Development and Effectiveness of the Interpersonal Caring Program for Young North Korean Defectors

Purpose@#The purpose of this study is to evaluate the effectiveness of the interpersonal caring program for young North Korean defectors which we developed based on Kim's interpersonal caring technique. @*Methods@#This study employs a non-equivalent control group pretest-posttest design. The subjects of this study are 36 young North Korean defectors living in three areas. The participants are recruited through alternative schools, churches, and acquaintances. The experimental group consists of 20 participants and the control group consists of 16 participants. Experiments are conducted by four days. Specifically, the experiments are conducted eight times and each takes about 120 minutes. Furthermore, we run the camp for two nights and three days. We test our hypothesis by using Kolmogorov-Smirnov, Independent t-test, Paired t-test, and Independent t-test. @*Results@#All the test statistics support our hypotheses such as self-esteem (t=1.87, p=.035), mental health (t=-1.69, p=.049), interpersonal relationships (t=1.93, p=.031), and quality of life (t=1.88, p=.034). @*Conclusion@#We found that the interpersonal caring program developed in this study is effective in improving North Korean defectors’ self-esteem, mental health, interpersonal relationships, and quality of life.

Development and Effectiveness of the Interpersonal Caring Program for Young North Korean Defectors

Purpose@#The purpose of this study is to evaluate the effectiveness of the interpersonal caring program for young North Korean defectors which we developed based on Kim's interpersonal caring technique. @*Methods@#This study employs a non-equivalent control group pretest-posttest design. The subjects of this study are 36 young North Korean defectors living in three areas. The participants are recruited through alternative schools, churches, and acquaintances. The experimental group consists of 20 participants and the control group consists of 16 participants. Experiments are conducted by four days. Specifically, the experiments are conducted eight times and each takes about 120 minutes. Furthermore, we run the camp for two nights and three days. We test our hypothesis by using Kolmogorov-Smirnov, Independent t-test, Paired t-test, and Independent t-test. @*Results@#All the test statistics support our hypotheses such as self-esteem (t=1.87, p=.035), mental health (t=-1.69, p=.049), interpersonal relationships (t=1.93, p=.031), and quality of life (t=1.88, p=.034). @*Conclusion@#We found that the interpersonal caring program developed in this study is effective in improving North Korean defectors’ self-esteem, mental health, interpersonal relationships, and quality of life.

Usefulness of Voice Therapy on Vocal Nodules in Professional Voice Users Treated with Steroid Injection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A local steroid injected directly into the vocal nodules has recently come to the forefront as another treatment option, which is reported as useful and effective. However, vocal nodules are caused mainly by excessive voice use, and therefore, even if a marked improvement was shown after injection, recurrence can occur unless the voice abuse habit is changed. We hypothesized that voice therapy after steroid injection would reduce recurrence of vocal nodules in professional voice users. SUBJECTS AND METHOD: This prospective study included thirty female professional voice users with vocal nodules treated with vocal cord steroid injection on between May 2010 and March 2011. The experimental group (n=15) received the voice therapy after vocal cord steroid injection, and the control group (n=15) received only vocal cord steroid injection. Videostroboscopy, acoustic voice analysis, and Voice Handicap Index (VHI) were evaluated prior to the steroid injection and 4 and 8 weeks after steroid injection. RESULTS: Jitter, shimmer, noise-to-harmonics ratio, and mean VHI improved significantly after steroid injection in both group (p<0.05). There was no significant complication and voice discomfort after steroid injection in both groups. And, there were no significant differences in all parameters between the two groups. However, the experimental group (13.3%) showed less recurrence rate of vocal nodules than the control group (53.3%) after 8 weeks. CONCLUSION: Vocal cord steroid injection was useful treatment option of vocal nodules in professional voice users. And voice therapy after steroid injection would be effective in preventing a recurrence of vocal nodules than only steroid injection.

A Case of Vertebral Osteomyelitis With Epidural Abscess Caused by Mycobacterium intracellulare in a Rheumatoid Arthritis Patient

Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial lung diseases, but vertebral osteomyelitis caused by MAC is rare. We experienced a case of vertebral osteomyelitis with epidural abscess in a rheumatoid arthritis patient who received immunosuppressive agents. Initial assessment was tuberculous vertebral osteomyelitis, and then treated with antituberculous drugs. Fifty-six days later, Mycobacterium intracellulare was identified from abscess culture and drugs were altered to clarithromycin, rifabutin, and ethambutol. After 3 months of M. intracellulare treatment, the radiological findings showed increases of epidural abscess. According to the suseptibility, the patient received intravenous amikacin for four weeks, and then, oral ciprofloxacin in addition to clarithromycin, rifabutin, and ethambutol. The patient is being treated with the medication for 13 months and currently showing slow improvements.

A Case of Isolated Small Intestinal Wall Calcification on Patient with Continuous Ambulatory Peritoneal Dialysis / 대한소화기학회지

The metastatic calcification is defined as the deposition of calcium salt in normal tissue with an abnormal serum biochemical environment, such as chronic kidney disease, hyperparathyroidism, and hypercalcemia related with malignancy. Although the metastatic calcification can develop in any organs and tissues, presenting its symptoms and complications are rare. Thus a few cases have been reported. This case shows the metastatic calcification of the small intestine without any peritoneal and mesenteric vascular calcification which was early diagnosed by computed tomography and mesenteric angiography in a patient with abdominal pain, receiving continuous ambulatory peritoneal dialysis due to end stage renal disease. The clinician should early consider the metastatic calcification as differential diagnosis when unidentified calcifications are noted in simple abdominal X-ray such as in the present case, and promptly confirm it by using appropriate diagnostic tests in order to prevent its complications and progression.

Unintended Cannulation of the Subclavian Artery in a 65-Year-Old-Female for Temporary Hemodialysis Vascular Access: Management and Prevention

Ultrasound-guided cannulation of a large-bore catheter into the internal jugular vein was performed to provide temporary hemodialysis vascular access for uremia in a 65-yr-old woman with acute renal failure and sepsis superimposed on chronic renal failure. Despite the absence of any clinical evidence such as bleeding or hematoma during the procedure, a chest x-ray and computed tomographic angiogram of the neck showed that the catheter had inadvertently been inserted into the subclavian artery. Without immediately removing the catheter and applying manual external compression, the arterial misplacement of the hemodialysis catheter was successfully managed by open surgical repair. The present case suggests that attention needs to be paid to preventing iatrogenic arterial cannulation during central vein catheterization with a large-bore catheter and to the management of its potentially devastating complications, since central vein catheterization is frequently performed by nephrologists as a common clinical procedure to provide temporary hemodialysis vascular access.

Autoimmune Pancreatitis Accompanied by Tubulointerstitial Nephritis / 대한내과학회지

Autoimmune pancreatitis (AIP) is type of chronic pancreatitis characterized by an autoimmune inflammatory process. IgG4-positive plasma cells can be found in both the pancreas and at extrapancreatic sites of involvement. A 60-year-old man presented with abdominal discomfort. Computed tomography revealed enlargement of the pancreas and kidneys as well as low-attenuated lesions in both kidneys. MRCP showed narrowing of the distal common bile duct and the proximal pancreatic duct. The serum IgG level was elevated, but IgG4 was normal. Histologic examination revealed lymphoplasma infiltration in the renal tubulointerstitium associated with fibrosis along with many IgG4-positive plasma cells, thereby confirming the diagnosis of tubulointerstitial nephritis-associated AIP. The abnormalities in the clinical, laboratory, and radiological findings improved after oral steroid treatment. This is a case of autoimmune pancreatitis accompanied by tubulointerstitial nephritis diagnosed by renal biopsy. Clinicians should suspect the possibility of extrapancreatic organ involvement in autoimmune pancreatitis, especially when abnormalities in other organs are suggested. Proper examinations must be performed.

A Case of Metformin-Induced Acute Kidney Injury without Lactic Acidosis: A Case Report / 대한구급학회지

Metformin is an oral antidiabetic drug in the biguanide class, which is used for type 2 diabetes. The side effects of metformin are mostly limited to digestive tract symptoms, such as diarrhea, flatulence and abdominal discomfort. The most serious potential adverse effect of metformin is lactic acidosis. A 51-year-old man was admitted due to hypoglycemia as a result of an overdose of antidiabetic drugs. He took massive dose of metformin. Conservative treatment failed for metabolic acidosis without lactic acidosis accompanied by acute kidney injury. Hemodialysis was executed to correct the high anion gap metabolic acidosis and acute kidney injury, and the patient recovered fully from metabolic acidosis. This case illustrates that the presence of clinical conditions, such as metformin-induced acute kidney injury and metabolic acidosis, can be developed without lactic acidosis. Prompt recognition of metabolic acidosis and early intervention with hemodialysis can result in a successful clinical outcome.

18FFDG PET Study of Cerebral Glucose Metabolism in Obsessive-Compulsive Disorder / 신경정신의학

OBJECTIVE: Functional imaging studies on obsessive-compulsive disorder(OCD) subjects have repeatedly reported increased metabolism in orbitofrontal lobes and caudate nucleus, resulting in the "frontal-subcortical" circuit abnormality theory. Limitations of the previous studies to date include little consideration for the duration of illness, and the use of regions of interest methods, as an image analysis method. Our study objectives are 1) to include the duration of illness as an important study variable, and 2) to use Statistical Parametric Mapping(SPM) method in order to tap relations between the brain function and the psychopathology and symptoms of OCD. METHOD: The [18] fluorodeoxyglucose positron emission tomography(FDG-PET) scans of OCD subjects and normal comparison subjects, as diagnosed by the Structured Clinical Interview for DSM-IV(SCID-IV), were analyzed using SPM. RESULTS: 1) Comparison of OCD and control groups: OCD subjects had significantly decreased metabolism in both parietal lobes and didn't have any areas of increased metabolism in comparison to comparison subjects(p<0.01). Four OCD subjects with the illness duration of 10 years or longer, had significantly increased metabolism in both orbitofrontal lobes(p<0.01). OCD subjects whose illness duration is shorter than 10 years didn't have any areas of increased metabolism and had significantly decreased parietal lobe metabolism, as in the analyses of all subjects(p<0.01). 2) Correlation analysis between areas and symptom severity: Metabolism of both thalamic areas showed significant positive correlation with Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) scores(p<0.01). Metabolism of right parietal area showed significant negative corre-lation with Y-BOCS scores(p<0.01). CONCLUSIONS: The current findings suggest that the increased metabolism in orbitofrontal lobe, previously reported, may be a secondary phenomenon due to the extended illness duration and that decreased metabolism in the parietal lobes are primary abnormality in OCD subjects. Thus Baxter's fronto-subcortical circuit theory should be extended into "fronto-parietal" complex theory, which includes the parietal lobes.