Objectives: Severe mental illness has become one of the leading concerns for the cost of health services. This study analyzed the demographic characteristics and compared the patterns of medical health service use according to the diagnosis of severe mental illness, including schizophrenia spectrum disease, bipolar disease, and major depressive disorder. Methods: The data from the National Health Insurance Corporation were analyzed, selecting subjects diagnosed at least once for severe mental illness between 2014 and 2019. Severe mental illness included the following: schizophrenia, schizotypal, and delusional disorders (F20– 29); manic episodes and bipolar affective disorder (F30–31); and moderate depressive episodes with psychotic features and recurrent depressive disorder (F32.3–F33). The demographic factors and patterns of medical services, such as outpatient, hospitalization, and re-admission differences, were compared according to the diagnostic categories. Results: This study included 842459 patients, with 39.6% people in F20–F29, 33.7% in F32.3– F33, and 26.8% in the F30–F31 category. There were significant differences in gender, age, insurance type, Charlson Comorbidity Index score, and economic level according to the diagnostic categories. The engagement of medical health services also showed significant differences among the diagnostic categories. F32.3–F33 showed higher engagement of outpatients than the out-groups, while F20–F29 showed a higher admission rate. The hospitalization duration was significantly longer in F20–F29, and the re-admission rate after discharge within one year was significantly higher in the same group. Conclusion This paper reviewed the differences in medical care utilization among severe mental illness. The result emphasizes the need for a mental health care system broadening to the community, facilitating psychosocial intervention, and case management.

Background and Objectives: The purpose of this study is to evaluate value of diagnostic tool for vocal cord palsy utilizing artificial intelligence without laryngoscopeMaterials and Method A dataset consisting of recordings from patients with unilateral vocal cord paralysis (n=54) as well as normal individuals (n=163). The dataset included prolonged pronunciations of the vowels /ah/, /u/, /i/, and vocal cord data from paralyzed patients. Various acoustic parameters such as Mel-frequency cepstral coefficients, jitter, shimmer, harmonics-to-noise ratio, and fundamental frequency statistics were analyzed. The classification of vocal cord paralysis encompassed paralysis status, paralysis degree, and paralysis location. The deep learning model employed the leave-one-out method, and the feature set with the highest performance was selected using the following methods. Results: Vocal Cord Paralysis Classifier: The classifier accurately distinguished normal voice from vocal cord paralysis, achieving an accuracy and F1 score of 1.0. Paralysis Location Classifier: The classifier accurately differentiated between median and paramedian vocal cord paralysis, achieving an accuracy and micro F1 score of 1.0. Breathiness Degree Classifier: The classifier achieved an accuracy of 0.795 and a mean absolute error of 0.2857 in distinguishing different degrees of breathiness. Conclusion Although the small sample size raises concerns of potential overfitting, this preliminary study highlights distinctive acoustic features in cases of unilateral vocal fold paralysis compared to those of normal individuals. These findings suggest the feasibility of determining the presence, degree, and location of paralysis through the utilization of acoustic parameters. Further research is warranted to validate and expand upon these results.

The herbal formula, DF-02, consisting of Ephedra intermedia and Rheum palmatum are used for the treatment of the metabolic diseases such as obesity and liver fibrosis in Korean local clinics. We aimed to develop the simultaneous analytical conditions for four standards, (+)-pseudoephedrine (PSEP) and (−)-ephedrine (EP) for E. intermedia, and aloe-emodin (AE) and chrysophanol (CP) for R. palmatum using HPLC-UV techniques. The validated conditions yielded the high precision (relative standard deviation (RSD) < 3.65%) and the recoveries (94 – 106%) using the calibration curves with high linearity (R² > 0.9994). As a result, four standards of DF-02 were simultaneously determined under the developed method, which will be utilized for the quality control or evaluation of DF-02 and many herbal preparations containing E. intermedia and R. palmatum.
Calibration ; Chromatography, High Pressure Liquid ; Ephedra ; Liver Cirrhosis ; Metabolic Diseases ; Methods ; Obesity ; Plant Preparations ; Quality Control ; Rheum

BACKGROUND: Recently, noise coming from the neighborhood via floor wall has become a great social problem. The noise between the floors can be a cause of physical and psychological problems, and the different types of floor impact sound (FIS) may have the different effects on the human's body and mind. The purpose of this study is to assess the responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact. METHODS: Ten men and 5 women were enrolled in our study, and the English listening test was performed under the twelve different types of FIS, which were made by the combinations of bang machine (B), tapping machine (T), impact ball (I) and sound-proof mattress (M). The 15 subjects were exposed to each FIS for about 3 min, and the subjective annoyance, performance ability (English listening test), cortisol level of urine/saliva and heart rate variability (HRV) were examined. The sound pressure level (SPL) and frequency of FIS were analyzed. Repeated-measures ANOVA, paired t-test, Wilcoxon signed rank test were performed for data analysis. RESULTS: The SPL of tapping machine (T) was reduced with the soundproof mattress (M) by 3.9–7.3 dBA. Impact ball (I) was higher than other FIS in low frequency (31.5–125 Hz) by 10 dBA, and tapping machine (T) was higher than other FIS in high frequency (2–4 k Hz) by 10 dBA. The subjective annoyance is highest in the combination of bang machine and tapping machine (BT), and next in the tapping machine (T). The English listening score was also lowest in the BT, and next in T. The difference of salivary cortisol levels between various types of FIS was significant (p = 0.003). The change of HRV parameters by the change of FIS types was significant in some parameters, which were total power (TP) (p = 0.004), low frequency (LF) (p = 0.002) and high frequency (HF) (p = 0.011). CONCLUSIONS: These results suggest that the human's subjective and objective responses were different according to FIS types and those combinations.
Female ; Heart Rate ; Humans ; Hydrocortisone ; Male ; Noise ; Pilot Projects* ; Residence Characteristics ; Social Problems ; Statistics as Topic ; Task Performance and Analysis*

PURPOSE: To determine the impact of noise on heart rate variability (HRV) in men, with a focus on the noise type rather than on noise intensity. MATERIALS AND METHODS: Forty college-going male volunteers were enrolled in this study and were randomly divided into four groups according to the type of noise they were exposed to: background, traffic, speech, or mixed (traffic and speech) noise. All groups except the background group (35 dB) were exposed to 45 dB sound pressure levels. We collected data on age, smoking status, alcohol consumption, and disease status from responses to self-reported questionnaires and medical examinations. We also measured HRV parameters and blood pressure levels before and after exposure to noise. The HRV parameters were evaluated while patients remained seated for 5 minutes, and frequency and time domain analyses were then performed. RESULTS: After noise exposure, only the speech noise group showed a reduced low frequency (LF) value, reflecting the activity of both the sympathetic and parasympathetic nervous systems. The low-to-high frequency (LF/HF) ratio, which reflected the activity of the autonomic nervous system (ANS), became more stable, decreasing from 5.21 to 1.37; however, this change was not statistically significant. CONCLUSION: These results indicate that 45 dB(A) of noise, 10 dB(A) higher than background noise, affects the ANS. Additionally, the impact on HRV activity might differ according to the noise quality. Further studies will be required to ascertain the role of noise type.
Adaptation, Psychological ; Confounding Factors (Epidemiology) ; Environment ; Heart Rate/*physiology ; Humans ; Male ; *Noise ; Questionnaires ; Stress, Psychological/physiopathology ; Young Adult

BACKGROUND: Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women. METHODS: We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis. RESULTS: Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (beta=-0.091 [P<0.001] and beta=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (beta=-0.059 [P=0.022] and beta=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985). CONCLUSION: We found that parity prevented hypertension in Korean women.
Adult ; Blood Pressure* ; Female ; Humans ; Hypertension ; Logistic Models ; Menopause ; Nutrition Surveys* ; Parity* ; Pregnancy

BACKGROUND: We investigated whether wogonin and apigenin significantly affect the epidermal growth factor receptor (EGFR) signaling pathway involved in MUC5AC mucin gene expression, and production from cultured airway epithelial cells; this was based on our previous report that apigenin and wogonin suppressed MUC5AC mucin gene expression and production from human airway epithelial cells. METHODS: Confluent NCI-H292 cells were pretreated with wogonin or apigenin for 15 minutes or 24 hours and then stimulated with epidermal growth factor (EGF) for 24 hours or the indicated periods. RESULTS: We found that incubation of NCI-H292 cells with wogonin or apigenin inhibited the phosphorylation of EGFR. The downstream signals of EGFR such as phosphorylation of MEK1/2 and ERK1/2 were also inhibited by wogonin or apigenin. CONCLUSION: The results suggest that wogonin and apigenin inhibits EGFR signaling pathway, which may explain how they inhibit MUC5AC mucin gene expression and production induced by EGF.
Apigenin* ; Epidermal Growth Factor* ; Epithelial Cells* ; Gene Expression* ; Humans ; Mucins* ; Phosphorylation ; Receptor, Epidermal Growth Factor*

BACKGROUND: In this study, we investigated whether lobetyolin, lobetyol, and methyl linoleate derived from Codonopsis pilosula affect MUC5AC mucin secretion, production, and gene expression from airway epithelial cells. METHODS: Confluent NCI-H292 cells were pretreated with lobetyolin, lobetyol, or methyl linoleate for 30 minutes and then stimulated with phorbol 12-myristate 13-acetate (PMA) for 24 hours. The MUC5AC mucin gene expression, and mucin protein production and secretion were measured by reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. RESULTS: Lobetyolin, lobetyol, and methyl linoleate inhibited the gene expression of MUC5AC mucin induced by PMA; lobetyolin did not affect PMA-induced MUC5AC mucin production. However, lobetyol and methyl linoleate inhibited the production of MUC5AC mucin; lobetyolin and lobetyol did not significantly affect PMA-induced MUC5AC mucin secretion from NCI-H292 cells. However, methyl linoleate decreased the MUC5AC mucin secretion. CONCLUSION: These results suggest that among the three compounds, methyl linoleate can regulate gene expression, production, and secretion of MUC5AC mucin by directly acting on the airway epithelial cells.
Codonopsis ; Enzyme-Linked Immunosorbent Assay ; Epithelial Cells* ; Gene Expression* ; Linoleic Acid* ; Mucins* ; Polymerase Chain Reaction ; Reverse Transcription

BACKGROUND: It is valuable to find the potential activity of regulating the excessive mucin secretion by the compounds derived from various medicinal plants. We investigated whether aqueous extract of the root bark of Morus alba L. (AMA), kuwanon E, kuwanon G, mulberrofuran G, and morusin significantly affect the secretion and production of airway mucin using in vivo and in vitro experimental models. METHODS: Effect of AMA was examined on hypersecretion of airway mucin in sulfur dioxide-induced acute bronchitis in rats. Confluent NCI-H292 cells were pretreated with ethanolic extract, kuwanon E, kuwanon G, mulberrofuran G, or morusin for 30 minutes and then stimulated with phorbol 12-myristate 13-acetate (PMA) for 24 hours. The MUC5AC mucin secretion and production were measured by enzyme-linked immunosorbent assay. RESULTS: AMA stimulated the secretion of airway mucin in sulfur dioxide-induced bronchitis rat model; aqueous extract, ethanolic extract, kuwanon E, kuwanon G, mulberrofuran G and morusin inhibited the production of MUC5AC mucin induced by PMA from NCI-H292 cells, respectively. CONCLUSION: These results suggest that extract of the root bark and the natural products derived from Morus alba L. can regulate the secretion and production of airway mucin and, at least in part, explains the folk use of extract of Morus alba L. as mucoregulators in diverse inflammatory pulmonary diseases.
Animals ; Biological Products* ; Bronchitis ; Enzyme-Linked Immunosorbent Assay ; Ethanol ; Lung Diseases ; Models, Animal ; Models, Theoretical ; Morus* ; Mucins* ; Plants, Medicinal ; Rats ; Sulfur

The tarsal tunnel is located beneath the flexor retinaculum, which connects the medial malleolus and calacaneus. The tarsal tunnel contains the posterior tibialis tendon, flexor digitorum longus tendon, posterior tibial artery and vein, posterior tibial nerve, and flexor halluces longus tendon. Tarsal tunnel syndrome is a compressive neuropathy of posterior tibial nerve and its branches under the flexor retinaculum. The etiologies of tarsal tunnel syndrome are space-occupying lesion, hypertrophied flexor retinaculum, osteophytes, tarsal coalition, varicose vein, and trauma. The symptoms are foot pain and hypoesthesia or paresthesia at dermatome according to involving nerve branches. Clinical diagnosis can be obtained from a detailed history and physical examination such as compressive test at the tarsal tunnel area. Ultrasonography and magnetic resonance imaging can reveal the space-occupying lesion, such as ganglion, lipoma, and neuroma. The initial treatments of tarsal tunnel syndrome are conservative management, such as physical therapy, night splint, and steroid injection. Surgical decompression is indicated after failure of conservative managements. Variable results of surgical treatment have been reported. Favorable result after decompression could be obtained from young patients, early onset symptoms, and space-occupying lesion.
Decompression ; Decompression, Surgical ; Diagnosis ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Lipoma ; Magnetic Resonance Imaging ; Neuroma ; Osteophyte ; Paresthesia ; Physical Examination ; Splints ; Tarsal Tunnel Syndrome* ; Tendons ; Tibial Arteries ; Tibial Nerve ; Ultrasonography ; Varicose Veins ; Veins