinary tract infection.
Child* ; Cicatrix ; Diagnosis ; Early Diagnosis ; Follow-Up Studies ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Medical Records ; Pediatrics ; Proteinuria ; Renal Insufficiency* ; Retrospective Studies ; Risk Factors ; Seoul ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

OBJECTIVES: To date, no population-based epidemiological studies have estimated the association between physical workload (standing or walking, carrying heavy loads, carrying people, repetitive hand or arm movements, wearing protective equipment) and work-related back pain in Korea. The purpose of this study was to evaluate the relationship between physical workload and work-related back pain using a nationwide survey. METHODS: We analyzed data obtained from working men and women age 15 to 64 (n=10,043) who participated in the 2006 national working condition survey of random sample workers in Korea. Using both simple and multiple logistic regression analysis, the association between physical workload and work-related back pain was evaluated. RESULTS: Carrying heavy loads, repetitive hand or arm movements, and wearing protective equipment were associated with an increased risk of work-related back pain. CONCLUSIONS: This study identifies that an increased risk of work-related back pain related to the nature and intensity of the physical workload of the general working population in Korea. We also found a strong association between repetitive hand or arm movements and back pain.
Arm ; Back Pain ; Female ; Hand ; Humans ; Korea ; Lifting ; Logistic Models ; Male ; Walking

PURPOSE: Prognosis of locally advanced inoperable non-small cell lung cancer (NSCLC) treated with radiation therapy alone has been disappointing. In recent years, concurrent chemoradiation therapy has potential of improving both local and metastatic disease-free survival. This phase II study was undertaken to determine the feasibility, toxicity, response rate, local control rate, and survival duration of locally advanced NSCL patients treated with concurrent chemoradiation using cisplatin and oral etoposide. MATERIAL AND METHODS: Forty-seven patients were enrolled and forty-one patients were evaluable. Chemotheray consisted of cisplatin 50 mg/m2/IV on days 1 and 8 and oral etoposide 100 mg/day on days 1 to 5 and 8 to 12 which was repeated, every 4 weeks for two cycles during radiation therapy. Radiation therapy was administered to a total dose of 6300 cGY. RESULTS: Among 41 evaluable patients, six patients achieved complete response, and twenty had partial response, for an overall response rate of 63.4% (95% confidence interval; 48.4% to 75.4%). Stable disease was reported in 10 patients (24.4%) and another 5 (12.2%) showed disease pro gression. Overall survival rate was 76% at 1 year, 34% at 2 years. Median survival duration was 17 months (range; 3 to 41 ). Eighty-three percents of patients had radiation pneumonitis but only one patients needed medical treatment. CONCLUSION: Concurrent chemoradiation therapy with cisplatin and oral etoposide at this level is a well tolerated and feasible.
Carcinoma, Non-Small-Cell Lung* ; Cisplatin* ; Disease-Free Survival ; Etoposide* ; Humans ; Prognosis ; Radiation Pneumonitis ; Survival Rate