Times to Discontinue Antidepressants Over 6 Months in Patients with Major Depressive Disorder

OBJECTIVE: The aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting. METHODS: We reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups. RESULTS: Mean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks. CONCLUSION: Sertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.

Clinical Features and Therapeutic Intervention of Survivors from Hijacked Samho Jewerly Cargo Ship : Case Series / 신경정신의학

OBJECTIVES: This study is based on the report including the psychological assessment results and therapeutic interventions of the survivors from hijacked Samho Jewerly by Somali pirates on January 15th, 2011. METHODS: We first assessed the emotional, cognitive, and personality functions of 7 crews, took 4-sessions of cognitive behavioral therapeutic intervention, conducted after-treatment assessments, and compared them with the previous results. RESULTS: Some of the crew showed PTSD due to the exposure to the stress triggered by the extreme state of fear, presented reexperience, avoidance of the trauma and chronical arousal state. CONCLUSION: Although this study was investigated with the minority group related to the one single accident, each case revealed the changes of symptoms and course after the trauma. The same traumatic event had different influences as how each individual perceived the experience. Furthermore, each clinical course was individually different either, depending on age, psychological resource, social support, daily life stress, or secondary gain.

Efficacy and Safety of Aripiprazole during Acute Treatment Phase in Patients with Schizophrenia, Schizophreniform Disorder and Schizoaffective Disorder: An 8-Week, Prospective, Open-Label Study / 대한정신약물학회지

OBJECTIVE: The purpose of the present study was to investigate the efficacy, safety, and tolerability of aripiprazole in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during acute treatment phase. METHODS: Prospective, multicenter, single group, and 8-week study was conducted in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. A total of 300 patients were enrolled in the present study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures were the PANSS positive and negative subscales scores, and Clinical Global Impression-Severity of Illness (CGI-S) score. Treatment-emergent adverse events, extrapyramidal symptoms (EPS), weight, vital signs, and laboratory tests were assessed as measures of tolerability and safety. RESULTS: Significant improvements in all efficacy measures were achieved by aripiprazole as early as 1-week and sustained through 8-week period. First-episode patients showed greater improvements in PANSS total, positive subscale score, and CGI-S score, compared with recurrent patients. Slightly increased akathisia (+0.32 from baseline score of Barnes Akathisia Rating Scale, p=0.033) and weight gain (1.15+/-3.44 kg, p<0.001) were observed by aripiprazole during 8-week acute treatment phase. CONCLUSION: The present study demonstrated that aripiprazole was effective in acute treatment of positive and negative symptoms of schizophrenia, schizophreniform disorder, and schizoaffective disorder. In general, aripiprazole showed favorable safety and tolerability profiles, although clinicians needed to pay attention to the possibility of akathisia and weight gain by aripiprazole in first-episode patients during acute treatment phase.

Efficacy and Safety of Aripiprazole during Acute Treatment Phase in Patients with Schizophrenia, Schizophreniform Disorder and Schizoaffective Disorder: An 8-Week, Prospective, Open-Label Study / 대한정신약물학회지

OBJECTIVE: The purpose of the present study was to investigate the efficacy, safety, and tolerability of aripiprazole in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder during acute treatment phase. METHODS: Prospective, multicenter, single group, and 8-week study was conducted in patients with schizophrenia, schizophreniform disorder, and schizoaffective disorder. A total of 300 patients were enrolled in the present study. The primary efficacy measure was the Positive and Negative Syndrome Scale (PANSS) total score, and secondary efficacy measures were the PANSS positive and negative subscales scores, and Clinical Global Impression-Severity of Illness (CGI-S) score. Treatment-emergent adverse events, extrapyramidal symptoms (EPS), weight, vital signs, and laboratory tests were assessed as measures of tolerability and safety. RESULTS: Significant improvements in all efficacy measures were achieved by aripiprazole as early as 1-week and sustained through 8-week period. First-episode patients showed greater improvements in PANSS total, positive subscale score, and CGI-S score, compared with recurrent patients. Slightly increased akathisia (+0.32 from baseline score of Barnes Akathisia Rating Scale, p=0.033) and weight gain (1.15+/-3.44 kg, p<0.001) were observed by aripiprazole during 8-week acute treatment phase. CONCLUSION: The present study demonstrated that aripiprazole was effective in acute treatment of positive and negative symptoms of schizophrenia, schizophreniform disorder, and schizoaffective disorder. In general, aripiprazole showed favorable safety and tolerability profiles, although clinicians needed to pay attention to the possibility of akathisia and weight gain by aripiprazole in first-episode patients during acute treatment phase.

Risperidone Combination in the Acute Treatment of Bipolar Mania and Mixed Episode: Prospective, Multicenter, Open Trial / 대한정신약물학회지

OBJECTIVE: Although mood stabilizer monotherapy is the recommended initial therapy for bipolar disorder, the use of atypical antipsychotics in bipolar patients is increasing recently. Moreover, the medical literature is demonstrating that the combination of atypical antipsychotics and mood stabilizers is a more effective therapy. The goal of this study was to assess the efficacy of risperidone in patients with acute manic and mixed state of bipolar disorder. METHODS: This study was a 4-week, open-label, combination, prospective investigation using risperidone in combination with mood stabilizers. In total, 114 patients with a DSM-IV diagnosis of bipolar disorder, manic or mixed episode, were recruited. Risperidone was given in combination with mood stabilizers in doses according to clinical response and tolerability. Efficacy was assessed with the Young Mania Rating Scale (YMRS), the Hamilton Rating Scale for Depression (HAMD), the Brief Psychiatric Rating Scale (BPRS), Global Assessment Scale (GAS), and the Clinical Global Impressions Scale-Bipolar (CGI-BP). The Simpson-Angus Rating Scale (SARS) was applied to assess extrapyramidal symptoms. RESULTS: The combination of risperidone with mood stabilizers produced highly significant improvements (p<0.001) on the YMRS, HAMD, BPRS, GAS, and CGI-BP at both 1 week and 4 weekweeks. Analysis of the YMRS, BPRS, GAS, and CGI-BP scores revealed significant improvement in both the manic and mixed group. The HAMD score was decreased only in the mixed group. Body weight was increased significantly after 1 week. Risperidone was well tolerated, and adverse events were mostly mild, with the most frequent extrapyramidal symptoms and sedation. CONCLUSION: Our findings suggest that the combination of risperidone with mood stabilizers was an effective and safe treatment for acute manic symptoms and coexisting depressive symptoms of bipolar disorder. Randomized, double-blind, placebo or active controlled studies are needed.

Antidepressant-Induced Adverse Effects and Management Strategy: Focused on Sexual Dysfunction

Sexual dysfunction is a relatively common adverse effect in the use of antidepressants. The sexual side effects may result in a lack of compliance with the prescribed antidepressants. The author reviewed the prevalence and updated treatment for the antidepressant-induced adverse effects focusing on sexual dysfunction. The incidence of sexual dysfunction is reported to exceed more than 50% especially with SSRIs. In order to obtain a quantified baseline and as an ongoing evaluation tool, clinicians may use some of the established questionnaires and validated instruments such as the Arizona Sexual Experience scale and Changes in Sexual Functioning Questionnaire. Clinicians should be aware that delayed ejaculation and orgasm, symptoms most frequently associated with antidepressants, are not usually associated with depression itself. Although many antidotes have been proposed, few have been subjected to double-blind trials. Some evidences have suggested that bupropion and buspiron may be the effective antidotes for SSRI induced sexual dysfunction. Additional trials will be requied to define what role, if any, bupropion and buspiron might have in the treatment of SSRI-induced sexual side effects. The available evidence is rather limited, with only small number of trials assessing each strategy. While further randomized data is awaited, for men with antidepressant induced erectile dysfunction, the addition of sidenafil or tadalafil may appear to be an effective strategy.

A Study Concerning the Psychopathology and Psychiatric Consultaion of Medical Outpatients: Focused on Medical Outpatients Compared with Health Control Group / 신경정신의학

OBJECTIVES: This study was carried out to investigate the characteristics of psychopathology of medical outpatients and to consider the necessity of psychiatric intervention. METHODS: Total 840 subjects were selected for this study. They were divided into two groups; patient group included 482 medical outpatients of our hospital, and the control groups included 190 ordinary people who have not been ill and 168 people who visited health care center. SCL-90-R (Symptom Checklist-90-Revision), BDI (Beck Depression Inventory), and STAI (State-Trait Anxiety Inventory) were used to measure psychopathology. A self-reported questionnaires were conpreted by the subjects and the hospital records were reviewed to find out the clinical characteristics and psychiatric consultation if any. RESULTS: 1) In the results of SCL-90-R, the patient group showed higher levels of somatization, depression, anxiety and psychosis in compared to the control group. 2) In the results of BDI, more people answered that they had serions difficulty in the patient group than in the control group. 3) In the results of STAI, the patient group showed higher score in the trait-anxiety as well as state-anxiety than the control group. 4) Many medical outpatients thought of psychological factor as the cause of their illnesses. 5) Despite medical outpatients were likely to suffer from physical symtoms of psychological causations, psychiatric consultation was no more than 3.1%. CONCLUSION: While medical outpatients showed overt depression, anxiety, somatization, psychosis, there was few psychiatric intervention. In considering that the depression and anxiety have a negative effect on medical outpatients, psychiatric consultation and treatment is needed to expand in the clinical field.

A Comparative Study Concerning the Psychopathologies between the Patients with Chronic Renal Failure and Those with Chronic Hepatitis: Focused on Medically-ill Outpatients Compared with Controlled Subjects who Received Medical Examination / 신경정신의학

OBJECTIVES: Although there were many studies examining anxiety and depression in hospitalized medically-ill patients, there were few studies in examining anxiety and depression of non-psychiatric outpatients or comparative studies among the disease categories. Therefore, we wanted to explore 1) psychopathologies in the patients with chronic renal failure and those with chronic hepatitis, 2) differences of psychopathologies by severity, 3) differences of psychopathologies by the duration of illness, and 4) psychiatric consultation. This was the second series of the whole project. METHODS: From March to April 1999, 38 patients with chronic renal failure and 26 patients with chronic hepatitis who visited the medical outpatient department are included in the subject group and 116 persons who visited the health examination center in September 1999 are included in the control group. We reviewed the medical records of the patients and inquired what they thought the causes of their illness were. We evaluated the patients with State-trait anxiety inventory, Beck depression inventory, Symptom checklist-90-Revision. RESULTS: In state anxiety, 62.2% of the patients with chronic renal failure fell into the anxious group, which is somewhat greater than the 52.0% of those with chronic hepatitis. The rates in both subjects are significantly higher than that of the control group. 16.7% of the patients with chronic renal failure were depressed, which is somewhat greater than the 9.1% found in chronic hepatitis. The rates in both subjects showed no significant difference from that of the control group. When the state anxiety scores were compared during the duration of the illness, it was found to be relatively higher during the early phase of disease in both the chronic renal failure patients and the chronic hepatitis patients. In the depression, the scores were found to be relatively higher in the chronic renal failure patients when the duration of illness was between 1 to 5 years compared to other duration groups, while the patients of chronic hepatitis were found to be relatively constant. Most frequently, 36.2% of the patients with chronic renal failure and 24.3% of those with chronic hepatitis thought the cause of their illness to be 'psychological', but the rates of psychiatric consultation in both subjects are 5.7%, 7.7% respectively. CONCLUSIONS: Our results suggest that proper psychiatric interventions are not being conducted yet and more cooperative and integrative roles are required among psychiatrists and internists.

A Case of Leopard Syndrome with Atypical Psychosis / 신경정신의학

Leopard syndrome is a neurocutaneous syndrome which may affect a variety of organ systems in the embryological aspects. It presents lentigines, EKG abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of genitalia, retardation of growth, and deafness as major teatures.We report a case of Leopard Syndrome with atypical psychotic features. The patient had many lentigenies on the face, cafe au lait spots on the part of the waist and the buttocks, mild atrial regugitation, clinodactyly, hyperextensibility of distal interphalangeal joint, flat foots, subclinical hypothyrodism, sensorineural deafness, and mild mental retardation. He also had autistic disorder, compulsion, pathologic collection, and violent behaviors as psychiatric problems. This raises a possibility that psychiatric diseases may be related to the variation of neuroectoderm. In clinical practice, when psychopathic patients with specific skin lesions are seen for consultation, the consideration of embryologically common aspects of both disease groups can be helpful to the discovery of abnormalities in other organs and to its treatment.

A Psychopathology and Socio-Psychiatric Study of Delinquent Adolescents doing School Violence / 신경정신의학

OBJECTIVE: The purpose of this study was to identify the characteristics of school violence, self concept, psychopathology and psychosocial characteristics of male aldolescent delinquency doing school violence. And we hoped to use this result as basic material for prevention of school violence through comparison of those of students group. METHOD: We surveyed 725 male adolescents including 331 deliquents from educational program called "Big Brothers and Sisters" in Pusan. We used self-reporting questionnaire composed of demographic data and attitude to violence. In order to investigate the psychopathology and self-concept, we used Child Behavior Check List, Youth edit, Korean version(CBCL) and the Piers-Harris Children's Self-Concept Scale. Statistical methods employed were Chi-square, t-test, two-way ANOVA. RESULT: The results show that in most demographic and psychosocial factor including age, education, socio-economic condition, religion and relationship with friends, there was no significant difference between delinquent and student group. And there was no significant difference between bully and non-bully in both group. The frequency of alcohol drinking and smoking were higher in bullying groups. For the feeling of watching violent mass-media, bullying delinquents reported more excited state than non-bullying delinquents in both group. On results of CBCL, subscales of delinquent behavior, aggressive behavior, externalizing problem, social scale in delinquent group were higher than those in student group. Subscale of somatic complaints, thought problem, attention problem, delinquent behavior, aggressive behavior, internalizing problem, and externalizing problem in bullying group were higher than those in nonbullying group. In both delinquent and student group, subscale of delinquent behavior, aggressive behavior, and externalizing problem in bullying group were significantly higher than those in nonbully group. In the results of self-concept scale, subscales of behavior, intellectual and school status in delinquent group were lower than those in student group. Subscale of somatic complaints, thought problem, attention problem, delinquent behavior, aggressive behavior, internalizing problem, and externalizing problem in bullying group were higher than those in nonbully group. CONCLUSION: In both delinquent and student groups, most psychosocial factors in bully group were not significantly different with those in nonbully group. Bully group was more influenced by internal psychic state, psychopathology and environmental factor than nonbully group.

Hyperglycemia Associated with Mirtazapine: A Case Report / 신경정신의학

Mirtazapine-a newly developed drug with reduce adverse effects and toxicity of original antidepre-ssants-has been known to have antidepressant effect by enhancing the transmission of norepinephrine and serotonin via blockade of alpha2-noradrenergic autoreceptor and heteroreceptor and to have common side effects such as sedation, weight gain, and dizziness. We report a case of 50 years old female depressive patient who developed mirtazapine-associated hyperglycemia during treatment with mirtazapine and returned to normal glucose level after stopping the usage of mirtazapine. In patients who receive drugs with the risk of hyperglycemia and diabetes mellitus, we should consider the evaluation for diabetes mellitus and follow it up carefully in the future.

Augmentation of Regional Cerebral Blood Flow Response by Repeated Administration of Methamphetamine in Rat / 대한정신약물학회지

OBJECTIVES: It was aimed to observe the regional cerebral blood flow (rCBF) response on methamphetamine challenge test in rats which were subjected to repeated administration of methamphetamine, and to investigate the mechanism(s) of changes in rCBF response in relation to the dopaminergic receptors and cyclic AMP. METHODS: Male Sprague-Dawley rats received daily injections of methamphetamine (0.3 mg/kg, i.p.) for 10 days, and were then allowed a 4-day drug-free period. Naive and methamphetamine-pretreated rats were challenged with topical application of methamphetamine on the surface of parietal cortex through a cranial window. The changes in rCBF were measured by laser-Doppler flowmetry. RESULTS: Acute topical application of methamphetamine dose-dependently increased rCBF with little effect on mean arterial blood pressure. The methamphetamine-induced increases in rCBF were significantly blocked by SCH23390, a D1-like receptor antagonist, but not by sulpiride, a D2-like receptor antagonist. Repeated administration of methamphetamine induced progressive augmentation of rCBF in response to the challenge of methamphetamine. Repeated administration of methamphetamine in combination with SKF38393, a D1-like receptor agonist, as well as with SCH23390 significantly attenuated the development of augmentation of rCBF response to methamphetamine. The augmentation of rCBF response was markedly inhibited by pretreatment with 2',3'-dideoxyadenosine, a specific adenylyl cyclase inhibitor, and Rp-cAMPS, a protein kinase A inhibitor, respectively. CONCLUSION: Based on these results, it is suggested that repeated administration of methamphetamine induces an augmentation of rCBF in response to the challenge of methamphetamine, and that D1-like receptor-mediated cyclic AMP plays a critical role in the development of augmentation of methamphetamine-induced rCBF response.

Temporal Lobe Epilepsy by Insulinoma: A Case of Persistent Abnormalities in Post-Operative EEG / 신경정신의학

Authors experienced a case of insulinoma which was initially misdiagnosed as idopathic temporal lobe epilepsy with automatism. This patients did not show other hypoglycemic symptoms except seizure. It has been reported that some of the patients with insulinoma are unaware of hypoglycemia and are at increased risk for seizures and coma. These patients would have normal glucose uptake in the brain and consequently no sympathoadrenal activation would begin, resulting in an awareness of hypoglycemia. It this case, abnomal EEG pattern consistent with a complex partial seizure remained after successful operation. Recent reports indicate that hypoglycemia is capable of killing neurons in the brain. An endogenous neurotoxin is produced and is released by the brain into tissue and cere-brospinal fluid. Endogenous excitotoxins produced during hypoglycemia may explain the tendency toward seizure activity often seen clinically. We suggest that persistent abnormalities of EEG in this case may be related to focal neuronal damage in hypoglycemia.

A Socio-Psychiatric Study on Family Violence by Delinquent Adolescents / 신경정신의학

OBJECTIVES: This research was performed to identify family violence by male adolescencts, and to examine the characteristics of male adolescent delinquents in terms of domestic viloence. METHODS: We surveyed 677 male adolescents including 238 delinquents from BBS(Big brothers and sisters) in Pusan, 209 criminal adolescents from adolescent correctional institution in Pusan, 230 high school students through questionnaire, MMPI(Minnesota Multiphasic Personality Inventory), and PBI(Parental Bonding Instrument), and then compared these three groups by Chi-square test, T-test, and Anova. RESULTS: In most cases, male delinquent adolescents were placed in poorer socio-economic conditions than those of students, but in better socio-economic conditions than those of criminal adolescents. In general, the assaulters were senior family members, physically stronger than sufferers, and have bad brotherliness. Compared with normal students, the serious problem of violence including violence to the ancestors in delinquent and criminal adolescents. On results of MMPI and PBI test, there were significant difference between violent group and non-violent group on the Sc score and Passive aggressive index in adolescent delinquents and parental overprotection in normal students. CONCLUSION: Generally the characteristics of family violence by male delinquent adolescents were intermediate between those of criminal adolescent and students, these results were same as those of previous socio-psychiatric study, and so the intervention in criminal adolescents is needed for the pre-vention of family violence.

A Study of Sailor Psychiatric Inpatients: Focusing on the Transition in a General Hospital / 신경정신의학

OBJECTIVES: The object of this study was to help the clinicians understand the characteristics of the sailors who were admitted to the psychiatric ward through elucidating the transition in the psychiatric aspect of them. METHODS: The results obtained from psychiatric records of 98 sailors who were admitted to department of psychiatry in a general hospital, from March 1, 1985 to Feb. 28, 1994 were compared with the results obtained from 34 sailor inpatients in the same hospital from March 1, 1982 to Feb. 28, 1985. RESULTS: 1) The number of sailor inpatients showed declining tendency and the age of them showed increasing tendency. 2) The number of patients of somatoform disorder, posttraumatic stress disorder, and organic mental disorder was increased. The number of patients of schizophrenia and mood disorder was decreased. 3) The proportion of inpatients from overseas fishing ship was increased markedly. We must ave a countplan and careful consideration f3r them. 4) We could infer that the groups of low education, crew, overseas fishing ship and below S year of employment duration had high admitted patient occurrence rate. The proportion of psychosis in the groups that were primitive school graduated and 1-5 year of employment duration was high relatively to neurosis(statistically not significant). 5) According to psychological test, the majority of sailor inpatients had constricted thought content, emphasis of responsibility for the family, submissive attitude to an authoritive figure and paranoid tendency. The MMFI profile of neurotic patients showed the tendency of finking bad.

Characteristics of Delinquent Adolescent's Mothers(III) / 신경정신의학

The present study was performed to identify the socio-psychiatric characteristics of mothers of delinquent male adolescent and thus to use them as basic material for ultimate prevention of adolescent delinquency by comparing their views with preceeding delinquent adolescent's own For this, we surveyed 111 mothers of delinquent male adolescent who had educationed in adolescent correctional institution in Pusan(B.B.S.) and 88 mothers of high school students through questionnaire of family environment and psychologic testings. Results were as follows: 1) By large, mothers of delinquent male adolescent were placed in poorer socio-economic conditions than those of control group's. 2) Degree of mantel harmony was nearly identical with preceeding survey of delinquent's The causes of marital disharmony were significant between delinquent and control group(delinquent group-economic difficulties, control group-personality difference). Types and resolution method of marital disharmony were also significant, delinquent group used more violent fighting type and more passive resolution method. 3) Mothers of delinquent male adolescent had low expectancy to their sons' future because of their own children's continuing delinquent behavior and low academic achievement. 4) For overcoming the difficult socio-economic situation, they participate in social activity This factors made them less attention to their children's life and thus their children's delinquent behavior were increased. 5) On results of MMFI test, both group had normal profiles and no significant differences except for L and Pa scores. On results of SCL 90-R test, both group also had normal profiles and no significant differences except for IS score only. According to above results, it would reasonable to introduce practitical, special socio educational program such as parent education and policy.

An experimental study on the fatigue characteristics of orthodontic brackets bonded to enamel / 대한치과교정학회지

The purpose of this study is to evaluate the effects of mechanical and thermal fatigue on the shear bond strength(SBS) in orthodontic brackets bonded to human premolars with chemically cured adhesive(Mono-Lok(2), Rocky Mountain Orthodontics). Two types of metal brackets (Ormesh, Microloc) and three types of ceramic brackets (Fascination, Starfire, Transcend 2000) were used in this study. The 10(6) loadcycles of l7.4 x 10(2)sin2piftl g,cm and the 1,000 thermocycles of 15 second dwell time each In 5degrees C and 55degrees C baths were acturated as mechanical and thermal fatigue stress, and SBS were measured after each fatigue test. The fracture sites were examined by stereoscope and scanning electron microscope. The results obtained were summarized as follows ; 1. In static shear bond test, Fascination brackets showed the maximum SBS(20.78+/-3.45 MPa) and Microloc brackets showed the minimum SBS(14.88+/-3.10 MPa). Fascination and Starfire brackets showed significantly greater SBS than Microloc brackets(P<0.05). 2. In mechanical fatigue test, Fascination brackets showed the maximum SBS (20.19+/-3.45 MPa) and Starfire brackets showed the minimum SBS(9.10+/-8.33 MPa). The SBS of Transcend 2000 brackets(P<0.01) and Starfire brackets(P<0.05) significantly decreased after 106 loadcycles. 3. In thermocycling test, Ormesh brackets showed the maximum SBS (19.36+/-2.76 MPa) and Starfire brackets showed the minimum SBS(l1.94+/-6.86 MPa). The SBS of Transcend 2000(P<0.01), Microloc and Starfire brackets(P<0.05) significantly decreased after 10(3) thermocycles. 4. Failure sites of thermocycling groups were similar to those of static groups but after mechanical fatigue test, Ormesh and Transcend 2000 brackets failed at the bracket/resin interface and Microloc brackets failed within adhesive. Facination brackets failed at the enamel/resin interface irrespective of experimental condition.

A photoelastic study of the stress distribution on the multiloop edgewise arch wire / 대한치과교정학회지

This study was designed to investigate the stress distribution, intensity and force mechanism derived from the MEAW by photoelastic stress analysis of the artificial teeth and surrounding bone composed of photoelastic(material/ PL-3 ). The findings of this study were as follows: 1. In case of no elastic on the MEAW with tip back, the moderate stress was observed on the molar and canine area, and the light stress was observed on the other area. 2. In case of the vertical elastic on the plain A.W. and the MEAW without tip back, the great stress was observed on the lateral incisor area, but on the MEAW with tip back, the moderate stress was observed on the anterior area and molar area. 3. In case of the C II elastic on plain A.W., the stress was concentrated on the anterior area hanged by elastic but on the MEAW without tip back, the stress was transmitted equally from the anterior area to the posterior teeth area, On the MEAW with tip back, the great stress was observed on the anterior and molar area. 4. In case of the C III elastic on the plain A.W., the stress was concentrated on the posterior area hanged by elastic but on the MEAW without tip back, the stress was transmitted equally from the posterior area to the anterior area. On the MEAW with tip back, the great stress was observed on the posterior area and the moderate stress was observed on the anterior area.

Chronic psychosis in Turner's syndrome / 신경정신의학

No abstract available.

A socio-Psychiatric study on male adolescent delinquency / 신경정신의학

No abstract available.