Effects of Positive Psychological Resources on the Relationship Between Adverse Childhood Experiences and Depressive Symptoms in University Students / 우울ㆍ조울병

Background@#This study was conducted to examine the effect of adverse childhood experiences on depressive symptoms in university students and to verify whether positive psychological resources act as a protective factor for depression. @*Methods@#Data from 1,317 young adults aged 18-29 years who took part in the university-based cross-sectional survey were analyzed. All participants completed self-report questionnaires that included demographic variables, the Adverse Childhood Experience (ACE) Scale, the Patient Health Questionnaire-9, and the Positive Resources Test. @*Results@#The incidence of depression was 33.3% and was higher in women than in men. Based on the 10 ACE categories, 32.7% of the students reported one or more adverse childhood experiences, and 14.4% reported two or more forms of adverse childhood experiences. Students with depressive symptoms were likely to report more traumatic experiences in childhood and fewer positive psychological resources than those without depressive symptoms. Hierarchical regression analysis indicated that positive psychological resources moderated the relationship between adverse childhood experiences and depression. @*Conclusion@#Based on these results, professionals should consider identifying adverse childhood experiences early and provide active mental health service support, including positive psychological and social resources for individuals who have adverse experiences during childhood.

The Moderating Effects of Accurate Expectations of Lethality in the Relationships between Suicide Intent and Medical Lethality on Suicide Attempts

Objective@#The purpose of this study was to explore the accuracy of expectation of medical lethality and to identify characteristics related to high medical lethality in suicide attempters. @*Methods@#A total of 370 suicide attempters (173 men, 197 women) who visited the emergency department at one university hospital were interviewed. @*Results@#Using the Lethality Scale, 103 (27.8%), 114 (30.8%), and 153 (41.4%) suicide attempters were assigned to the low, medium, and high medical lethality groups, respectively. The medium and high medical lethality groups were older, and reported poorer socioenvironmental conditions, compared with the low lethality group. Higher levels of suicide intent were associated with more lethal attempts but only for those attempters who had accurate expectations of the medical lethality of their attempts. @*Conclusion@#The accuracy of expectations about the likelihood of dying was found to moderate the relationships between suicide intent and medical lethality.

Association between Maternal Adverse Childhood Experiences and Risk of Post-traumatic Stress Disorder in the Offspring

Objectives@#Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. @*Methods@#A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. @*Results@#Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). @*Conclusion@#Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

Association between Maternal Adverse Childhood Experiences and Risk of Post-traumatic Stress Disorder in the Offspring

Objectives@#Adverse childhood experiences (ACEs) of mothers may negatively affect the mental health of their offspring. Little is known about the intergenerational effect of maternal ACE on post-traumatic stress disorder (PTSD) in the offspring. This study investigated the impact of maternal ACEs on PTSD in the offspring. @*Methods@#A total of 156 mothers with children aged 13–18 years completed the Diagnostic Interview Schedule for Children (DISC) Predictive Scales to determine the presence of psychiatric disorders in their offspring. The subjects completed the ACE questionnaire and the Early Trauma Inventory Self-Report-Short Form. Multivariable logistic regression was used to analyze the relationship between maternal ACEs and PTSD in the offspring. @*Results@#Of the mothers, 23.7% had at least one ACE, and PTSD was reported in 21.8% of the offspring. The offspring of the mothers in the ACE group had a significantly higher rates of traumatic experiences and PTSD than the offspring of the mothers in the no ACE group. Maternal household dysfunction independently predicted offspring PTSD [odds ratio (OR)=3.008, p=0.05), and three or more maternal ACEs were significantly related to PTSD in the offspring (OR=10.613, p=0.025). @*Conclusion@#Maternal ACEs have a significant impact on the risk of traumatic experiences and PTSD in the offspring. These findings suggest the presence of intergenerational transmissions by which maternal ACEs affect the mental health of the offspring.

The Association between Childhood Traumatic Experiences and Suicidality in College Students / 우울ㆍ조울병

Background@#To address the high suicide rate in Korea, determining the suicidality risk factors is a key concern in policymaking and prevention. This study aimed to describe the effects of traumatic childhood experiences on suicidality among young adults. @*Methods@#This study included 1,379 subjects from two universities in Jeju, Korea. All participants completed selfadministered questionnaires that included demographic variables, the Adverse Childhood Experiences (ACE) scale to evaluate traumatic childhood experiences, and a Korean version of the Suicide Module of the Mini International Neuropsychiatric Interview to evaluate suicidality. @*Results@#Of the subjects, 33.2% reported experiencing traumatic childhood experiences, and the prevalence of positive suicidality was 21.8%. Regression analyses indicated a significant association between traumatic childhood experiences and positive suicidality after controlling for multiple variables. Furthermore, subjects with positive suicidality were likely to report experiencing more traumatic childhood experiences (p<0.001). After categorizing the subjects into two groups according to ACE score, the positive ACE group showed a higher risk of suicidal ideation (p<0.001, adjusted odds ratio [AOR]=2.09) and suicidal attempt (p<0.001, AOR=4.15) than those negative ACE. @*Conclusion@#Intervention and practical strategies for college students with a history of traumatic childhood experiences must be considered for suicide prevention.

Clinical significance of abnormal chest radiographic findings for acute kidney injury in patients with scrub typhus

Background@#Abnormal chest radiographs are frequently encountered in patients with scrub typhus. This study aimed to investigate whether chest radiography on admission is significant as a predictive factor for acute kidney injury (AKI) in patients with scrub typhus. @*Methods@#From 2010 to 2016, 467 patients were diagnosed with scrub typhus in our hospital. We divided the patients into two groups: normal chest radiograph (NCR) and abnormal chest radiograph (AbNCR), based on chest radiography findings. The incidence, clinical characteristics, and severity of AKI were compared between AKI and non- AKI groups according to the RIFLE classification. @*Results@#Of the 467 patients, 96 (20.6%) constituted the AbNCR group. Compared with NCR patients, AbNCR patients were older (71 ± 11 vs. 62 ± 13 years, P < 0.001) and had higher total leukocyte counts (9.43 × 103/mL vs. 6.98 × 103/mL, P < 0.001). The AbNCR group had significantly longer duration of hospital stay (8.9 ± 5.5 vs. 6.3 ± 2.8 days, P < 0.001) and higher incidence of AKI (46.9% vs. 15.1%, P < 0.001). The common abnormal chest radiographic findings were pulmonary abnormalities, such as pulmonary congestion and pleural effusion. The overall AKI incidence was 21.6%, of which 12.4%, 7.9%, and 1.3% cases were classified as risk, injury, and failure, respectively. In a multivariable logistic regression analysis for association with AKI, old age, presence of chronic kidney disease or hypertension, leukocytosis, hypoalbuminemia, and chest radiographic abnormalities on admission were significant predictors of AKI. @*Conclusion@#Chest radiographic abnormalities on admission were independently associated with AKI in patients with scrub typhus.

Association between Social Anxiety Symptoms and Suicidal Risk in College Students / 우울ㆍ조울병

BACKGROUND: Social anxiety and suicide are serious common problems in college students. However, there are few studies on the relationship between social anxiety symptoms and suicidal risk. Therefore, we evaluated the associationbetween social anxiety symptoms and suicidal risk in college students.METHODS: A total of 579 college students were recruited for a college-based cross-sectional survey in the Jeju area. The participants completed a questionnaire gathering sociodemographic information; they also completed the Korean Social Avoidance and Distress Scale (SADS) to assess social anxiety symptoms and the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms. To obtain information regarding suicidal risk, we administered the Korean version of the Suicide module of the Mini International Neuropsychiatric Interview (M.I.N.I.).RESULTS: The prevalence of higher levels of social anxiety symptoms among college students was 28.0% (n=162). A higher level of social anxiety symptoms resulted in a 2.10-times higher suicidal risk after adjusting for depression in college students (95% confidence interval, 1.05-4.23; p=0.037).CONCLUSION: Based on the results of this study, social anxiety symptoms should be managed and controlled to prevent suicidality in Korean college students.

Factors associated with Bullying in College Students / 우울ㆍ조울병

BACKGROUND: School bullying is considered the most common type of bullying, and bullying related to stressful relationships is a significant risk factor for college students' depression and suicide. However, bullying is often overlooked in college students. Therefore, we investigated the prevalence of peer victimization in Korean college students and identified factors associated with bullying victimization.METHODS: From the Jeju area, 941 college students were included in this study. The students were divided into two groups according to whether they had experienced bullying. Sociodemographic and clinical characteristics, including depression (Beck Depression Inventory) and health-related conditions, were compared between groups.RESULTS: In total, 82 students (8.7%) reported being bullied by other students. Factors associated with bullying were low socioeconomic status (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.10–3.64), obesity (OR, 2.20; 95% CI, 1.13–4.29), body dissatisfaction (OR, 3.92; 95% CI, 2.36–6.50), and depression (OR, 2.42; 95% CI, 1.53–3.85).CONCLUSION: Our findings might have important implications for development of strategies and interventions to prevent bullying among college students.

Prevalence and Associated Factors of Post-traumatic Stress Disorder in Gangjeong Village Residents, Jeju-do / 신경정신의학

OBJECTIVES@#Most studies on post-traumatic stress disorder (PTSD) have involved a small sample size and a specific traumatic event, with few studies reporting on subjects who have been continuously exposed to a traumatic event. Timely assessment and treatment are crucial for individuals chronically exposed to a traumatic event. Therefore, this study investigated the prevalence of PTSD and associated factors in all residents of Gangjeong village, who, recently, have been exposed to a traumatic event for a prolonged period.@*METHODS@#The subjects of this study were the residents of Gangjeong village, who have been exposed to a traumatic event related to the construction of the Jeju Civilian-Military Complex Port. The survey included items related to general characteristics and PTSD symptoms, which were assessed using the Impact of Event Scale-Revised, Korean version.@*RESULTS@#The prevalence of PTSD symptoms was 26.8% (95% confidence interval=23.54–30.04). Multivariate logistic regression analysis identified age, length of residence, and marital status as factors significantly associated with PTSD symptoms.@*CONCLUSION@#The prevalence of PTSD symptoms was higher among the study population than in the general population. Economically active age groups, people exposed to the traumatic event throughout their duration of residence in the village, and unmarried individuals were found to be more likely to develop PTSD symptoms. Mental, social, and financial support should be directed to the affected groups of individuals.

Peritoneal Dialysis-associated Peritonitis Caused by Chryseobacterium indologenes / 대한내과학회지

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.

The Effect of Traumatic Experiences in Childhood on Depressive Symptoms for College Students : Focusing on the Moderating Effects of Positive Psychological Resources / 우울ㆍ조울병

OBJECTIVES: The purpose of this study was to examine effects of traumatic experiences in childhood, on depressive symptoms of college students, and to determine how depression depended on positive psychological resources.METHODS: A total of 430 students were recruited, from two universities in Jeju area. All participants completed self-report questionnaires, that included demographic variables, Adverse Childhood Experience (ACE) Scale, Patient Health Questionnaire-9, and Positive Resources Test (POREST).RESULTS: Prevalence of depression was 47.9%, and a total of 133 (30.9%) college students reported traumatic experiences in childhood. Students with depressive symptoms, were likely to report more traumatic experiences in childhood, and less positive psychological resources. Results from regression analyses indicated that, while controlling for a range of demographic variables, positive psychological resources moderated the association, between traumatic experiences in childhood and depression.CONCLUSION: Based on results, professionals must consider positive psychological and social resources, for treatment to reduce depressive symptoms in patients with history of childhood adversity.

Peritoneal Dialysis-associated Peritonitis Caused by Chryseobacterium indologenes / 대한내과학회지

Chryseobacterium indologenes (C. indologenes) is a nonmotile, gram-negative bacillus that is widely distributed in nature. Generally considered nonpathogenic, C. indologenes rarely infects humans and is not normally present in the human microflora. C. indologenes infections have been observed in cases of peritoneal dialysis (PD)-associated peritonitis, although the incidence of these infections is low. Although C. indologenes is generally susceptible to trimethoprim-sulfamethoxazole, levofloxacin, ciprofloxacin, piperacillin-tazobactam, and cefepime, no guidelines have been established for the treatment of PD-associated peritonitis. Here we report the first case of PD-associated peritonitis in Korea with C. indologenes identified as the sole etiologic agent. The patient recovered after intraperitoneal antibiotic treatment without the need for Tenckhoff catheter removal.

A Case of Methanol Poisoning Treated with Continuous Renal Replacement Therapy: The Serial Measurements of Serum Methanol Concentrations in Methanol Poisoning

Methanol poisoning is a medical emergency that requires rapid elimination of the toxin and its metabolites for recovery. The danger of methanol results from the accumulation of its toxic metabolite formic acid. This accumulation may result in the development of metabolic acidosis, visual impairment, and damage to the basal ganglia. Extracorporeal treatment is recommended in severe cases of methanol poisoning with coma, seizure, new vision deficits, metabolic acidosis, high serum anion gap, elevated methanol concentrations or impaired kidney function. Although the serum methanol concentration is helpful in determining the use of extracorporeal treatment, methanol assays are not standard laboratory tests in Korea. Herein, we report a case of methanol poisoning in which the patient's clinical improvement was confirmed using serum and urine methanol levels.

Acute interstitial nephritis induced by Solanum nigrum

Acute interstitial nephritis (AIN) is an important cause of reversible acute kidney injury and pathologically characterized by inflammatory infiltrate in the renal interstitium. Solanum nigrum (S. nigrum) is a medicinal plant member of the Solanaceae family. Although S. nigrum has been traditionally used to treat various ailments such as pain, inflammation, and fever, it has also been reported to have a toxic effect, resulting in anticholinergic symptoms. However, there have been no reports of AIN caused by S. nigrum. Here, we report the first case of biopsy-confirmed AIN after ingestion of S. nigrum. The patient was successfully treated using corticosteroid therapy.

Predictability of Complete Blood Count Parameters for Heavy Drinking according to the Facial Flushing

BACKGROUND: Alcohol is personal and social problem around the world. Though binge drinking is associated with the elevation of arbohydrate deficient trasnferrin and r-glutamyl transpeptidase, studies of the relationship between heavy drinking and other biological markers are rare. The purpose of this study is to investigate the association between heavy drinking and CBC figures through flushing and non flushing using both NIAAA and Korean guidelines. METHODS: The subjects were 581 Korean adult males: who had undergone a comprehensive medical evaluation at Chungnam National University Hospital between June and December of 2013. 98 of total were non-drinkers, 225 of them flushers, and the rest 258 of them were non-flushers. One standard drink is defined as any drink that contains 14 grams of alcohol. Criteria for immoderate drinking was applied to greater than 14 glasses/week and more than 8 glasses on any day for a non-flush group with reference to the United States' guideline (National Institute in Alcohol Abuse and Alcoholism, NIAAA) and South Korean guideline, and it was also applied to greater than seven glasses/week, and more than four glasses on any day for a flushing group. It was to investigate whether immoderate drinking would be predictable according to increased mean corpuscular volume (MCV), decreased hemoglobin (Hb), and decreased platelet (PLT). Our investigation was to find the correlation with the increased MCV, decreased Hb, and decreased PLT as a means of predictions for immoderate drinking. The study was to examine the CBC's predictability of immoderate drinking through a combination of increased MCV, decreased Hb, or decreased PLT. If one of these three items were abnormal: group A, if two of the three items were abnormal: group B. RESULTS: Predictability of group A was 23.1% in flushing drinkers and 21.7% in non-flushing drinkers for US NIAAA immoderate drinking, whereas 30.8% in flushing drinkers and 30.4% in non-flushing drinkers considering Korean guideline immoderate drinking. Predictability of B group was 100% in flushing and non-flushing drinkers for both NIAAA guidelines and Korean guidelines. CONCLUSIONS: It is desirable for physicians to use any combination of the three CBC indicators (increased MCV, decreased Hb, or decreased PLT) for predicting immoderate drinking.

Case of Follicular Bronchiolitis in Rheumatoid Arthritis

Follicular bronchiolitis is an uncommon bronchiolar disorder that is characterized by the presence of hyperplastic lymphoid follicles with reactive germinal centers. The condition is associated with connective tissue diseases such as rheumatoid arthritis, Sjögren’s syndrome, and immunodeficiency disorders. A 56-year-old man with rheumatoid arthritis was admitted to hospital with a progressively enlarging pulmonary nodule in the left upper lobe. A follow-up contrast tomography scan showed that the nodule had increased in size from 4.2 mm to 6.3 mm over a 3 month period. An open lung biopsy was performed to establish a definite pathologic diagnosis of the pulmonary nodule, which was suspected to be a lung malignancy. The nodule was diagnosed as follicular bronchiolitis based on the histopathology findings. We describe a patient with follicular bronchiolitis that was confirmed by an open lung biopsy, and is believed to have had rheumatoid involvement.

Relationship between Neck Length, Sleep, and Cardiovascular Risk Factors / 가정의학회지

BACKGROUND: Neck circumference, as a predicator of obesity, is a well-known risk factor for obstructive sleep apnea and cardiovascular diseases. However, little research exists on neck length associated with these factors. This study explored the association of neck length with sleep and cardiovascular risk factors by measuring midline neck length (MNL) and lateral neck length (LNL). METHODS: We examined 240 patients aged 30 to 75 years who visited a health check-up center between January 2012 and July 2012. Patients with depressive disorder or sleep disturbance were excluded from this study. MNL from the upper margin of the hyoid bone to the jugular notch and LNL from the mandibular angle to the mid-portion of the ipsilateral clavicle were measured twice and were adjusted by height to determine their relationship with sleep and cardiovascular disease risk factors. RESULTS: Habitual snorers had shorter LNL height ratios (P = 0.011), MNL height ratios in men (P = 0.062), and MNL height ratios in women (P = 0.052). Those snoring bad enough to annoy others had shorter MNL height ratios in men (P = 0.083) and women (P = 0.035). Men with objective sleep apnea had longer distances from the mandible to the hyoid bone to the mandible (P = 0.057). Men with metabolic syndrome had significantly shorter LNL height ratios (P = 0.021), and women with diabetes, hyperlipidemia, and metabolic syndrome had shorter MNL height ratios (P < 0.05). CONCLUSION: This study shows that a short neck by measuring the MNL is probably associated with snoring. In addition, MNL is related to cardiovascular disease risk factors in women.