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1.
Article in English | WPRIM | ID: wpr-900687

ABSTRACT

Objectives@#Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. @*Methods@#The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. @*Results@#Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. @*Conclusion@#Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

2.
Article in English | WPRIM | ID: wpr-892983

ABSTRACT

Objectives@#Tic disorder is a neurodevelopmental disorder characterized by multiple involuntary movements of muscles or vocalization. Although tic symptoms subside as the patient ages, some patients suffer from significant functional impairments related to severe tic symptoms. This manuscript aimed to review the latest scientific evidences for the effect of cognitive-behavioral interventions on tic disorder. @*Methods@#The relevant studies were identified by searching medical research databases. We focused our search on studies published between 2000 and 2020 in order to reflect the latest scientific evidence. A total of 821 articles were identified in the initial database search and 27 articles were finally included for the review after the exclusion of duplicated and irrelevant articles. @*Results@#Behavioral therapies including habit reversal training, Comprehensive Behavioral Intervention for Tics, and exposure and response prevention were the most widely studied interventions for tic disorder and are recommended as first-line treatments for tic disorders with high confidence. Cognitive psychophysiologic approaches were also reported to be effective. @*Conclusion@#Further studies are needed to support the future treatment of tics with low-cost and more widely available treatments, in order to ensure better treatment outcomes.

3.
Psychiatry Investigation ; : 1068-1075, 2021.
Article in English | WPRIM | ID: wpr-918730

ABSTRACT

Objective@#This study aimed to identify the central symptoms of late-life depression using network analysis and the item response theory. @*Methods@#A total of 3,472 older adults were enrolled and the Geriatric Depression Scale-15 (GDS-15) was used to evaluate the depressive symptoms. To identify the central symptoms and the network structures among the individual symptoms, the analyses of symptom network structures and item response theory were performed. @*Results@#Among items on the GDS-15, “Happy,” “Hopeless,” “Empty,” “Bored,” “Worthless,” and “Good spirits” showed significantly higher strength centrality than the other symptoms. Among all the edges, the edge between “Empty” and “Bored” was the strongest; however, these two symptoms were not connected strongly to other symptoms. In the analysis of item response theory, “Empty,” “Bored,” “Hopeless,” “Worthless,” “Happy,” “Helpless,” and “Satisfied” presented a very high value on the discrimination parameter. @*Conclusion@#Our study identified the central symptoms and the network structures among symptoms listed on the GDS-15. Most of central symptoms identified by network analysis and item response theory coincided. Our results suggest that these central symptoms need to be prioritized as highly comorbid symptoms and can contribute to the development of a brief screening tool for the elderly.

4.
Article in English | WPRIM | ID: wpr-918154

ABSTRACT

Objectives@#:The characteristics of depressive symptoms in patients with cancer is different from those in control group. However, few research has focused on the association between depressive symptoms in cancer patients. The aim of this study was to compare the network structure of depressive symptoms between patients with cancer and normal control. @*Methods@#:This study was based on cohort data from Korea National Health and Nutrition Examination Survey in 2016-2018. The Patient health Quetionnaire-9 (PHQ-9) was used to assess depressive symptoms in 599 patients with cancer and 599 age-sex matched controls. We estimated network structure of depressive symptom using Isingfit model. @*Results@#:There was no significant difference of each PHQ-9 item score. There were strong associations be-tween symptoms were concentration problem-psychomotor activity, anhedonia-depressed mood, and depressed mood-suicidal ideation in both groups. Strength centrality of worthlessness was significantly higher in patients with cancer. @*Conclusions@#:These results suggest that worthless is associated with other depressive symptoms more tightly in patients with cancer. Worthless can serve as important treatment targets for intervention of depression in patients with cancer.

5.
Endocrinology and Metabolism ; : 1219-1231, 2021.
Article in English | WPRIM | ID: wpr-914238

ABSTRACT

Background@#Dual-energy X-ray absorptiometry (DXA) is the most widely used method for evaluating muscle masses. The aim of this study was to investigate the agreement between muscle mass values assessed by two different DXA systems. @*Methods@#Forty healthy participants (20 men, 20 women; age range, 23 to 71 years) were enrolled. Total and regional body compositional values for fat and lean masses were measured consecutively with two DXA machines, Hologic Horizon and GE Lunar Prodigy. Appendicular lean mass (ALM) was calculated as the sum of the lean mass of four limbs. @*Results@#In both sexes, the ALM values measured by the GE Lunar Prodigy (24.8±4.3 kg in men, 15.8±2.9 kg in women) were significantly higher than those assessed by Hologic Horizon (23.0±4.0 kg in men, 14.8±3.2 kg in women). Furthermore, BMI values or body fat (%), either extremely higher or lower levels, contributed greater differences between two systems. Bland-Altman analyses revealed a significant bias between ALM values assessed by the two systems. Linear regression analyses were performed to develop equations to adjust for systematic differences (men: Horizon ALM [kg]=0.915×Lunar Prodigy ALM [kg]+0.322, R2=0.956; women: Horizon ALM [kg]=1.066×Lunar Prodigy ALM [kg]–2.064, R2=0.952). @*Conclusion@#Although measurements of body composition including muscle mass by the two DXA systems correlated strongly, significant differences were observed. Calibration equations should enable mutual conversion between different DXA systems.

6.
Article in English | WPRIM | ID: wpr-914068

ABSTRACT

Objective@#Attention-deficit/hyperactivity disorder (ADHD) and tic disorder (TD) are among the most common comorbid psychopathologies and have a shared genetic basis. The psychopathological and neurophysiological aspects of the mechanism underlying the comorbidity of both disorders have been investigated, but the pathophysiological aspects remain unclear. Therefore, this study aimed to compare the neurophysiological characteristics of ADHD with those of TD using resting-state electroencephalography and exact low-resolution brain electromagnetic tomography (eLORETA) analysis. @*Methods@#We performed eLORETA analysis based on the resting-state scalp-recorded electrical potential distribution in 34 children with ADHD and 21 age-matched children with TD. Between-group differences in electroencephalography (EEG) current source density in delta, theta, alpha, beta, and gamma bands were investigated in each cortical region. @*Results@#Compared with the TD group, the ADHD group showed significantly increased theta activity in the frontal region (superior frontal gyrus, t = 3.37, p < 0.05; medial frontal gyrus, t = 3.35, p < 0.05). In contrast, children with TD showed decreased posterior alpha activity than those with ADHD (precuneus, t = −3.40, p < 0.05; posterior cingulate gyrus, t = −3.38, p < 0.05). These findings were only significant when the eyes were closed. @*Conclusion@#Increased theta activity in the frontal region is a neurophysiological marker that can distinguish ADHD from TD. Also, reduced posterior alpha activity might represent aberrant inhibitory control. Further research needs to confirm these characteristics by simultaneously measuring EEG-functional magnetic resonance imaging.

7.
Psychiatry Investigation ; : 172-178, 2021.
Article in English | WPRIM | ID: wpr-875358

ABSTRACT

Objective@#This study aimed to develop a brief self-report measure of depressive and anxiety symptoms in victims of sexual violence. @*Methods@#The sample, which consisted of 215 victims and 255 healthy controls, was recruited between December 2016 and November 2018 from eight Sunflower Centers. Eligible items were selected from existing scales of depression (CES-DC and CES-D) and anxiety (SAI-C and BAI) symptoms by item-total correlation coefficients and item response theory (IRT) analysis. Internal consistency coefficients were computed and the receiver operating characteristics curve was inspected to assess the validity of the brief scale and determine optimal cutoff scores. @*Results@#The brief scales showed high internal consistency across all age groups. The optimal cutoff score of brief depression scale was 1.5 for children, 2.5 for adolescents, and 2.5 for the adults. That of brief anxiety scale was 8.5, 6.5, and 3.5, respectively. @*Conclusion@#The results underscore the need for age-appropriate screening measures of depressive and anxiety symptoms in victims of sexual violence.

8.
Article in English | WPRIM | ID: wpr-874547

ABSTRACT

Background@#This phase 3 study evaluated the efficacy and safety of 6-month treatment with romosozumab in Korean postmenopausal women with osteoporosis. @*Methods@#Sixty-seven postmenopausal women with osteoporosis (bone mineral density [BMD] T-scores ≤–2.5 at the lumbar spine, total hip, or femoral neck) were randomized (1:1) to receive monthly subcutaneous injections of romosozumab (210 mg; n=34) or placebo (n=33) for 6 months. @*Results@#At month 6, the difference in the least square (LS) mean percent change from baseline in lumbar spine BMD (primary efficacy endpoint) between the romosozumab (9.5%) and placebo (–0.1%) groups was significant (9.6%; 95% confidence interval, 7.6 to 11.5; P<0.001). The difference in the LS mean percent change from baseline was also significant for total hip and femoral neck BMD (secondary efficacy endpoints). After treatment with romosozumab, the percent change from baseline in procollagen type 1 N-terminal propeptide transiently increased at months 1 and 3, while that in C-terminal telopeptide of type 1 collagen showed a sustained decrease. No events of cancer, hypocalcemia, injection site reaction, positively adjudicated atypical femoral fracture or osteonecrosis of the jaw, or positively adjudicated serious cardiovascular adverse events were observed. At month 9, 17.6% and 2.9% of patients in the romosozumab group developed binding and neutralizing antibodies, respectively. @*Conclusion@#Treatment with romosozumab for 6 months was well tolerated and significantly increased lumbar spine, total hip, and femoral neck BMD compared with placebo in Korean postmenopausal women with osteoporosis (ClinicalTrials.gov identifier NCT02791516).

9.
Article in English | WPRIM | ID: wpr-874538

ABSTRACT

Background@#Glucagon-like peptide-1 (GLP-1) analogues regulate glucose homeostasis and have anti-inflammatory properties, but cause gastrointestinal side effects. The fibroblast growth factor 21 (FGF21) is a hormonal regulator of lipid and glucose metabolism that has poor pharmacokinetic properties, including a short half-life. To overcome these limitations, we investigated the effect of a low-dose combination of a GLP-1 analogue and FGF21 on atherosclerosis-related molecular pathways. @*Methods@#C57BL/6J mice were fed a high-fat diet for 30 weeks followed by an atherogenic diet for 10 weeks and were divided into four groups: control (saline), liraglutide (0.3 mg/kg/day), FGF21 (5 mg/kg/day), and low-dose combination treatment with liraglutide (0.1 mg/kg/day) and FGF21 (2.5 mg/kg/day) (n=6/group) for 6 weeks. The effects of each treatment on various atherogenesisrelated pathways were assessed. @*Results@#Liraglutide, FGF21, and their low-dose combination significantly reduced atheromatous plaque in aorta, decreased weight, glucose, and leptin levels, and increased adiponectin levels. The combination treatment upregulated the hepatic uncoupling protein-1 (UCP1) and Akt1 mRNAs compared with controls. Matric mentalloproteinase-9 (MMP-9), monocyte chemoattractant protein-1 (MCP-1), and intercellular adhesion molecule-1 (ICAM-1) were downregulated and phosphorylated Akt (p-Akt) and phosphorylated extracellular signal-regulated kinase (p-ERK) were upregulated in liver of the liraglutide-alone and combination-treatment groups. The combination therapy also significantly decreased the proliferation of vascular smooth muscle cells. Caspase-3 was increased, whereas MMP-9, ICAM-1, p-Akt, and p-ERK1/2 were downregulated in the liraglutide-alone and combination-treatment groups. @*Conclusion@#Administration of a low-dose GLP-1 analogue and FGF21 combination exerts beneficial effects on critical pathways related to atherosclerosis, suggesting the synergism of the two compounds.

10.
Psychiatry Investigation ; : 275-282, 2020.
Article | WPRIM | ID: wpr-832484

ABSTRACT

Objective@#Situations in which elderly people are the primary caregivers for their grandchildren are becoming more common. Thisstudy aimed to investigate moderating factors of and the association between grandchild care and the grandparents’ perceived health.Financial support in return for grandchild care was also investigated as a moderating factor. @*Methods@#Participants included 357 elderly people over the age of 60 years. The assessment to evaluate the perceived health status andsocial support was performed via a questionnaire. It included questions regarding the care of grandchildren and demographic variables,as well as the Medical Outcome Survey (MOS) 36-item short-form health survey (SF-36), and the MOS Social Support Survey (MOSSSS). @*Results@#The subscale scores of SF-36 and MOS-SSS did not differ significantly for grandchild-care status. However, the subscale scoresof SF-36 were significantly higher in groups that received regular financial support from adult children in return for grandchild carethan in groups that did not. @*Conclusion@#Our data suggest that regular financial support in return for grandchild care may be a moderating factor in the associationbetween grandchild care and the perceived health status of elderly people. These findings have important social implications and warrantfuture study to reveal the psychological mechanism of these associations and enhance the health of elderly individuals.Psychiatry Investig 2020;17(4):275-282

11.
Article in English | WPRIM | ID: wpr-832087

ABSTRACT

Objective@#Habitual snoring is a common problem in children. We evaluated the association between a high risk for sleep-disordered breathing and attention deficit/hyperactivity symptoms. @*Methods@#Parents of 13,560 children aged 6 to 12 years responded to questionnaires including items on habitual snoring and the Korean attention deficit/hyperactivity disorder rating scale. The snoring score comprised the number of “yes” responses to habitual-snoring items, and a high risk for sleep-disordered breathing was defined as a snoring score ≥ 2. @*Results@#The odds ratio (OR) of a high risk for sleep-disordered breathing was significantly higher in boys (OR = 1.47; p < 0.001), overweight children (OR = 2.20; p < 0.001), and children with current secondhand-smoking exposure (OR = 1.38; p < 0.001). The Korean attention deficit/hyperactivity disorder rating scale score increased significantly with the snoring score (0 vs. 1, B = 1.56, p < 0.001; 0 vs. 2, B = 2.44, p< 0.001; 0 vs. 3, B = 2.48, p< 0.001; 0 vs. 4, B = 3.95; p < 0.001). @*Conclusion@#Our study confirms several risk factors of sleep-disordered breathing, namely male sex, overweight, and exposure to tobacco smoking, and found a positive association between habitual snoring and attention deficit/hyperactivity symptoms.

12.
Article | WPRIM | ID: wpr-832064

ABSTRACT

Objective@#Bisphenol A (BPA) is a widely produced synthetic chemical used to manufacture polycarbonate plastics and epoxy resins. We aimed to investigate the association between exposure to BPA and behavioral and cognitive function in children with attention-deficit/hyperactivity disorder (ADHD) and healthy controls. @*Methods@#The study included 444 children aged from 6 to 10 years. The ADHD and control groups included 195 and 249 children, respectively. BPA levels were assessed via urinalysis, while behavior was assessed using the Korean version of the ADHD Rating Scale (K-ARS) and the Behavior Assessment System for Children (BASC-2). Cognitive function was assessed using the Continuous Performance Test (i.e., ADHD Diagnostic System [ADS]). Participants were categorized into tertile groups based on urinary BPA concentration. @*Results@#Scores on the K-ARS and the hyperactivity, aggression, anxiety, and depression subscales of the BASC-2 were significantly different among tertile groups for urinary BPA levels. Scores on visual omission error, commission error, response time variability, and auditory commission error of the ADS were significantly different among three BPA groups. Subgroup analysis revealed that these differences of behavior and cognition among three BPA groups were observed in only boys and normal controls. @*Conclusion@#Exposure to BPA was associated with unfavorable behavioral and cognitive outcomes. Our study extends the findings of previous studies regarding the association between BPA exposure and behavior/cognitive function by including children with ADHD. Further studies are required to determine the mechanisms underlying sex- and group-based differences in these associations.

13.
Article in English | WPRIM | ID: wpr-902983

ABSTRACT

Objectives@#As a protective measure to slow down the transmission of coronavirus disease 2019 in Korea, social distancing was implemented from February 29th , 2020. This study aimed to evaluate the prevalence of domestic incidents and intentional injury during March 2020 when social distancing was in effect. @*Methods@#There were 12,638 patients who visited the Level 1 trauma center of Chungnam province with injuries from domestic incidents, familial discord, and intentional injury. The prevalence of injuries during March 2020 was compared with the average of the previous 5 years, and the average for every March between 2015 and 2019. @*Results@#The prevalence of domestic incidents in March 2020 was significantly higher than the 5-year average, and the average for every March from 2015 to 2019 (p < 0.001). Familial discord (p = 0.002) and intentional injury (p = 0.031) were more frequently observed in March 2020. Adolescents showed a markedly higher level of intentional injury in March 2020 than in both the 5-year average (p = 0.031), and average for every March over the previous 5 years (p = 0.037). @*Conclusion@#The prevalence of domestic incidents and intentional injury were significantly higher during the period of social distancing in Korea. There is a need for social consensus, better policies, and psychological support services, especially if faced with a second or third wave of coronavirus disease.

14.
Article in English | WPRIM | ID: wpr-895279

ABSTRACT

Objectives@#As a protective measure to slow down the transmission of coronavirus disease 2019 in Korea, social distancing was implemented from February 29th , 2020. This study aimed to evaluate the prevalence of domestic incidents and intentional injury during March 2020 when social distancing was in effect. @*Methods@#There were 12,638 patients who visited the Level 1 trauma center of Chungnam province with injuries from domestic incidents, familial discord, and intentional injury. The prevalence of injuries during March 2020 was compared with the average of the previous 5 years, and the average for every March between 2015 and 2019. @*Results@#The prevalence of domestic incidents in March 2020 was significantly higher than the 5-year average, and the average for every March from 2015 to 2019 (p < 0.001). Familial discord (p = 0.002) and intentional injury (p = 0.031) were more frequently observed in March 2020. Adolescents showed a markedly higher level of intentional injury in March 2020 than in both the 5-year average (p = 0.031), and average for every March over the previous 5 years (p = 0.037). @*Conclusion@#The prevalence of domestic incidents and intentional injury were significantly higher during the period of social distancing in Korea. There is a need for social consensus, better policies, and psychological support services, especially if faced with a second or third wave of coronavirus disease.

16.
Article in English | WPRIM | ID: wpr-766030

ABSTRACT

BACKGROUND: Exposure to cigarette smoking (CS) is a major risk factor for the development of lung cancer. CS is known to cause oxidative DNA damage and mutation of tumor-related genes, and these factors are involved in carcinogenesis. 8-Hydroxydeoxyguanosine (8-OHdG) is considered to be a reliable biomarker for oxidative DNA damage. Increased levels of 8-OHdG are associated with a number of pathological conditions, including cancer. There are no reports on the expression of 8-OHdG by immunohistochemistry in non-small cell lung cancer (NSCLC). METHODS: We investigated the expression of 8-OHdG and p53 in 203 NSCLC tissues using immunohistochemistry and correlated it with clinicopathological features including smoking. RESULTS: The expression of 8-OHdG was observed in 83.3% of NSCLC. It was significantly correlated with a low T category, negative lymph node status, never-smoker, and longer overall survival (p < .05) by univariate analysis. But multivariate analysis revealed that 8-OHdG was not an independent prognostic factor for overall survival in NSCLC patients. The aberrant expression of p53 significantly correlated with smoking, male, squamous cell carcinoma, and Ki-67 positivity (p < .05). CONCLUSIONS: The expression of 8-OHdG was associated with good prognostic factors. It was positively correlated with never-smokers in NSCLC, suggesting that oxidative damage of DNA cannot be explained by smoking alone and may depend on complex control mechanisms.


Subject(s)
Carcinogenesis , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , DNA , DNA Damage , Humans , Immunohistochemistry , Lung Neoplasms , Lymph Nodes , Male , Multivariate Analysis , Risk Factors , Smoke , Smoking , Tobacco Products
17.
Psychiatry Investigation ; : 425-432, 2019.
Article in English | WPRIM | ID: wpr-760950

ABSTRACT

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in elementary school children. The present study investigated the characteristics of ADHD in Korean elementary school children using the Korean version of the ADHD Rating Scale (K-ARS). The data was compared with those obtained from a comparable American population. METHODS: Participants included 29,914 elementary school children, aged 6–12 years, from a medium-sized city. The parents completed the home version of the K-ARS. The total and subscale-specific normative data and sex- and age-related mean score differences were analyzed. These data were compared with those obtained from the American population using independent t-tests. RESULTS: Mean total and subscale K-ARS scores were significantly higher among boys (vs. girls) and younger children aged equal to or less than 8 years old (vs. older children). Mean scores on the hyperactivity-impulsivity subscale were lower than those of American children, but similar to another Korean sample. CONCLUSION: Our data characterized ADHD symptoms in Korean children. However, further studies are needed to identify the cultural differences underlying ratings of ADHD symptom severity.


Subject(s)
Child Psychiatry , Child , Cross-Cultural Comparison , Humans , Impulsive Behavior , Neurodevelopmental Disorders , Parents
19.
Psychiatry Investigation ; : 470-475, 2018.
Article in English | WPRIM | ID: wpr-714477

ABSTRACT

OBJECTIVE: We aimed to investigate symptom trajectory of attention-deficit hyperactivity disorder (ADHD) in Korean school-age children. METHODS: Four hundred fifty six elementary school children were enrolled when they were in 1st grade and assessed once per year until 4th grade. Symptom severity was assessed by parents using the Korean version of the ADHD rating scale (K-ARS). High-risk was defined as a K-ARS score >18; 377, 325, and 284 children participated in the subsequent assessments. Symptom trajectory was analyzed using a mixed-model approach consistent with the longitudinal nature of the present study including missing data. RESULTS: K-ARS scores demonstrated significant main effects of time (F=35.33; p < 0.001), sex (F=20.77; p < 0.001), and first-year high-risk group (F=240.90; p<0.001). It also demonstrated a significant time×first-year high-risk group interaction effect (F=38.14; p < 0.001), but not a time×sex interaction effect. CONCLUSION: K-ARS scores demonstrated a tendency to decline with aging. Individuals in the high-risk group demonstrated earlier declining tendency than those in the non-high risk group. Although total K-ARS scores differed significantly between the sexes at all assessments, the declining pattern between both sexes did not differ significantly. Further studies including larger sample sizes, diagnostic interviews, and complete data sets are needed to confirm findings of the present study.


Subject(s)
Aging , Child , Dataset , Humans , Parents , Sample Size
20.
Article in English | WPRIM | ID: wpr-713172

ABSTRACT

BACKGROUND: Thyrotoxicosis is a common disease resulting from an excess of thyroid hormones, which affects many organ systems. The clinical symptoms and signs are relatively nonspecific and can vary depending on age, sex, comorbidities, and the duration and cause of the disease. Several symptom rating scales have been developed in an attempt to assess these symptoms objectively and have been applied to diagnosis or to evaluation of the response to treatment. The aim of this study was to assess the reliability and validity of the Korean version of the hyperthyroidism symptom scale (K-HSS). METHODS: Twenty-eight thyrotoxic patients and 10 healthy subjects completed the K-HSS at baseline and after follow-up at Seoul National University Bundang Hospital. The correlation between K-HSS scores and thyroid function was analyzed. K-HSS scores were compared between baseline and follow-up in patient and control groups. Cronbach's α coefficient was calculated to demonstrate the internal consistency of K-HSS. RESULTS: The mean age of the participants was 34.7±9.8 years and 13 (34.2%) were men. K-HSS scores demonstrated a significant positive correlation with serum free thyroxine concentration and decreased significantly with improved thyroid function. K-HSS scores were highest in subclinically thyrotoxic subjects, lower in patients who were euthyroid after treatment, and lowest in the control group at follow-up, but these differences were not significant. Cronbach's α coefficient for the K-HSS was 0.86. CONCLUSION: The K-HSS is a reliable and valid instrument for evaluating symptoms of thyrotoxicosis in Korean patients.


Subject(s)
Comorbidity , Diagnosis , Follow-Up Studies , Healthy Volunteers , Humans , Hyperthyroidism , Male , Reproducibility of Results , Seoul , Thyroid Gland , Thyroid Hormones , Thyrotoxicosis , Thyroxine , Weights and Measures
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