OBJECTIVE: Weight gain and DM can be serious side effects in the use of atypical antipsychotics (AAP), although conventional antipsychotics (CAP) have also been implicated. Also weight gain & DM are the adverse effects that are often associated with noncompliance and medical problems. The relationship between weight gain, dyslipidemia and DM is well established. Patients with schizophrenia are not only at risk of DM, but also taking antipsychotic medication further increases the chance of developing non-insulin-dependent hyperglycemia. Thus, this pilot study was conducted to investigate the risk of hyperlipidemia & DM in Korean patients taking antipsychotic medications. METHODS: After receiving informed consent, demographic data and history of medication were collected from medical records of 174 inpatients (92 male, 82 female). For the laboratory tests blood sampling was done at 7 A.M. before the meal and medication. RESULTS: For all subjects, the mean age was 41.10+/-9.56 years (range 14-65 years); 88% were diagnosed with schizophrenia. Of these, 55% were treated with antipsychotics alone (Monotherapy) and 45% were treated with combination therapy (such as antipsychotics plus a mood stabilizer). The mean age of onset of illness was 24.8+/-47.25 years old and mean duration of admission was 45.44+/-133.84 months. In the monotherapy group, the duration & dosage of each medications were 42.1+/-60.5 weeks and 12.2+/-8.22 mg/day of haloperidol (N=35), 6.95+/-9.52 weeks & 5.03+/-1.88 mg/day of risperidone (N=19), 9.1+/-11.1 weeks & 13.9+/-6.5 mg/day of olanzapine (N=8), 10.2+/-6.3 weeks and 287.6+/-62.9 mg/day of lodopine (N=4), 15.7+/-9.54 weeks and 335+/-172.8 mg/day of clozapine (N=5), 20+/-22.23 & 620+/-265.9 mg/day of chlorpromazine (CPZ; N=5). Mean weight gains of CAP group and AAP group, which was divided by the main therapeutic drug, were 0.18+/-5.99 and 2.18+/-6.38 kg in total subjects, however, there was no statistical significance between the groups. Moreover, there was no statistically significant difference in weight gain between groups when comparing each individual monotherapy (haloperidol, risperidone, olanzapine, lodopine, clozapine, CPZ: ANOVA; df=5, f=1.12, p=0.35). In the laboratory test results of total subjects abnormality of total cholesterol was 23.6%, triglyceride was 50.6%, fasting blood sugar (FBS) 1.7%, hemoglobin A1c (HbA1c) 27.6%, insulin 3.4%. There were statistical significances of correlations between HbA1c & FBS (r=0.489, p<0.01), total cholesterol (r=0.286, p<0.01), low density lipid (LDL; r=0.299, p<0.01) and triglyceride (TG; r=0.277, p<0.05), high density lipid (HDL; r= -0.192, p<0.05), original weight (r=0.154, p<0.05). With ANOVA for the evaluations of drug effect in monotherapy groups, the level of ALT (SGPT; p=0.04) was higher in olanzapine group, TG was higher in clozapine & CPZ group (p=0.03). HDL was lower in lodopine, clozapine & CPZ group (p=0.01). LDLwas highr in olanzapine & lodopine group (p=0.01). Abnormalities of ALT in olanzapine & clozapine group were 37.5% & 40%, those were statistically significant (p=0.02). Although there was no statistical significance (p=0.05), clozapine (60%), CPZ (60%) & olanzapine (37.5%) groups revealed more abundant abnormalities than haloperidol (11.4%) & risperidone (21%) groups in total cholesterol. CPZ (100%), clozapine (80%), lodopine (75%), olanzapine (75%) groups revealed more abundant abnormalities than haloperidol (48.6%) & risperidone (57.9%) groups in TG, however, there was no statistical significance. And the abnormality of HbA1c was 62.5% in olanzapine group and 40% in CPZ group, those were more abundant than other groups (20-25.1%), even though no statistical significance. CONCLUSION: In the cases of Korean patients taking antipsychotic medication, the tentative risk rate of hyperlipidemia might be 18.3% and hyperglycemia might be 27.6%. CPZ, clozapine and olanzapine, as compared with haloperidol and risperidone, may be associated with more adverse changes in total cholesterol and TG. Olanzapine and CPZ, as compared with haloperidol, risperidone and clozapine, may be more risky in the development of hyperglycemia. HbA1c may be an indicator to detect the risk of hyperlipidemia and hyperglycemia in patients taking antipsychotic medications.
Age of Onset ; Antipsychotic Agents* ; Blood Glucose ; Chlorpromazine ; Cholesterol ; Clozapine ; Dyslipidemias ; Fasting ; Haloperidol ; Humans ; Hyperglycemia* ; Hyperlipidemias* ; Informed Consent ; Inpatients ; Insulin ; Male ; Meals ; Medical Records ; Pilot Projects ; Prevalence* ; Risperidone ; Schizophrenia ; Triglycerides ; Weight Gain

OBJECTIVES: This study investigated whether the lower extremity muscle mass index (LMI) mediates the relationship between general obesity, central obesity, and knee osteoarthritis in middle-aged and elderly women in Korea. METHODS: Data of 2,843 women aged ≥50 years were collected from the Korean National Health and Nutrition Examination Survey conducted between 2009 and 2011. General obesity and central obesity were evaluated based on body mass index (BMI) and waist circumference (WC), calculated through anthropometric measurements and body composition assessments. LMI was calculated by dividing the muscle mass in both legs—measured using the dual-energy X-ray absorptiometry—by body weight. Knee osteoarthritis was defined as a Kellgren-Lawrence scale (KL) grade of ≥2 as assessed through radiographic images. RESULTS: Knee osteoarthritis prevalence, indicated by KL grades, was significantly higher in the general obesity and central obesity groups compared to the normal group, and conversely, lower with varying LMI levels. Using mediation analysis with bootstrapping and adjusting for covariates, we found that LMI mediated the relationship between BMI and KL (β, 0.005; 95% confidence interval [CI], 0.000 to 0.010) and WC and KL grade (β, 0.002; 95% CI, 0.001 to 0.003), explaining 4.8% and 6.7% of the total effects of BMI and WC on KL grade, respectively. CONCLUSIONS The study suggested that LMI partially mediates the link between general obesity and/or central obesity and knee osteoarthritis, proposing that a higher proportion of lower limb muscle mass relative to body weight can alleviate the increased risk of knee osteoarthritis caused by obesity.

PURPOSE: This study was done to identify the effects of human rights sensitivity training on human rights consciousness and attitudes toward the mentally ill by psychiatric mental health nurse. METHODS: A non equivalent control group pre-posttest design was used for this study. The 54 participants were selected from the mental health institute in Y city. The experimental group (n=26) received the interventions 3 times a week for 2 weeks. The evaluation tools were Human Right Consciousness and Community Attitude toward the Mentally Ill (CAMI). Data were analyzed using chi2-test, Fisher's exact test, t-test, paired t-test, repeated measure ANCOVA with the SPSS/WIN 12 program. RESULTS: There was a significant mean change in human rights consciousness in the experimental group. But there was no significant difference in attitudes toward mentally illness. CONCLUSION: The results of the study indicate that the human rights sensitivity program is effective in increasing human rights consciousness of psychiatric mental health nurses. Therefore, this program can be utilized in the field of mental health care services to improve human rights of person with mental illness.
Human Rights* ; Humans ; Mental Health* ; Mentally Ill Persons

OBJECTIVES: In this study, we examined the relationship between attachment style, alexithymia, marital satisfaction, and depressive symptoms in married couples. METHODS: We administered the Korean version of Experiences in Close Relationships questionnaire-Revised (K-ECR-R), Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), Revised-Dyadic Adjustment Scale (R-DAS), Korean version of the Beck Depression Inventory (K-BDI), and to 105 men and 115 women in the community. The data was analyzed with correlation analysis between related variables, and the regression analysis method of Baron and Kenny (1986) was used. RESULTS: The current study assumes that alexithymia mediates between attachment style and marital satisfaction, and these factors influence depressive symptoms. The results were as follows : 1) alexithymia mediated perfectly between attachment anxiety style and marital satisfaction and 2) alexithymia, and marital satisfaction had significant influences on depressive symptoms. Attachment avoidance style was excluded for dissatisfaction with the assumption of the regression analysis method of Baron and Kenny (1986). CONCLUSION: These results suggest that attachment style, alexithymia, and marital satisfaction seem to be important factors in depressive symptoms among married people. These results suggest that different interventions according to attachment style may helpful for the enhancement of marital satisfaction and the reduction of the depressive symptoms of married couples.
Affective Symptoms ; Anxiety ; Depression ; Family Characteristics ; Female ; Humans ; Male

PURPOSE: This study was performed to evaluate the dietary nutrient intake status and hair mineral content of Korean young children. METHODS: Fifty-five children who visited Seoul National University Bundang Hospital were divided into three groups by age: infants, toddlers, and preschoolers. The 24-hour recall method was used to collect the food intake data of the subjects. Hair mineral analysis was conducted using a Mass Spectrometer. Serum iron, ferritin, and calcium were also measured. RESULTS: The mean energy intakes of the subjects were 730.3 kcal, 994.3 kcal, and 1,482.9 kcal for each age group. The mean percentage of energy intake compared to recommendation was 101.4% and was not different by age group. Toddlers of 37.8% and preschoolers of 54.5% consumed less than the Estimated Average Requirement (EAR) of calcium. Infants of 28.6%, toddlers of 10.8% and preschoolers of 9.1% consumed less than the EAR of iron. In the case of zinc, copper, and selenium, only 0% to 5% of toddlers and none of the preschoolers consumed less than the EAR of those minerals. The hair calcium, iron and copper concentrations were lower in toddlers and preschoolers than those in infants. Serum calcium levels of preschoolers were significantly lower than those of infants, whereas serum iron and ferritin levels were not. CONCLUSION: Hair calcium, iron, and copper concentrations were significantly lower in toddlers and preschoolers than in infants. Insufficient dietary intake of calcium and iron seems to be related with decreased hair mineral contents in young children.
Calcium ; Child* ; Copper ; Ear ; Eating ; Energy Intake ; Ferritins ; Hair* ; Humans ; Infant ; Iron ; Methods ; Minerals ; Miners* ; Selenium ; Seoul ; Zinc

This study was performed to evaluate the effect of iron supplement for 4 weeks on iron status, immunity, and antioxidant status of national female soccer players (n = 25). This study was performed at summer hard training period right before competition. A single blind design was used to divide the subjects into iron-supplement (IS) or placebo group (P). Iron-supplement group was supplemented with iron (40 mg/d) for 4 weeks. The mean age of the subjects was 23.3 +/- 2.5 years old. Mean height and body weight of the subjects were 164.4 +/- 5.7 em and 57.4 +/- 4.6 kg, respectively. The mean carrier as soccer player was 11.0 +/- 2.6 years and mean training time was 7.0 +/- 1.3 hr/day. The mean hemoglobin, hematocrit, total iron binding capacity and ferritin concentrations before iron supplementation were not different between two groups. After 4 weeks of summer training and iron supplementation, serum ferritin level was significantly increased only in IS group after supplementation. Mean corpuscular volume and total iron binding capacity were significantly decreased in both groups. Meanwhile, hemoglobin and red blood cell count were significantly lowered only in placebo group. The IgM concentration increased significantly in both groups, but IgG concentration had increasing tendency only in IS group (p<0.064). Therefore, iron supplementation during hard training period may be helpful to improve work capacity of the athletes by improving ferritin status and humoral immune responses.
Anemia ; Athletes ; Body Weight ; Erythrocyte Count ; Erythrocyte Indices ; Female* ; Ferritins ; Hematocrit ; Humans ; Immunity, Humoral ; Immunoglobulin G ; Immunoglobulin M ; Iron* ; Soccer*

Autoimmune hepatitis (AIH) is a chronic liver disease, characterized by elevated levels of transaminases, immunoglobulin G, and positive autoantibodies. The disease course is dynamic and presents heterogeneous disease manifestations at diagnosis. This review summarizes the issues regarding the treatment and monitoring of AIH in adult patients. Glucocorticoids and azathioprine are the first line of treatment. Alternative first-line treatments include budesonide or mycophenolate mofetil (MMF). Although no randomized controlled trials have been performed, MMF, cyclosporine, tacrolimus, 6-mercaptopurine, 6-thioguanine, allopurinol, sirolimus, everolimus, infliximab, or rituximab have been attempted in patients not responding to or intolerant to first-line treatments. Most patients require life-long special monitoring, with or without maintenance treatment.

Objective: We investigated the sleep parameters and clinical factors related to short sleep onset latency (SL) in cancer patients. Methods: We retrospectively reviewed the medical records of 235 cancer patients. Patient Health Questionnaire-9, State and Trait Anxiety Inventory (State subcategory), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep, and Fear of Progression scale scores and sleep related parameters including sleeping pill ingestion time, bedtime, sleep onset time, and wake-up time were collected. We also calculated the duration from sleeping pill ingestion to bedtime, sleep onset time, and wake-up time; duration from wake-up time to bedtime and sleep onset time; and time spent in bed over a 24 hours period. Results: Among patients not taking sleeping pills (n = 145), early wake-up time (adjusted odds ratio [OR]: 0.39, 95% confidence interval [CI] 0.19−0.78), early sleep onset time (OR: 0.50, 95% CI 0.27−0.93), and low ISI score (OR: 0.82, 95% CI 0.71−0.93) were identified as expecting variables for SL ≤ 30 minutes. Longer duration from wake-up time to bedtime (OR: 2.49, 95% CI 1.48−4.18) predicted SL ≤ 30 minutes. Among those taking sleeping pills (n = 90), early sleep onset time (OR: 0.54, 95% CI 0.39−0.76) and short duration from pill ingestion to sleep onset time (OR: 0.05, 95% CI 0.02−0.16) predicted SL ≤ 30 minutes. Conclusion Cancer patients who fell asleep quickly spent less time in bed during the day. Thus, before cancer patients with insomnia are prescribed sleeping pills, their sleep parameters should be examined to improve their SL.